Mental Health Awareness Month: Depression – Addressing Unhelpful Thoughts
This is part three of our series on depression. If you would like to go back and read the first two posts you can locate them by going here and here.
Addressing Your Thought Life
In part one of our series on depression I shared a very basic 30, 000 foot view of common signs and symptoms of depression. In part we, the focus was on lifestyle factors and behavioral tips to help yourself continue to function as you go through a depressive episode. Today’s post is all about your thought life and the presence of unhelpful thinking styles that are often present when depression is present.
Cognitive distortions, or as I prefer to call them, unhelpful thinking styles, are often present when depression is present. Simply put, these are errors in thinking or false beliefs that have been accepted as true. All humans engage in this type of thinking every now and then; but, this type of thinking is often happening more frequently when depression (and anxiety) are present. I cannot go so far as to say this type of thinking is the cause of depression or that depression causes these thinking errors. But, there is a mutual relationship between these unhelpful thinking styles and depression (and anxiety).
There are several different unhelpful thinking styles. There are lists all over the internet, some of which say there are 10, others say 15, and still others say there are 22 different types of distorted thinking. I am not going to attempt to address all of them. I have chosen a few that I see most commonly in session.
- All or Nothing Thinking (some call this “black & white thinking”) – This is a very polarized way of thinking. For example, Sally set a goal to meal prep for the next day every night before she goes to bed. Sally’s been consistently meeting this goal for the past 6 nights. However, tonight Sally was out late celebrating with friends. As a result, she was exhausted and didn’t take time to prepare meals. So instead, she grabbed fast food for breakfast on the way to work and thought to herself, “Well, I’ve already blown it. I’m a failure at this. I might as well just give up.”
- Overgeneralizing – This happens when we take a situation that’s only happened once, maybe twice, and assume it’s going to happen all the time. Continuing with the example regarding Sally’s meal prepping above you can see overgeneralizing taking place as well. Sally believes she will never be able to consistently prepare meals again because of one experience, so she gives up.
- Mental Filtering – This happens when we only focus on the one negative piece of information, despite having multiple positives, too. In the meal prepping example above Sally had almost a week of following through. Unfortunately, because Sally got off track one night, she made the choice to believe that she could never be consistent with meal prepping in the long-term.
- Disqualifying the Positive – This type of thinking occurs when we have been provided with positive feedback, maybe from a boss or a friend, and we choose to ignore it for some reason, discounting that it’s actually true. For example, Sally went to see her therapist and shared that she’s a failure at meal prepping. Sally’s therapist reminds her of the positive qualities that have been identified in previous sessions and mentions that she had been consistent for 6 out of 7 days, which was also positive. But, Sally doesn’t believe her therapist and says, “That’s not true. You’re just trying to make me feel better.”
- Labeling/Mislabeling – This type of thinking is a more extreme negative version of overgeneralizing that leads to being judgmental of oneself or others. For example, Sally has often labeled others who struggled with being consistent as failures. So, when Sally didn’t prepare her meals one night she labeled herself as a failure as well.
- Should-ing or Must-ing – This type of thinking involves the arbitrary rules we set for ourselves and others, which leads to unrealistic and unmet expectations. I/you should / must / ought to… plan ahead… always be on time… be independent thinkers… always put others’ needs above your own… never get angry… If we continue with the meal prepping example, we could assume that Sally’s “goal” to meal prep every night was more of a strict rule she’d given herself to follow instead of a goal she was working on accomplishing. The rule might sound like, “Healthy people should meal prep every night.”
- Emotional Reasoning – “I feel it, so it must be true.” This type of thinking assumes that because you feel a certain way, then it must absolutely be true and factual. Many times, this is just not the case. For example, your partner says something makes you feel angry so you assume he’s doing it on purpose, instead of checking the facts. So you withdraw, blame him, and assume the relationship is over. If we follow the example with Sally and meal prepping, it would sound like this: “I feel like a failure because I didn’t meal prep all 7 days, so it must be true. I’m a failure.”
So, how do we combat these unhelpful thinking styles? There are several different ways to do this. The first and most important step is becoming aware of these types of thoughts. The list above is just a snapshot of some of the cognitive distortions people have. If you’d like a more complete list with different examples, check out this post over on GoodTherapy.
One way you can become more aware of the types of thoughts you’re having is by keeping a Thought Diary. There are numerous ways these diaries or logs can be formatted. A quick online search will pull up several different printable forms. You can create your own by purchasing an unlined notebook from the local dollar store. Next, you’ll divide each page into 6 columns with the following headings and fill out the information for each column as noted:
- The Situation – In this column, briefly describe in as much detail as possible what was going on
- Automatic Thoughts – This is the column where you’ll write the specific automatic negative thoughts that entered your mind, paying special attention to identify any cognitive distortions that are present along with any images or urges that came along with it. Identify the most intense thought & circle it. Rate how much you believed this thought to be true at the time on a scale of 1-10.
- Emotions – Write the emotions you experienced & rate their intensity on a scale of 1-100. Having a feelings wheel taped inside the front of your notebook might be helpful.
- My Initial Response – In this section describe the actions that took place. In other words, write about what you said and did.
- A New Response – This last column is very important. After reflecting on everything you’ve identified, take time now to reflect on what you could do or say differently based on your new awareness. Make sure you take note of any new emotions and their intensity with this new response. Also, go back to the original intense thought and re-rate your belief in it now that you have this new information and new response.
If you notice that you engage in judgmental thinking or speaking, it might be helpful to start identifying the rules that you have for yourself and others. You can do this by taking the following steps:
- Identify the Rule that was broken
- Ask the unpacking questions: WHAT? WHY? WHERE? HOW?
- WHAT did you do to break the rule?
- WHY did it bother you?
- WHERE did this rule come from?
- HOW is this rule helpful and how is it hurtful?
- Now what? Keep it? Toss it? Modify it?
- If you decide to keep/modify it write out the new version of the rule
If you notice you engage in emotional reasoning it may be helpful to engage in some fact-finding. Feelings and opinions are not facts. They are subjective in nature. When you’ve identified a problematic thought, you can write that thought down at the top of a piece of paper. Then, divide the paper into two columns, leaving some space at the bottom. The left column will be titled “Facts For” and the right column will be titled “Facts Against.” In each column you will write just the facts that either support or do not support the thought. After you’ve written and reviewed the facts, write your determination at the bottom. Is the thought accurate? Balanced? Helpful? If not, rewrite it in the space to make it more accurate, balanced, and helpful.
Below are formatted and printable versions of these interventions if you’d like to try them out:
Please remember: while some things you may be able to tackle on your own, sometimes it’s necessary and helpful to have a knowledgeable and neutral person to talk through difficult thoughts and emotions with.
To find a board certified counselor in your area you can go to https://nbcc.org/search/counselorfind.
If you live in the state of Alabama, Eagle Counseling is here to help. We offer in-person and virtual counseling to anyone residing in the state.