The Cure for Depression: Cognitive Behavioral Therapy

It’s that time again: time to cure our depression. Way back in January, I proposed that curing isn’t exactly possible -BUT I listed 14 ideas that will help. We’ve talked about 8 or 9 others; like connecting with people, eating right, talking to a doctor or therapist, medicating, and doing happy things.

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Today, I’d like to get into Cognitive Behavioral Therapy. At least, I thought to get into it. I opened my hand-me-down laptop, typed that big, impressive-sounding word into a search, and then thought, Holy flipping crap! (Yep, I don’t swear often.)

Cognitive Behavioral Therapy is LEGIT. It has its own, lengthy Wikipedia page.

Aaaaand I’ve just barely heard about it.

Hopefully, that means that all of YOU readers are nearly as clueless as I was, and will be impressed and amazed at the paltry light I’ll be shedding on this topic.

So, first: What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy is often abbreviated to CBT. Cognitive Behavioral Therapy (hereafter referred to as “CBT,” for the laziness of the writer) is simply a bunch of exercises to teach our brains better habits.

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Second: Why do we need it?

Let’s say that you’re a little kid playing with a hose out in the mud. You, sweet little unsupervised thing, have full command of an entire patch of mud and have decided to make trails and paths and mountains and mudpies. It’s a glorious, messy afternoon!

Using only the best sticks you find laying around, you begin digging waterways. The hose water follows. You’re a kid, so are not quite the best at design and such. Some of your water pools at places, overruns its banks at others, and ultimately empties right into the neighbor’s back fence and washes away their freshly-planted flowers.

Oops.

An adult comes over to help. He says he’s Dr. Civil Engineer and is also licensed in psychology. “Let’s turn off the water first,” he says. “Now, my good friend and trusted colleague, CBT, is going to gently help you with mud-forming.”

You aren’t exactly sure what a colleague is, or CBT. You just want to play in the mud, and get the neighbor to stop yelling at you about flowers. Don’t flowers need water? You shrug, and watch what CBT starts doing with your mud. CBT builds up a turn, repairs an overflow area, and (most frequently) digs new paths into less destructive directions.

What’s more, CBT tells you what it is doing and how you can do it, too.

Third: We need this. Professionals say so.

My paid friend keeps telling me that my brain has learned behaviors (almost all negative) and I need to stop and complete them with the more-positive truth when negative thoughts come up. Psychologists refer to these learned behaviors as cognitive distortions. Like the mud and water analogy, our mind forms automatic reactions to situations or thoughts or feelings in order to handle them next time; and, like our first, unguided attempts, they’re not always the best.

These automatic reactions are like cringing when hit in sensitive areas, crying when our nose gets hurt, or kicking our leg when the tendon below our patella is hit.

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CBT is training to get over knee-jerk reactions. It’s still having the jerking, but toward somewhere that doesn’t actually kick someone and, especially, with the result of leaving us feeling happy that we kicked our leg instead of then kicking ourselves for reacting.

Fourth: How does one CBT?

Doesn’t CBT sound fantastic? I think it sounds a bit difficult, myself. How do we get started? Can we actually change how we think? I am not very successful at self-run things, and (yep) I tell myself that I’m not very successful.

I highly recommend getting someone professional to run this for you. CBT is the most common therapy of its kind. However, like many major startups, it has spawned subgroups of more specific subjects, die-hard zealots of original teachings, and side-therapies of similar names run by leaders who couldn’t get credit for starting the first one. Some professional navigation of those twisty roads will help you.

If you’re poor, shy, or just starting out, there are self-help options. A blog I somehow found recently lists online worksheets. Other sites exist, as well as books you can purchase.

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Fifth: No, really: does it actually help?

CBT really does help. My counselor is of the camp that minor mental issues are wholly the result of years of negative thought processes and reactions. Psychiatrists advocate for mostly medical measures, no matter how minor. I think the farmer and the cowman can be friends and meet us halfway.

Most health professionals agree that medicine and therapy, together, are the winning combination for fighting mental health issues.

Our bodies become resistant to medications and substances. Our hormones and brain chemistry change with time and stressful situations. Our motivation becomes dependent on that boost we get from outside stimuli, like prescriptions, drug overuse, and stimulants.

CBT is very nearly the silver bullet of therapies. It empowers YOU. It teaches you how to better handle your own brain -which is great because that’s what you’re stuck with all the time! Even doctors, as empathetic or sympathetic or knowledgeable as they are, cannot EVER understand exactly what you feel and experience. They have their own brains, not yours.

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Sixth: How about a run-through?

I’m getting a bit long here, even with shortening Cognitive Behavioral Therapy to CBT so many times, but can’t leave without some practical advice for all y’all. Here’s one type of CBT method you can run through, from wikihow:

  1. Notice when you’re negative.
    My therapist had me make a list what I know about me. It was about 80% self-critical and even the positive items were less-complimentary.
    Or, meditation is an option. Take at least ten minutes without distraction and pay attention to where your thoughts and feelings go.
    Think about a situation in the past that was negative.
  2. Recognize the connection between your thoughts and your feelings.
    Obviously, if you were dropped from a speeding airplane by members of the mafia into a boiling volcano, you had little control over feeling dead afterwards.
    But most situations, even sucky ones, do not cause our bad feelings at the end. WE cause them. YOU cause them. Your natural, poorly-designed mud paths caused the overflow of emotion.
    See the connection, and tell yourself that you felt bad because you had bad thoughts.
  3. Notice automatic thoughts
    All during the day, stuff happens. Automatically, we have some sort of reaction to the stuff.
    Let’s say I went to the store and realized I forgot my credit card. It’s back home in the freezer or whatever. An automatic negative thought from my brain would be, You’re always forgetting things. Further, I would think, Now you have to put all the groceries back. You should never come back to this store again.
    ALL THOSE are not good.
    I need to stop, drop and roll -er, *ahem* I need to stop that thought, way back when it started. Then, I tell myself it’s negative. Finally, I decide to tell myself something more like, Oops! I’ll look for some cash. I’l ask the cashier to hold these for me while I look, or drive home. Heck, I’m not the first person to forget payment; they’ll work with me.
  4. and 5. Talk about core beliefs. Specifically, about tying the automatic cognitive distortions to faulty internal beliefs.
    I’m not in favor of this step, because it’s self-analyzing. Getting into my terrible self-esteem and my potentially-damaging childhood without assistance sounds like a worse idea than the ones my mind comes up with.

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  1. Identify cognitive distortions. This may help with stopping the negative thoughts. Like, you can tell yourself, “I’m not a terrible person! I’m just overgeneralizing. It’s a typical misconception.” Common distortions listed on wikihow are:
    -Catastrophizing by predicting only negative outcomes in the future
    -Having all-or-nothing thinking
    -Discounting the positive
    -Labeling something or someone without knowing more about it or them
    -Rationalizing based on emotions rather than facts
    -Minimizing or magnifying the situation
    -Having “tunnel vision” by seeing only the negatives
    -Mind reading in which you believe you know what someone is thinking
    -Overgeneralizing by making an overall negative conclusion beyond the current situation
    -Personalizing the situation as something specifically wrong with you

Hopefully, this first method of 6(ish) steps works as a starting place for you. The wikihow article lists two other methods as well.

Seventh: A different initial approach is also helpful.

Besides these suggested steps, I’m a big proponent of creating an initial positive environment. I feel like I’m constantly in a negative haze, self-protected and negatively-pressured to the point of not sticking a toe out into the world.

A suggestion from my counselor was to think back on a time when I felt happy or good. Then, I was to keep asking myself, “Why?” until I traced it to a core emotion. For example: I said I’d felt happy driving to the appointment. Why? It was sunny and warm outside and I was alone. Why did that make you happy? I like feeling warm and comfortable. -Holy crap! I like being comfortable. Comfort was my core emotion.

One may also repeat a mantra each morning and evening. Something like, “I am of worth. I love myself;” or reciting an uplifting poem.

Morning meditation is good as well, or prayer.

Whatever activity you do, the goal is to create a positive atmosphere. We want to start our thoughts in a better direction and keep them going that way. Over time, your brain will form better neural pathways. You won’t flood anyone’s flower beds. You’ll have the practice and skills to handle past habits and fight new triggers.

And don’t get discouraged. You’ve had your entire life to build these habits; you can’t change overnight but you can change.

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Photo Credits:
Artem Bali
Pixabay
Pixabay
Sharon McCutcheon
Pixabay
Wikimedia Commons
Tyler Nix

 

*Chelsea Owens is not a licensed anything, except a Class D driver in her home state, and shares all information and advice from personal experience and research.

The Blue-Green Pill

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“You take the red pill, …and I show you how deep the rabbit hole goes.”

Some small part inside me loves Morpheus’ challenge: Do you have what it takes to see and accept the truth? While others might settle back down on the couch, chewing another handful of Cheetos, I foolishly stand.

Truth is a deep motivator for me. I cannot be fully religious because of this, by the definitions of many sects. I squeeze under the radar of my current denomination, by telling myself I trust it will all be cosmically explained someday.

My rational voice, upset by a few years of Atheism, plays Devil’s Advocate (ironically). It warns that no explanation will come when I cease to exist.

Why bring up such things? This is where my mind goes; this is the side effect of swallowing the left-hand option.

Surely my mindset, worldview, and even depression are Truth. They are me, as much as my blood type or detached earlobes. I need to be true to myself, to accept myself, and -above all- to not smother my emotional expression.

And yet… my daily red dosage has somehow morphed to a less-swallowable shape.

I noticed a slightly misshapen quality when I began listening to a counselor. “Your core is never negative,” she told me. Furthermore, she said my depressive reactions and tendencies were all learned behaviors.

I read self-help books on the subjects of happiness and self-esteem. They made valid points as well; like, that people honestly can raise their baseline of happiness.

However, all the psychological affirmations and literary anecdotes in the world were not enough. With or without seeking Truth, it came anyway. It laughed at my hopes and optimisms as I repeatedly returned to the dark corner of my mind.

On Facebook, I wrote the following:

When I spoke fluttering lies and raised my smiling mask, I cried inside.
But you didn’t know.

I tried to write about sunshine, as my heart grew ever overcast.
You didn’t look between the lines.

I sat in my small, shadowed corner at home, as you visited each other and laughed.
And didn’t care.

Sometimes I curiously contemplate the world without me there. Surely my departure will cause a ripple somewhere.
Instead, you’ll stand with the friends you always do, and say, “I didn’t know.”
And forget what was never known.

I got a few internet hugs in response. I felt morosely validated that, yes, they did not care.

The problem is that there is no red pill. We cannot be freed from our minds, because we are delicately and intricately attached to them. And, Truth is always, always affected by our perceptions.

Had real-life Neo entered my counselor’s office with me, he may have been given a third option: a doctor’s referral.

I’ve been dreading medical intervention for years; assuming, as I said earlier, that I would lose myself. I also assumed I would only ever have the option of anti-depressant, horrible-side-effect, me-changing medication.

Instead, I have been offered the blue-green pill.

It’s a small dose of seratonin: popularly thought to be a contributor to feelings of well-being and happiness.

I’ve swallowed it once daily for the last three weeks. I thought there to be no difference, but my husband disagreed. Given that I’ve had only one depressive episode since first taking it, he may be right.

In fact, I have been able to think in a manner that is less depressive just this weekend -a first for me. I attended a few social events Friday and Saturday; and did not feel the lingering effects of my usual, self-critical social hangover.

I feel able to agree with and utilize the strategies outlined, previously, by my paid friend and the self-help book.

I see, now, the red pill was the placebo all along. To change my life for the better I needed a new perspective -not some supposed Truth. It could not come from only me, however, since I stand a few feet lower in the ground than others.

Are you, like me, sunk in the Swamps of Sadness? Affirmation will not work. Get someone to look at all your options. Even if the dry ground you need is found through heavier medications, I can now say it’s worth it.