It is thought that 2.6 in every 100 people suffer from depression (Mind). As common as it may be, and sometimes it is even patently clear that it is right there in front of us, it is rarely talked about. Winston Churchill described depression as the ‘black dog’ but it seems that it seems more to be the elephant in the room.
When I start working with a client who is depressed, we look at all the potential causes, whether that is in the present, the past, an unhelpful way of thinking, or even an unhealthy relationship. It is important to have as open a mind to the potential causes, and it is rare that the depression is attributable to one factor.
Once we have a clear idea of what might be the potential causes, the difficult part is to challenge the status quo. This is difficult because we often develop ways of living for a very good reason. For example, as a child it might have been easier to believe that we were intrinsically a bad person, if this meant that it made sense of the cruelty inflicted on us by a parent.
To let go of the belief that we are intrinsically a bad person, and so deserving of the cruelty, we have to identify, and gently start to challenge, our distorted thinking. We need to reality-test our assumptions and replace these with more rational ways of thinking. But how can we do this? Here are some examples of distorted thinking, and how we can challenge these–
Depression often makes us believe that we cannot do anything unless we do it perfectly. If we do not challenge perfectionism, we will end up caught in the depression cycle. This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed. As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity. To challenge perfectionism -
Tyranny of the 'shoulds'
I often work with clients who are depressed because they believe that certain things should happen (I should, they should), and if these things do not happen, they are left feeling frustrated. It can be helpful to try and challenge these 'shoulds' in the following ways -
In parallel with the focus on your thinking patterns and underlying beliefs, you should take care not to fall into the depression cycle. This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed. As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity. Break out of this cycle and set yourself simple tasks to achieve each day. Include a mixture of different types of activities (social, educational, creative and recreational), and use an activity diary to rate your feeling of achievement for each task. Do not expect to immediately find these tasks enjoyable, and each day, increase the frequency and number of activities.
I hope you find this useful. Do get in touch if you would like to discuss any of this.
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