Updated: Jan 10
Depression has been a very common mental illness in our country, even before the coronavirus pandemic. During the COVID-19 pandemic, negative mental health conditions in adults became more prevalent with all the deaths, uncertainty, and economic hardship.
You may be on the fence about whether to receive psychotherapy for depression, or you may think that you can handle it on your own. However, there is no shame in getting help when you are stuck, whatever challenge you are facing. The courageous choice is to face your problem head-on, so that it doesn’t become worse and keep you from the life that you want and deserve.
If you’re wondering, “how does psychotherapy help in the treatment of depression,” here are just five of the ways that this occurs.
Automatic Negative Thoughts
First, psychotherapy is helpful in recognizing negative thought patterns that are not realistic or helpful. Depression changes how you think, so that you have a negative bias and your thoughts are not that realistic anymore. You may exaggerate how awful things are, because they seem that way. Cognitive behavioral therapists call these thought errors “cognitive distortions,” or negative cognitions. The problem is, when you’re depressed it’s hard to tell whether these thoughts are realistic or not. They might seem perfectly natural to you while you’re depressed. Yet when you examine them closely, they usually don’t hold up that well.
Some examples of automatic negative thoughts are that you will never get better, that nobody likes you, or that everything that happened to you is because you’re somehow unworthy of good luck. Thinking about these ideas rationally, you see that there is no way for you to know whether everyone likes you or not, and that no one is universally likable. There will always be someone who doesn’t like even the most popular person. And there are probably people in your life who actually do like you, but you don’t recognize it or appreciate it while you are depressed.
Your rational mind also realizes that everyone suffers misfortune at some point in their lives, not because they deserve it, but because that’s just the way it is. You are not special in your ability to attract bad fortune, but it could seem that way right now because you feel so low.
Cognitive Behavioral Therapy, or CBT, helps you identify when your thinking is irrational and unhelpful. Once you identify your negative thinking patterns, you can change them to something more realistic and kinder to yourself. This can be very helpful in the treatment of depression.
For example, the idea that you will never get better is referred to as crystal ball thinking. The assumption is that you have a crystal ball and can see in the future. Arguably, nobody has a crystal ball. Even if they did, many other outcomes are also possible in addition to your doomsday prediction. Hard as it may be to believe, you probably don’t know what will happen in the future. But you do get a vote in how you live in the present.
Dr. Martin Seligman’s research identified what he called the “three P’s” of pessimism, which were personal, pervasive, and permanent. When you get caught in thinking that misfortune is personal (only you suffer this greatly), you are likely to feel lousy emotionally. If you think everything in your life is going to hell in a handbasket, this also makes you feel bad. Finally, if you think that all your problems in life cannot be solved and you’ll always be depressed, that doesn’t leave much room for improvement or motivation to try to get better. Cognitive Behavioral Therapy Is helpful for the treatment of depression because it helps you spot these faulty ways of thinking, and come up with more positive, realistic alternatives.
The second thing that psychotherapy does to help in the treatment of depression, is train you to identify what might be causing your depression. There may have been a loss in your past, such as an important loved one who died or losing your job. You might have been abused or neglected as a child. Alternately, you might have survived an abusive relationship as a teen or adult.
Another possible reason for developing depression is that you had a relatively normal upbringing, but your brain chemistry is imbalanced. Finding out what went wrong can help you change the negative patterns in your thoughts and behaviors later in life. It also allows you to look at these situations in a fresh new way.
Sometimes problems seem insurmountable when you were a child or adolescent. Yet when you look at that problem as an adult, you have a different perspective because of time passing and because you have greater understanding now. Whatever started your depression, you can revisit it now with an older, more mature outlook.
For instance, you might have thought that your parents’ divorce was your fault because of the way you behaved as a child. Now, as an adult, you can comprehend that children don’t break up marriages. Adults make that decision and hopefully, they take responsibility for that choice.
Within an adult's perspective, you have a greater opportunity to heal from the past.
Have you ever reminisced about a problem that seemed so different when you were a child or teenager? When you go back as an adult, it doesn’t seem so big and intimidating. That’s because you are an adult now, and you have more life experience to bring to the same situation. Oftentimes, this can help you move forward in your life. This is one of the many ways how psychotherapy helps with the treatment of depression.
Focus on Your Strengths
Psychotherapy can also help you identify ways that you have overcome low moods in the past. Solution-focused brief therapy, or SFBT, emphasizes the ways that you have been strong and resilient in the past. It also helps you identify ways that you’re currently strong. You may not even realize your own ability to get through difficulty. It’s my job as your therapist to help you remember times when you were successful, and to build on that success in the present.
Once you start to think about ways that you have conquered challenges in the past, it becomes easier to do small things. Those small things add up to big changes in how you think, feel, and behave today.
If you tend to be self-critical, you may not see the progress that you have made in recovering. Even calling for an appointment with a therapist is a sign of courage, faith, and strength. Reading about depression and how you can recover from it is another step in the direction of feeling better. Congratulations! You’re already doing recovery right now!
Many people tell me that they had a period of time when they went to the gym or went walking consistently, but when they got depressed, they stopped. Psychotherapy can help you identify things that gave you a boost in the past, that can also be altered to fit the present circumstances.
Reduce Your Isolation
One of the main features of depression is wanting to be left alone. Sometimes depressed people complain about being lonely, but they isolate themselves from other people. Part of this is due to not having the energy or motivation to do anything. Depending on the severity of the depression, people can have trouble returning phone calls, keeping contact with family or friends, or even going to work sometimes. Social contact can feel awkward and too much work for depressed folks.
When you are depressed, you might do things that push other people away. You might not call friends or family for weeks at a time. Or you may find difficulty asking for the help you need, or bottle up your emotions when you feel hurt. These behaviors can put a strain on your relationships and make people think that you don’t like them, or that you're distant. Now, on top of your depressed mood, you also have funky relationships.
However, there is something special about depression that also makes people extra sensitive to criticism, blame, or even healthy feedback. Sometimes people have an inappropriate sense of guilt when they are depressed. All these factors combine to make it hard to socialize.
One of the ways therapy can help with depression is to re-establish contact with other people. Let’s face it --when you talk to your therapist, you are talking to another live human being. The reason it’s important not to stay away from others is that we need other people’s opinion so that we don’t get trapped in our own negative thinking. We also need relationships with other people to help us thrive emotionally and physically.
You may not care about contacting people when you’re depressed. But when it passes, you will likely feel lonely and sad that you pushed other people away. I always encourage people to keep in touch, even just to let people know that your life, even if you are not ready to have longer conversations.
Psychotherapy can help with relationship skills
Psychotherapy is a place to practice communicating in a positive, constructive way so that you can take these skills to other relationships and improve how you relate to people. This, in turn, helps guard against feeling sad and upset later. By learning new ways to relate to other people, you have a chance to examine what’s going right and wrong in your existing relationships. Sometimes, things that seem perfectly normal to you might be off putting to others.
These behaviors might get in the way of interacting well with them. It’s hard to see that from your perspective, but psychotherapy can help you gain a different perspective on what the other person might be thinking and feeling. You can use that understanding to improve the relationship.
Psychotherapy helps bring these issues to light and once you are aware of these issues, you can start to behave differently. This can improve your relationships and make life more enjoyable and meaningful.
Put Your Plan for Overcoming Depression into Action
The fifth way that psychotherapy helps with depression is by coming up with a solid action plan for improving your life. Karmen Thulin wrote that the therapist should create enough comfort with a client to establish a good working relationship, but should challenge the client enough to stimulate action that is helpful and goal-directed. In other words, I can empathize with your pain, but I challenge you to take steps that may feel uncomfortable in the short run so you can enjoy a life in the long run.
Psychotherapy is there not to just console you and make you feel comfortable, but to get you to take steps, however small, to make your life better. Sometimes, that means stepping out of your comfort zone and forcing yourself to do something that you know will benefit you in the end.
The seductive power of depression
Depression is a sneaky little SOB. All the things that make it worse, like exercising, talking to people, making your bed, etc. feel like a monumental drag. Who wants to be uncomfortable when you already feel crummy? Depression beckons to you to surrender to fatigue, apathy, and loneliness. It feels perfectly okay to lie in bed for extended periods of time, not get any exercise, avoid doing the dishes, and shun your friends and family members. However, all these things just perpetuate the depression and make it worse.
If you give into your urge to stay home from work, what happens to your job? If you indulge your desire to stay in bed all day, what happens to your sleep schedule, your hygiene, and your overall physical and mental health? Neglect is far from benign!
When people get into action mode, they can get overwhelmed by all the things they need to do. How do you exercise more, bathe more, talk to your friends, and clean up around the house all at once? A therapist can help you take baby steps until you start to feel better, but the point is to move forward, not just stay stuck.
This means that therapy is a collaborative effort. Even if you don’t want to do the things that will benefit you in the long run, there needs to be a willingness to participate, so that you at least try. Many people come back to me later and tell me that even though they were a little annoyed with me when they were down, they were grateful for my pushing them to journal, speak up with loved ones, exercise, eat healthier, etc.
This is another instance where solution-focused therapy can be useful in the treatment of depression. You may have been depressed in the past but somehow recovered on your own and found your way back to normal functioning. How did you do that? What steps did you take, or what decision did you make? Thinking about how this happened and doing what worked then, often restores people to normal functioning again.
Getting unstuck from depression involves identifying and changing unrealistic thinking, finding the root cause of depression, focusing on your strengths, reducing isolation, developing and implementing an action plan. These are just some ideas of how psychotherapy helps in the treatment of depression.
If you are struggling with depression and feel ready to benefit from psychotherapy, please give me a call at 661-233-6771. I look forward to helping you soon.