What is depressive thinking?

When you are depressed there are changes in the way you think, as well as in how you feel. You tend to look on the black side of everything, see the worst in yourself, in your life and your future. Once you are feeling down, you are more likely to remember the bad things that have happened and ignore the good ones. Negative thinking can also trigger depression and it slows down recovery. Everyone has negative thoughts, but they also have positive ones. A healthy balance seems to be about two positive thoughts to 1 negative one. When you are depressed, this balance is disturbed. You may also have thoughts that are distorted and don't fit the facts, such as 'I am a waste of space' and 'I am a complete failure'. Have you noticed differences in the way people think about events? Can you relate to the example below?A colleague was promoted at work rather than you…

Learning to recognise unrealistic, negative thoughts and to balance them with more realistic, positive ones can be very helpful. However, changing your way of thinking is quite difficult at first and you will need to keep working at it. It may help to enlist the help of someone you trust.

IDENTIFYING NEGATIVE THINKING

Negative thoughts can be difficult to spot because they become a habit, they can flash quickly into your mind and most of us are not used to noticing our thoughts. Learning to spot and catch these negative thoughts is a skill you can master with time. When you are depressed, you tend to think in particular ways that are distorted in a negative way. These are called 'thinking errors'. Here are some common examples. Try to spot the ones which apply to you.

• Thinking the worst, eg your boy/girl friend doesn't phone. You assume they don't like you any more.

• Thinking that everything is going wrong when only one thing has gone wrong (over-generalizing). For example, you make one mistake at work and think 'I'll never succeed. I can't do anything'.

• Ignoring the positive and only seeing the negative, eg 'The shelves I put up are no good because a screw fell out.'

• Arguing away anything positive, eg 'He said he liked what I did because he is sorry for me'.

• Making negative predictions, eg 'It's no good my doing that, I'm bound to fail. It'll be a disaster'.

• Taking things personally and blaming yourself for what others do, eg 'My son failed that exam. I should have helped him more. I am a bad parent' or 'My partner has left me. I am no good'.

• Exaggerating the negative, eg 'This is a complete disaster, a total failure'.
Thinking the worst, eg your boy/girl friend doesn't phone. You assume they don't like you any more.

You may also have beliefs about yourself and about how the world is and should be that are unrealistic. These beliefs may be making it harder for you to deal with the problems in your life and so may be contributing to your depression. Here are some examples of beliefs that make people more likely to get depressed.

• I should be happy all the time.
• To be a good person, I have to be nice to everyone
• If someone is hurt by something I say or do, I am a bad person.
• If I show emotion, it means that I am weak
• It is shameful for me to show any sign of weakness.
• If someone does not like me, it means there is something wrong with me.
• If I argue or disagree, people won't like me
• If I am criticised, it means I am wrong
• If I don't succeed, I am worthless
• I cannot handle it when things go wrong

CHANGING NEGATIVE THINKING

It is likely that you have been thinking in a negative way for sometime now. It will take a lot of practice to change these ways. You may find it quite difficult at first and this may trigger more negative thoughts, such as 'I'm useless. I can't do anything right'. You may need help from a friend or from your health worker. Give yourself time. Remember you can learn to think more positively and this will make a huge difference in your life.Here are some suggestions:

First, write down your negative thoughts as soon as possible. If it's difficult to notice any thoughts, try noticing when you feel down and ask 'What went through my mind just before I started feeling sad'.

Second, ask yourself 'Is what I believe TRUE?'

• It will be useful to consult someone outside the situation for their opinion
• Ask yourself if everyone would have the same belief in this situation
• Examine other possible explanations for the event occurring
• Ask yourself if you could be making a mistake in the way you are thinking
• Try a real-life experiment. For example, if your friend doesn't phone, call him or her to ask why. Check out if your assumption that he or she no longer likes you is true.

Third, balance each negative/unreasonable thought with more realistic ones

• These should be different to the unreasonable belief
• Try to make them realistic statements
• Try to make as many counters as possible

Now, read the following example and work out your own examples using the same format. You can do this with the help of your friend, doctor and/or your counsellor.

Example
The example below shows how negative and positive thoughts lead to different reactions to the same situation.

SITUATION: Was not chosen for job

Unreasonable/negative thoughts:

• Just as well I didn't get the job, I would have failed at it anyway
• I am no good/stupid
• I am a failure
• I should give up
• I will never succeed.

Resulting feelings:
Worthlessness, depression.
Now lets look at the same situation from a different angle:Reasonable/positive thoughts:

• Many people do not get the job they want
• I need to practice some interview techniques
• I am not a failure, I have achieved many good things in the past
• I will not get anywhere by giving up
• If I persevere I can succeed
• I have succeeded in the past and I will continue to succeed

Resulting feelings:
Disappointment, but enthusiasm and hope.Now you can work through your own examples. Write down a situation that has made you unhappy and any negative thoughts you may have had and the resulting feelings. Next, opposite each negative thought, write down a more balanced thought and any new feelings. You will find that after practising this technique for a while, you get much better at balancing your thoughts.

Remember it will take time to change the way you think and feel

FINALLY

• Doing the exercises when you are depressed can be difficult
• It might be useful to work through them with a trusted friend or family member.
• If you need extra help you can always talk to your doctor and/or your counsellor.

This leaflet has been adapted, with permission from World Health Organization, 1998, Mental Disorders in Primary Care: a WHO Education Package