People with depression often have negative or irrational beliefs, which continue to fuel their depressive thinking. According to the cognitive model of depression, the emotions in depression such as sadness, guilt, hopelessness, worthlessness, helplessness, anger, frustration, and anxiety are triggered by a dysfunctional thought process. This dysfunction involves misinterpretation or misattribution of situations, past events, memories, and even feelings leading to irrational thoughts – also called cognitive distortions – that in turn perpetuate depressive symptoms. These irrational thought patterns are described below:
1. All-or-None Thinking: This type of irrational thinking is also called black-and-white thinking or dichotomous thinking. This is thinking in extremes or absolutes with no consideration for any alternatives in between the extremes. For example, if you get a below-average performance evaluation and feel that you will never get a good performance evaluation in the future, you are indulging in black-and-white thinking. The same is true if you were rejected by someone who you were hoping to have a relationship with and your thoughts were, “I am a total failure in relationships.” All-or-none thinking defies the universal truth that people’s abilities and their character exists on a continuum and can never be pigeon-holed into an either/or category. Pay attention to words like “total,” “complete,” “always,” and “never” when you describe something that didn’t happen the way you expected it to. Most likely, in these circumstances, your mind has been hijacked into an all-or-nothing thinking mode. You will be successful in some areas of your life and not so much in others. Your failure in one aspect of your life doesn’t negate your successes or accomplishments in other areas; however, it does so when you are going through depression. This is because of selective abstraction, another type of irrational thinking, described next.
2. Selective abstraction: You focus on one particular detail of a situation or thought, take it out of context, and ignore other important and positive aspects of the situation. People with depression focus on the negative aspects of a situation and ignore the positives, thus perceiving the entire situation as being negative. Also called “mental filter,” this type of irrational thinking is common in depression, especially in people with a pessimistic outlook. For example, a student who got a “B” in one subject and “As” in all the other subjects may dwell on the “B” ignoring their excellent performance in other subjects, thus feeling dejected. Selective abstraction can make you undermine your strengths and underestimate your self-efficacy. Some people with depression take this distorted thinking to even a greater level and start disqualifying the positives as described next.
3. Disqualifying the positives: Depression can cloud your thinking into not just ignoring the positives, but also making you actively negate the positives. This is particularly true when depression lowers your self-esteem, which then makes you feel that you don’t deserve positive things in your life. You can recognize this type of irrational thought when you use the “yes, but” language to discount positive changes. An often cited example for this distorted thinking is when upon being complimented, you find an excuse to justify why you are not worthy of the compliment – “they said this just to make me feel better.” Another variant is when you don’t give credit to yourself and either shift the credit to others or use justifications like, “I just got lucky.” When carried to an extreme, this type of thinking can make you loathe in self-pity to the extent that anything positive seems foreign to you.
4. Arbitrary interpretation: You wrongly assume that others are thinking in bad terms about you without any factual evidence to support your notion. This irrational thought pattern is also referred to as jumping to conclusion or mind reading. Typically, this type of misinterpretation occurs when the cues are ambiguous. For example, if you say “Hi” to your coworker when you walk into the office and they don’t reply back because they are too engrossed in their own thoughts, you may think they are ignoring you and feel bad about the situation.
5. Overgeneralization: You lose perspective of the situation as a whole and allow one problem or perceived deficit to color your perception to negatively interpret the entire situation. An example is when you fail to make a good impression at a meeting and start believing that you don’t have any people skills.
6. Labeling: You use negative labels to describe yourself or others. Labeling is an exaggerated form of overgeneralization and is usually recognized in sentences starting with “I am a ….” Examples include, “I am a loser,” or “He is good for nothing.” In labeling, the emotional reaction to an event is out of proportion to the actual intensity of the event.
7. Magnification/minimization: You inflate your problems or faults and underestimate your strengths and abilities. For example, you are involved in a minor fender-bender and your first reaction is, “This is going to cost a fortune to repair.”
8. Catastrophizing: Magnification taken to an extreme is catastrophizing. You predict the worst-case scenario for a future situation ignoring all the evidence to the contrary. Also called fortune-telling, this type of irrational thought pattern is more common in anxiety. You can recognize this pattern of thinking if you are using statements starting with, “What if…” and ending with a bad outcome. For example, a person who is afraid of heights may think, “What if I feel dizzy and fall over the balcony?” A person afraid of flying may think, “What if I have a panic attack in the plane and no one can help me?” Catastrophic thinking evokes your sense of vulnerability and takes it to an extreme level overriding your rational mind to come up with other more plausible alternatives.
9. Personalization: You take personal responsibility and blame yourself for a situation gone bad or other problems. You even take blame for what others may have done. For example, a woman going through divorce may believe that she is a disappointment to her children and family because she couldn’t save her marriage. As evident, personalization evokes the feelings of irrational guilt, which perpetuate depression.
10. “Should” and “must” statements: You have impractical, often absurd, expectations and you use these expectations as a yardstick to evaluate yourself, others, or a situation. For example, “I should always do my best,” “He should have tried harder,” or “I must win every time.”
11. Emotional reasoning: Your strong emotions make you believe that the feeling-state you are in is actually true without considering evidence to the contrary. For example, “I am feeling guilty, and, therefore, I should deserve to feel bad.”
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HARPREET S. DUGGAL, MD, FAPA
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