Reversing the Cycle of Depression

6 Tips to Treat and Manage Depression

 

upward spiralIn a previous post, we looked at the cognitive behavioural therapy (CBT) model of the vicious cycle of depression involving thoughts, feelings, behaviours, memories and physical symptoms. One of the first steps in overcoming depression is to put and end to this vicious cycle, and gain some momentum that can help you cycle in a positive direction.

Just as automatic negative thoughts result from and contribute to depression, by engaging in more neutral and balanced ways of thinking, we can begin to stop the vicious cycle involving negative thoughts and depression. Cognitive therapy provides an effective tool to help break out of negative patterns of thinking. As our thoughts become less negative, we begin to feel less depressed, and as we become less depressed, our thoughts about ourselves, our lives and our future become less negative, and so on.

We can experience similar reversal in these vicious cycles in other areas of our lives that are affected by, and affect depression. Cognitive behavioural therapy (CBT) can help change behaviours that result from and contribute to depression such as reducing level of activity and withdrawing socially. Changes in diet, exercise, sleep habits and self-care can help alleviate the distressing physical symptoms associated with depression and lead to more energy and motivation.

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DBT Skills: Emotion Regulation

emotionsEmotion regulation is a core dialectical behavior therapy (BDT) skill. In some earlier posts about emotion regulation we learned that the ways in which we often try to deal with emotions—such as trying to problem solve, control, or avoid them—tend to be counterproductive. We also looked at a number of more helpful ways we can deal with our emotions such as validation and acceptance. The video below puts this altogether and explains the DBT skill of emotion regulation. To learn more about emotion regulation, please check out my free DBT Skills Course.

DBT Skills: Emotion Regulation and Acceptance

 
 

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Cognitive Fusion and Defusion in Acceptance & Commitment Therapy

 

In a previous post we looked at some ways to practice letting go of thoughts, but it can often be difficult to let of thoughts because they have such a powerful pull, especially when the thoughts are related to a strong emotion. In my post, What is Acceptance and Commitment Therapy?, we learned why acceptance is so important in ACT. Cognitive defusion is a way of accepting our thoughts, allowing them to pass into and out of our minds, without getting stuck in our heads.

Steven Hayes, who developed Acceptance and Commitment Therapy (ACT), coined the term “cognitive fusion” to describe times when we are so tightly stuck to our thoughts, we become “fused” to them. When we’re experiencing cognitive fusion, we can’t separate ourselves from our thoughts. Our thoughts become our reality. We feel removed from the world outside of our thoughts, removed from our senses, from what we’re doing, and even from the people around us.

The opposite of “cognitive fusion” is “cognitive defusion.” Cognitive defusion involves taking a step back from what’s going on in our minds, and detaching a little from our thoughts. In this state of defusion, we can observe our thoughts and other internal processes without getting lost in them, stuck in them or fused with them. We can simply notice our thoughts, watch them, accept them and let them go if we choose to.

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Watching Thoughts and Letting Them Go

 

In a recent post we looked at how mindfulness can help us let go of our thoughts when we get caught up in ruminating or worrying or just thinking in circles. Letting go of thoughts is never easy, however, and in this post we’ll look at how simply watching our thoughts can help us let them go.

Thoughts pop into our heads all the time, and usually we don’t pay any special attention to them: they enter and leave our minds all on their own, just like a car that drives into our line of sight, remains in our field of vision for a few moments, and then drives along and passes out of our line of sight again.

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Letting Go of Thoughts Mindfully

racing thoughtsIt’s easy to get swept away by our thoughts, especially in the face of strong emotions. We get stuck ruminating and dwelling about the past, filled with guilt or regret. Or our minds start racing and we can’t stop worrying about the future and imagining all the things that could go wrong. Or we replay conversations over and over again in our heads, trying to make sense of them or figure out what we could have said differently.

When our minds get going like this, not only is it exhausting; these patterns of thinking tend to make us feel bad, intensifying the emotions we’re already feeling and generating additional negative emotions as well. Because this experience is so unpleasant, it’s natural to want to these thoughts to stop, and to be able to prevent yourself from even having them in the first place. We often wind up trying to make these thoughts go away, and shut them out completely and make sure they don’t come back. But just like we can’t control our emotions or suppress our emotions, neither can we control or suppress our thoughts.

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STOPP and Be Mindful

 
 

STOP is a distress tolerance skill from dialectical behavior therapy we can use whenever we’re feeling overwhelmed by stress and anxiety or distressing emotions.

Often we allow our stress and anxiety and emotions to build and build all day without doing anything to calm them, trying to just ignore them and hoping they’ll go away. Then, when we finally can’t take it anymore and start feeling overwhelmed and desperate, things have often accumulated too much and begun to spiral downwards and it can be so hard to get any relief.

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