Tuesday, June 19, 2012

What to do when depression strikes

I'm reading Dr. David Burns's book Feeling Good. It's an excellent resource to tackle the problems of depression, guilt, procrastination, low self-esteem and hopelessness. As the front page blurb puts it, the book's effects are equal to and in some cases greater than anti-depressant drugs.

I won't go into the details of the advantages and limitations of cognitive behavioral therapy here. This post is about the central idea of his book, namely that depression arises from negative and distorted thoughts. Correct the distortions in your thinking and your depression will be treated. He has catalogued 10 types of cognitive distortions that he returns to again and again throughout the book.

1. All or Nothing Thinking - you see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.

2. Overgeneralization - You see a single negative event as a never-ending pattern of defeat.

3. Mental filter - You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that colors the entire beaker of water.

4. Disqualifying the positive - You reject positive experiences by insisting they 'don't count' for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.

5. Jumping to conclusions - You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
    a. Mind reading - you arbitrarily conclude that someone is reacting negatively to you, and you don't bother to check this out.
    b. The Fortune Teller error  - You anticipate that things will turn out badly, and you feel convinced that your prediction is an already established fact.


6. Magnification (Catastrophizing) or minimization - you exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). This is also called the binocular trick.

7. Emotional Reasoning - You assume that your negative emotions necessarily reflect the way things really are: "I feel it therefore it must be true."

8. Should Statements - You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "Oughts" are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration and resentment.

9. Labeling and Mislabeling - This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him: "He's a goddamn louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.

10. Personalization - You see yourself as a cause of some negative external event which in fact you were not primarily responsible for.

(From Table 3-1, pg 42, Feeling Good)

Correcting these distortions requires patience, work and guidance, and the rest of the book provides that with real life examples.

Most of these distortions might seem to be common sense stuff. Who thinks like that? But these are very real for anyone who is depressed.

And depression is way more common than people realize. It is one of the biggest public health problems. Not a surprise given that many people who haven't experienced depression doubt that it is actually a mental illness. This helps create a stigma around such illnesses, making people even less likely to seek help. It's another story that fewer than 25 % of those affected have access to effective treatments globally.

And that's one of the things I like about Dr. Burns's approach. He places a well-researched, tried and tested method right in your hands, wherever you may be. I hope more people come across his work.

Image(s): FreeDigitalPhotos.net

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Your thoughts are very welcome and I look forward to them eagerly. Just be mindful of being civil. This is a good book about the same in case you are interested:
Choosing Civility: The Twenty-five Rules of Considerate Conduct - P.M.Forni