“There is a voice that says I’m doing something terribly wrong and that I’m a horrible person,” said Therese Borchard, author of the book Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes.

In the book, Borchard lists the many things she feels guilty for, everything from not cleaning the house to letting her kids eat more candy to worrying too much to being overly candid with her writing to overeating. And that’s just a snippet she jotted down while penning that page.

If you also have depression, you, too, probably have a list. And you, too, probably can relate to the gnawing, stubborn and heavy weight of guilt.

It’s guilt that can lead to self-doubt or even self-harm. For Borchard, guilt sparks insecurity, indecision and even poor decisions. “It colors my decisions and my conversations and I’m always second-guessing myself.”

Some research may explain why people with depression feel especially guilty. A 2012 study found that individuals with depression respond differently to guilt than people without depression. According to the news article about the study:

Investigators used fMRI to scan the brains of a group of people after remission from major depression for more than a year, and a control group who have never had depression. Both groups were asked to imagine acting badly, for example being “stingy” or “bossy” towards their best friends. They then reported their feelings to the research team.

“The scans revealed that the people with a history of depression did not ‘couple’ the brain regions associated with guilt and knowledge of appropriate behavior together as strongly as the never depressed control group do,” said Zahn, a MRC Clinician Scientist Fellow.

“Interestingly, this ‘decoupling’ only occurs when people prone to depression feel guilty or blame themselves, but not when they feel angry or blame others. This could reflect a lack of access to details about what exactly was inappropriate about their behavior when feeling guilty, thereby extending guilt to things they are not responsible for and feeling guilty for everything.”

Depression dampens a person’s reasoning and problem-solving functions, said Deborah Serani, PsyD, a psychologist and author of the book Living with Depression. “This is why a person can feel unrealistically negative about himself, feel guilty or responsible for things that he might not truly believe if the depression wasn’t active.”

5 Tips to Help Chip Away at Your Guilt

Of course, guilt isn’t something that simply dissolves with several quick fixes. But you can slowly chip away at your guilt. The below tips may help.

1. Move your body.

According to Serani, “Getting physical will lower cortisol, increase endorphin flow and awaken your senses.” It also helps people with depression think more clearly and feel better overall, she said.

2. Shift your thoughts.

“Feelings of guilt can set a depressed individual into a cycle of negative thinking; each thought worsening into a deeper, more hopeless frame of thinking,” Serani said. That’s why working on your thoughts is key. Serani suggested revising negative thoughts into positive thoughts or using positive imagery. She gave examples such as “I can do this,” or “I’m light and floating on blue beautiful water.”

3. Remember guilty thoughts are not facts.

Borchard finds it helpful to remind herself that her guilt is just a voice. “Once I say, ‘Oh, there’s the guilt,’ I can put some distance between me and the guilt.”

4. Try humor.

Borchard also finds that humor can lighten the heaviness. For instance, she refers to guilt as “my ‘mini-Vatican’ or something like that. I always laugh when my doctor reminds me that, of all the depressive symptoms I have, guilt will probably be the last to leave me.”

5. Try visualization.

In Beyond Blue, Borchard describes a visualization technique her therapist recommended. Borchard writes:

“She told me to imagine myself driving a car along the highway. Whenever I get one of those guilty thoughts, my car is out of alignment…it’s dragging right. So I pull over and assess the problem. I check to see if I need to make any adjustments. If I stole something, I should give it back. If I wronged someone, I need to make amends. Then I merge back on to the highway.

Each time my car wants to rear off the main drive, I should ask myself, Is there something I need to do? If not, I need to get my car back on the road.

For many people with depression, guilt is a real and stubborn symptom. It manipulates the facts and exacerbates your mood. But while guilt can be persistent and overwhelming, it also can be managed and minimized.