Depression is a master manipulator. It spins negative stories and makes you think these tall tales are cold, hard facts.
But they’re really cognitive distortions.
“[N]ot only does the illness make our thoughts more negative, but it tends to make us see negative events as internal, stable and global,” said Lee H. Coleman, Ph.D., ABPP, a clinical psychologist and assistant director and director of training at the California Institute of Technology’s student counseling center.
This includes everything from believing something is wrong with you when your friend cancels dinner to assuming bad things always happen to you to being convinced you’ll never feel better ever again.
According to psychologist Deborah Serani, PsyD, depression’s top three distortions revolve around helplessness, hopelessness and poor problem solving. Depression diminishes functioning in the frontal lobe of the brain, home to goal-directed behavior, problem solving and reasoning, she said.
Coleman often tells his patients that even though depression is classified as a mood disorder, the cognitive effects may be even more debilitating.
Cognitive distortions can lead to self-destructive behavior and dangerous situations, such as not reaching out to others for support, not eating, skipping medication, drinking excessively, driving too fast and self-harming, said Serani, also author of the books Living with Depression and Depression and Your Child.
One of her patients revealed that her son was so depressed that he climbed a tower’s electrical wires to see if he could touch the top one. This could’ve killed him. Thankfully, the police were able to stop him.
“After he received treatment for his depression, he told his mother that he can’t explain why he did that because he’d never in a million years do that now that he’s feeling better.”
Common Cognitive Distortions
“It’s all my fault I have depression.” Coleman regularly reminds his clients that no one asks to be depressed; “nobody can inflict themselves with depression. It’s a complex illness with roots in our biology, our family backgrounds, and so many other factors that are completely out of our control.”
He believes that instead of focusing on how you got there, it’s more useful to focus on what may be maintaining your depression right now, such as social isolation or unmet needs, he said. Paying attention to your needs for social contact, meaningful work, leisure time and other needs helps you figure out where you can take action. “Is there something you need that you haven’t spoken up about?”
“Nothing I do will make any difference, so why bother?” This kind of thinking is called catastrophizing, which triggers a loop of hopelessness and bleak ruminations, said Serani. Naturally, this makes every part of a person’s life feel difficult.
Small acts such as getting up and taking a shower start to feel impossible. Bigger tasks such as paying bills and holding down a job test a person’s “mind, body and soul to the point of exhaustion,” she said. Slowly, as their ability to endure these demands diminishes, people “wither into a state of hopelessness.”
But the truth is, she said, there are many ways to reduce your depression and people who love you and want to help. There also are “tremendous hopeful changes just around the corner once you begin treatment.”
Coleman stressed the importance of remembering that things are rarely black and white. “Even small steps can have a cumulative effect on your mood.” You might feel a bit better after talking to your friends or going for a walk. These small differences count.
“[I]t’s OK to keep doing those things for yourself, even if you don’t suddenly feel better all at once.”
“I’m always going to feel this way.” Depression can be utterly painful, and because it makes you interpret problems more internally, you assume your suffering is permanent. The good news is that “most people feel better within a matter of months — and even more quickly when they seek treatment,” said Coleman, also author of the book Depression: A Guide for the Newly Diagnosed.
“I can’t find a way out of this.” As mentioned above, depression often hinders a person’s ability to problem solve, and may lead to self-destructive or life-threatening decisions. “Depression colors our perception in such a dark and narrow way that it seems like there’s no way out,” Serani said. However, as you start recovering, you’ll be able to see positive solutions.
Overcoming Cognitive Distortions
The best way to overcome cognitive distortions is to seek treatment. When depression is moderate to severe, it seizes your ability to think and reason clearly, Serani said. “This is what makes depression one of the most lethal of mental disorders.”
When people with depression start therapy, one of the first symptoms to improve is the distorted thinking, Serani said. Psychotherapy “brings about hope, reduces helplessness and aids in problem solving.”
In fact, Serani cited research that has shown that the very pathways in the frontal lobe that depression damages seem to improve with psychotherapy. She also noted that antidepressants can help with distortions, as well, but typically take up to several weeks to work.
For milder cases of depression, readers can first try exercising, practicing yoga, meditating and learning to use positive self-talk, Serani said.
Everyone may benefit from keeping a gratitude journal or record of positive experiences. “Otherwise, depression just has a way of making us forget or overlook positive events,” Coleman said.
Another strategy is to consider external factors. The above example of a friend canceling dinner plans ignores external possibilities. According to Coleman, “Perhaps the friend didn’t feel well, or didn’t have the money to go out but felt ashamed to say anything. You’ll probably never know for sure, but it doesn’t make sense just to assume that it was about you.”
Coleman also suggested asking other people for their perspectives to help you consider alternative viewpoints. “You don’t necessarily have to agree with how others see things, but maybe it’s enough to notice that other people perceive situations in a different way than you do.”
For instance, if you got laid off, and automatically think, “These things always happen to me,” ask a trusted friend how they see the situation, Coleman said. “[Y]ou’ll probably find that they take an empathic but less negative view of it than you do.”
In addition to its physical and emotional symptoms, depression is an illness that interferes with your brain functioning and psychological reasoning. It distorts your view of yourself and your world.
In short, it lies.
Seeking treatment can help to diminish the distortions and help you recognize the truth: You’re a good person, who can get better.