ANTI-DEPRESSANT LIFESTYLE: STRICTLY AVOID FRIGHTENING IDEAS
In depressed people the most frightening ideas do not generally come from fear of the outside world but result from turning the darkened lens of depression towards the interior and finding it to be full of self-doubt, self-criticism, guilt, recriminations about the past and grim predictions for the future. All of these thoughts are not only symptoms of depression but, according to the cognitive theory of depression, developed by Dr Aaron Beck and others, can actually propagate the depression and make it worse. Based on this theory, these researchers have developed a psychotherapeutic approach to depression called cognitive therapy, which has actually been shown to be as effective as anti-depressant medications in some studies of mild to moderate depression.
Cognitive therapists have developed a way of breaking down depressive thinking into its different components and showing how once you recognize these specific types of depressive thoughts, you can actively work to overcome them. For example, these therapists have accurately recognized the tendency of depressed people to engage in what they refer to as ‘all or none thinking’. So a depressed person may regard a project that was not a dazzling success as a total failure. Most ventures in life are not total successes or failures but some mix of the two. A positive attitude enables a person to enjoy those elements of the mix that are successful while learning from the failed elements, and then to move on to the next project. This is very hard for the depressed person, who is likely to expend valuable time and energy obsessing about, and magnifying, the failure. The depressed person has difficulty modulating responses to all sorts of stimuli.
Several other specific distortions of the depressed mind are also worth noting. One is overgeneralization. A depressed person who makes an error is quite likely to think, ‘You see, nothing I ever do succeeds.’ Cognitive therapy would seek to challenge this distortion by encouraging the depressed person to find areas in life where he or she has clearly succeeded. Overgeneralization is commonly seen following rejection. A depressed person is likely to take a single rejection as a sign that nobody will ever accept him or her. A healthier approach would be to accept that rejection is part of life and that a single rejection does not necessarily mean that others will follow. Excessive sensitivity to rejection can affect people at any age or stage of life, whether it be the child looking for a friend in the playground, the adolescent calling someone for a date, or the adult applying for a job or submitting a manuscript or proposal to a publisher or grant agency. Nobody enjoys being rejected, but we can develop ways of putting it into perspective and recognizing that further efforts might well be rewarded with acceptance. After being rejected a depressive person might avoid taking new initiatives for fear of further rejections, thereby greatly diminishing the likelihood of future success. Once again, the depressed person’s intellect can be recruited to help understand that this type of thinking is a costly distortion that can be corrected with proper guidance and systematic efforts.
One of the most painful aspects of overgeneralization is that it gets projected into the future. T will never succeed/ ‘No one will ever love me’ or T will never find happiness’ are common distortions of this type that greatly add to feelings of sadness and pessimism. Such distortions have been labelled ‘fortune-telling’ by cognitive therapists, a term that conveys the sense of assurance that a fortune-teller might offer about the future when plain sense indicates that there are too many imponderables to make such predictions with any degree of reliability. This can be pointed out by a skilful cognitive therapist repeatedly to good effect. Allied to this magical depressive tendency to fortune-telling is ‘mind-reading’, a process by which the depressed person thinks and talks as though he or she can read what is in another person’s mind. So a depressed person might say ‘She didn’t want to come on a date with me because she thinks I am too dull and nerdy/ or an unsuccessful applicant may say ‘He didn’t accept me for the job because I’m not qualified.’ The cognitive therapist will point out that other possible explanations for these outcomes abound. The girl who declined to go out on a date with you may already be committed to someone else; the prospective employer may have an inside candidate in mind for the job, and so on. Bearing in mind these alternative possible explanations empowers the rejected person, who is then more easily able to pursue other possibilities. In contrast, depressive thinking tends to paralyse the thinker, increasing his or her sense of powerlessness and reducing enthusiasm for making further efforts, which might be more successful.
In summary, it is important to recognize and address frightening thoughts, more technically known as depressive distortions.
Fortunately, treatment strategies have been developed to tackle such thoughts and these work if they are implemented diligently and systematically. For those interested in learning more about cognitive therapy, I provide references to further relevant reading in the Bibliography and Further Reading chapter.
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