Depression
Depression develops over time but it feels like it has descended upon us without warning. We become lethargic, lose our ability for enjoyment and human connection. Everything, including an evening out with friends or brushing our teeth, becomes a chore. Things flatline. Nothing seem to matter.
Our life experiences are vastly different and yet the way in which depression is maintained is similar for most people. We experience negative automatic thoughts in response to triggers or difficult circumstances (items 1 and 2 in the diagram to the left). Keep in mind that anything can be a trigger – from being rejected by a romantic partner to having to deal with a less than polite neighbor to watching a movie in your living that causes you to compare yourself to the main character. Our thoughts in response to triggers happen very vast and sometimes might be hard to notice. We call these thoughts automatic thoughts as they happen automatically whenever a “trigger-button” is pressed. Our automatic thoughts influence our emotions (4), including associated physical reactions (5). Then, before we even know it, we end up by reacting in predictable ways. Our behaviours (5) lead to outcomes (6) that might be deeply disappointing but nevertheless feel familiar. We could have drawn arrows going in every direction here as thoughts influence behaviour and emotions and emotions influence physical reactions etc. The bottom line: our thoughts, emotions, physical reactions and behaviours are synchronized. It is impossible to have a negative view of the world and be bursting with positive energy.
Often the story of depression goes much deeper. A depressed person might have had some terrible life experiences (7) that led them to develop a host of very rigid core beliefs about themselves, other people and the future or life in general (8). These core beliefs are held much more strongly than our automatic thoughts. In response to these beliefs and life circumstances, we develop a series of rules and assumptions (9) that we might not even be fully aware of. These assumptions color what we think and what we do in triggering circumstances. They might also be a root of self-fulfilling prophecies in our lives as they guide us across a variety of situations, leading to outcomes that further reinforce our original predictions.
It is true that sometimes we have to challenge depression at very difficult times – someone might be undergoing chemotherapy or has experienced recent bereavement. No amount of therapy would change such circumstances. However, we can learn to take advantage of moments of respite and build resilience to enable us to preserve what we still have. If possible, we start anew. You might have heard stories of people telling a bereaved parent that at least they have another child left. Such advice tends to provoke anger, as it seems to dismiss the pain of losing a child. Yet there is wisdom in it: bereaved parents risk losing not only the child that died but also the child who lives as grief prevents them from connecting at an emotional level. Loss happens. We owe it to ourselves not to lose more than we absolutely have to. Depression can rob us from what we might still have or have the potential to experience.
