What is Depression?
If you are depressed, then it is likely that you have a persistent feeling of unhappiness and loss of interest in the things in life you used to enjoy. When you are depressed you will probably experience a sense of sadness and hopelessness about your life, your future, and the world around you. It is completely normal to experience sadness or a low mood from time to time. However, someone who is depressed will notice their low mood persist for two weeks or more. The intensity of your low mood may vary throughout the day, and it is generally accompanied by a sense of hopelessness and despondency.
It is also common for someone who is depressed to experience anxiety, such as worrying about the future, or that things might not get better. If you experience depression, you may also notice that it affects your energy levels and motivation to get things done. Daily tasks can feel like a big effort to accomplish. This is due to the physical symptoms associated with depression, such as feelings of lethargy or changes in sleeping patterns (sleeping too much or too little). Also, feelings of guilt and self-blame are common to someone who is depressed, which are accompanied by self-attacking/self-critical thoughts and low self-esteem.
What causes depression?
Depression can be caused by several different types of challenges in your life such as experiencing loss, a sense of failure, low self-esteem, stress, substance misuse, relationship difficulties and developmental trauma. Depression can also be caused by biological factors such as genetics, hormonal or neuroendocrine imbalances.
Depression and ‘Overthinking’ (Rumination)
If you are depressed you will probably experience overthinking, in particular thinking negatively about your problems. When we are depressed we are genuinely trying to solve our problems by thinking them through however this can get us stuck in negative thinking patterns known as ‘rumination’. This includes dwelling on how difficult life is for you and the things that distress you. It might involve thinking about how hard a world it is to live in, or how bad you are feeling, and the worry that things might not get better. It is a thought process whereby we get stuck thinking repeatedly about the same things. I call it the ‘washing machine’ or the ‘hamster wheel’ of the mind. We get stuck in a loop by going through the same distressing scenarios in our mind over and over.
We all ruminate from time to time to solve our problems, and this can be helpful especially if it leads us to take an action to solve a problem. However, excessive rumination is ‘problem solving’ in overdrive. When we ruminate excessively, we are sincerely trying to solve our problems, we are trying to make things better so that we can feel better. But the problem is that rumination keeps us stuck on particular scenarios or problems. We do not actually solve our problems, but instead we maintain our feelings of hopelessness and despondency. It keeps us stuck in a rut and prevents us from taking actions that could help us to improve our situation and wellbeing.
Thinking styles in rumination can include ‘why does this always happen to me?’ or ‘what did I do to deserve this?’, whereas problem solving is more action focused such as ‘what can I do to solve this problem?’ or ‘how can I make this situation better?’.
How can CBT help with Depression?
Cognitive Behavioural psychotherapy is recommended as the treatment of choice for mild to moderate depression by the National Institute of Clinical Excellence (NICE). For more severe or major depression a combination of CBT and medication is recommended by the NICE Guidelines.
As a talking therapy for depression, CBT is a combination of cognitive therapy and behavioural therapy. Cognitive therapy works with your thoughts or perceptions to improve your mood. Treatment involves learning more balanced and helpful ways to cope with low mood and patterns of negative, self-critical and self-defeating thoughts.
In CBT, we identify ‘cognitive distortions’. These are habitual thought patterns that serve to maintain low mood, keeping you locked into a cycle of negative thinking. These habitual self-defeating and unhelpful thought patterns are the types of thoughts we have when we ruminate. They include, black and white thinking, catastrophizing, mind-reading (assuming we know what someone else is thinking), dismissing the good things that happen to us, or getting caught up in the ‘should, musts and ought’.
Behavioural therapy focuses on our actions or what we do to increase energy levels and mood. Common symptoms of depression comprise low motivation or energy and a decreased capacity to experience pleasure. Behavioural therapy addresses these symptoms by improving energy levels and increasing your ability to enjoy the things in life that matter to you.
If you are experiencing five or more of the following symptoms for a period of more than two weeks then please get in touch, you are not alone:
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
- Feeling worthless or guilty
- Negative, self-defeating and self-critical thoughts.
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
Feel free to contact us if you have any questions or if you would like to to book an appointment don’t hesitate to get in touch on our contact form below, or phone us at 086 840 3722.