Depression’s Vicious Circle

Here’s a brief discussion of how depression leads to hurting yourself, sometimes in ways you’re not even aware of.

Depression is best understood as a vicious circle, the result of current stress acting on a vulnerable individual to push him or her into this cycle that feeds itself: depressed moods lead to depressed thinking and behavior, which leads to a more depressed mood, and so on in a downward spiral. Depression is also accompanied by negative thinking (I can’t. . .The cards are stacked against me. . .There’s no use trying) and hopelessness.  In addition, depression affects the brain directly:  we stop producing dopamine (hence have less drive and energy) and the cells that are meant to receive endorphins, the happy hormones, shrivel away so that we can’t experience good feelings.  The depressed person is usually slowed down, stuck in molasses, unable to think clearly or see a better future; his/her speech is often a slow monotone that sounds like an effort and conveys no feeling at all.  What does it matter. . .why bother. . .it’s useless. 

If you have a mood disorder, by definition you have trouble with self-destructive behavior.  It’s usually a passive form of self-destruction—staying home isolated, giving up hope, expecting the worst—though there are angry depressed people who get into fights and emotionally abuse others.  You may turn to alcohol or drugs to help comfort you.  Depression is usually accompanied by suicidal thoughts and impulses, and suicide is often a real risk.  Impulses like driving into a bridge abutment or stepping off a high place can come out of nowhere and convince you that you are going crazy, though they’re very common with depression.

Your assumptive world changes drastically with depression, and the depressed assumptions turn into self-fulfilling prophecies that just make you feel worse.  Depressed people tend to take too much responsibility for the bad things that happen in life, but feel that the good things are just accidents that they had nothing to do with and are unlikely to happen again.  If you’re depressed, you are probably quite pessimistic in your thinking, assuming that everything is getting worse all the time, and there’s nothing you can do about it.  You feel that you have to be in control every moment, and if you relax, things will fall apart; at the same time you don’t really believe that your efforts to control will really do any good.  The glass is always half empty, good things are temporary and unreliable, bad things are permanent and pervasive, other people are always better, more attractive, more successful than you.  When you know what you ought to do to feel better, but are too depressed to do it, you blame yourself for lacking will power, as if it’s a character trait that you either have or don’t have, and that adds to your low self-esteem.

Here are some of the self-destructive behaviors most commonly associated with depression:

  • Overeating to comfort yourself, a consolation prize
  • Social isolation because you don’t feel worthy of attention
  • Substance abuse
  • Procrastination—for all kinds of reasons
  • A cycle of overwork and collapse
  • Staying in destructive situations—letting your partner, boss, or coworkers take advantage of you
  • Neglecting your health because you don’t feel you’re worth the effort
  • Poor sleep—insomnia or waking at 4 AM and obsessively ruminating is a classic sign of depression
  • Not exercising—you don’t have the energy and you don’t think it’ll do any good
  • Won’t ask for help because you’re ashamed and guilty
  • Suffering in silence—not expressing your feelings is both a cause and symptom of depression
  • Depressed shopping, spending money you don’t have to buy things you hope will make you feel better
  • Parasuicide—nonfatal suicide attempts, suicidal gestures
  • Self mutilation
  • Anorexia/bulimia
  • “Wearing the victim sign”—unconsciously communicating that you can be taken advantage of
  • And many more

All these things obviously interfere with recovery, but they also make your mood problems worse.  Every time you try to get control over these patterns and fail, you have another experience that confirms your own shame about your illness.  You blame yourself, and you become more hopeless.

If you ask depressed people to spend ten minutes thinking about their problems, they become more depressed (because of all their negative thinking patterns).  If you give them another subject to spend ten minutes thinking about, they become less depressed.  Pay attention to this, because it’s counterintuitive; it’s important to our worldview to believe that if we just apply mental power to our problems, we’ll find a way out.  But that just backfires with depression, because the illness has so pervaded our minds that our beliefs and assumptions are twisted, and our ability to concentrate and make decisions is damaged.  In fact, it’s rather obvious that if the ordinary powers of the conscious mind were able to counter depression, we wouldn’t be depressed to begin with.  This is a very ironic form of self-destructive behavior, and why I refer to depression as the Catch-22 of mental illness; trying your best to figure out what’s wrong and what to do about it just makes you feel worse.  But no one recognizes this without help.

That doesn’t mean there’s nothing you can do about it.  I ask people to keep a log of their depressed mood shifts, what’s going on around them at the time, and what their thoughts and feelings were.  They thus learn to identify their triggers, and develop some control because they can strategize how to avoid or respond differently to things that make them feel bad.  At the same time, they develop some of that metacognitive awareness that accompanies mindfulness; the fact that there are explanations for their mood shifts means that they’re not crazy or out of control, and lends hope.

By Richard O’Connor, Ph.D.

Dr. O’Connor is a psychotherapist in NYC and Connecticut who specializes in treating those with depression. He is the author of the bestselling books, Undoing Depression: What Medication Can’t Give You and Therapy Can’t Teach You.

 

Depression: Is Critical Thinking Part of the Cure?

One of the most well-known strategies for dealing with depression is the use of the class of medications know as SSRI’s. For many people, Prozac, Paxil, Zoloft, and the like have been incredibly helpful in dealing with depression.

Given this, why would a philosopher such as myself have something to say about depression?  One reason is that there is another resource which may be helpful in dealing with depression, perhaps in concert with SSRI’s and other forms of treatment. That resource is sound critical thinking, and this is something that I am familiar with as a philosopher.

My claim is not that unsound or illogical thinking is the cause of depression, or that the depressed person is blameworthy for how she thinks, but rather that the thinking that is characteristic of someone suffering from depression is sometimes illogical thinking. Such thinking can perpetuate depression.

In cognitive therapy, an individual can come to recognize these illogical patterns of thought. Then, through a variety of means, she can begin to change those patterns. We all fall into these patterns of thought at times, but for the depressed they are perhaps more severe or exert more power over their lives. But what sorts of patterns of illogical thought are present in depressed thinking?

All or Nothing Thinking

Here, we tend to see black and white where they do not exist.

For example, someone might believe something like this: “Either I’m a total success, or I’m a total failure.” A successful person might lose out on a promotion, and then think that because of this he’s a complete failure. However, this type of thinking commits a logical fallacy, the fallacy of the false dilemma. When committing this fallacy, a person is assuming that only two options exist when there are more than two. So in the promotion example, rather than seeing himself as a failure, he would see himself as someone who is successful, but has suffered a professional setback

Disqualifying the Positive 

Consider the depressed student who doesn’t think that anyone likes her. She discusses this with her roommate, who says “I like you, and so does your family and your 3 friends down the hall.” This is evidence that her belief is false, but the depressed person often persists in this thinking by believing that they don’t really like her, or they only like her because they have to, or something along these lines. This type of thinking is an example of the fallacy of suppressed evidence. This fallacy occurs when we overlook or ignore or unjustifiably discount relevant evidence that supports a different conclusion than what we believe.

Emotional Reasoning

This is when we believe that our negative feelings about something reflect reality, when they do not. For example, someone feels like they have nothing to offer anyone else, when this is not in fact that case. Feelings are powerful, and important, and they can reflect reality. But when they fail to reflect reality and we believe what they tell us anyway, we commit the fallacy of insufficient evidence. This fallacy occurs when we believe a conclusion even though there is not enough evidence to warrant that belief.

Should Statements

Depressed thinking often includes these types of statements: “I should exercise 3 times this week,” or “I should never feel angry with my children.” This type of self-talk can be harmful and demotivating, and may helpfully be replaced with statements like “It would be good to exercise 3 times this week,” or “It would be nice for my kids if I were more patient with them.” Sometimes, should statements exhibit the fallacy of the false dilemma: “I should exercise 3 times this week or I’m worthless and undisciplined.”

This is a false either-or type of reasoning. At other times, should statements reflect the fallacy of unacceptable premise, which occurs when one accepts a premise that is unwarranted by the evidence. For example, a depressed person might think that “Anyone who feels angry with their kids is a very bad parent and should feel very guilty. Since I sometimes feel angry with my kids, I’m a very bad parent and should feel very guilty.”
The unwarranted and unrealistic premise is that “anyone who feels angry with their kids is a very bad parent and should feel very guilty.” This is not to condone anger or belittle patient love, but it is to point out that feelings of anger are sometimes appropriate, and even when they are not it does not follow that one is a bad parent merely for having such feelings.

There are many issues here worth pursuing. How much can correcting these illogical ways of thinking help the depressed person? How can a depressed person begin to correct this thinking, when it occurs in her mind? I will leave it to the experts in psychology to answer these types of questions, but there is at least good philosophical evidence that sound critical thinking belongs in the toolbox of the person who is dealing with depression, as well as the toolbox of those who are seeking to help such an individual.

 

Michael W. Austin, Ph.D., is a professor of philosophy at Eastern Kentucky University. Austin has published numerous books and journal articles related to ethics, philosophy of religion, philosophy of the family, and philosophy of sport. He speaks on these and a variety of other topics related to the connections between character and human fulfillment.

 

 

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From the blog Epic Fail: Law School Disaster,  good blog written by a pessimistic law student who is learning to be an optimist.  Read the Blog

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