The quest to understand why I am depressed and what to do about it – my reading and thinking and trying things out – has lead to this: cautious optimism that I can get really well. And firing on mental cylinders not yet sparked.
So that is the plan: to go for it. Sadly my other thing (rescuing bats), which usually takes all my time in the summer, has ended. Henceforth my number one priority will be the relentless pursuit of beating my depression.
Since the last post about the ‘new laws of psychology‘ and its emphasis on psychological rather than neurological/chemical underpinnings of depression, I have read more about this and tried to pin down the apparently all-important “sense I make of myself, other people, the world and the future.”
Beck’s cognitive triad
This idea comes from American psychiatrist Aaron Beck, the Daddy of cognitive behaviour therapy (CBT), who assigned a central role to what he called the ‘cognitive triad’ in depression; namely, pervasive negative attitudes that the depressed individual has towards him/herself, towards the outside world, and towards his/her future. The description of each certainly resonates with me:
1. The view of self.
The depressed patient’s cognitive schemas that relate to self-assessment consist of seeing himself as deficient, inadequate, or unworthy. He will often attribute his unpleasant feelings and experiences to some kind of physical, mental, or moral defect within himself. He will then consider himself worthless because of his presumed defects, and will “reject” himself.
2. The view of the world.
The depressed person tends to see his world as making exorbitant demands on him and as presenting, obstacles that cannot be surmounted. He interprets his interactions with his environment in terms of defeat and failure, deprivation, or disparagement.
3. The view of the future.
The depressed person’s negative cognitive patterns that relate to the future become evident in his view that his current difficulties or suffering will indefinitely continue. Thus, he anticipates unremitting hardship, continued frustration, and never ending deprivation. Such schemas essentially amount to a pervasive hopeless attitude.
Source: AN Weissman and AT Beck Development and Validation of the Dysfunctional Attitude Scale: A Preliminary Investigation. Mar 78
So if depression is not so much shonky wiring as shonky thinking, can thoughts be changed? That is the premise of cognitive behavioural therapy of course – learning how to challenge and alter our own negative thoughts, and in so doing, feel better.
I have done a course of CBT though my local NHS service, and found it helpful, but – and maybe I’ve missed the point somewhere – it seems to deal with the symptoms of depressive thinking rather than the cause. The negative thoughts I have are automatic, unconscious, constant. Challenging each one is fine, but akin to pulling drowning bodies out of the thought-flow rather than venturing upstream to stop them falling in in the first place.
Our sense of ourselves and the world and our future develops from our (mostly early) experiences and our environment. In depressed people, according Beck, that sense is negative and damaging, and it profoundly affects our thinking, which leads to us feeling bad.
I have tried to change my thinking, through CBT, but it only helps a bit. I want to change the sense I have of myself, the world and my future. To stop the bodies falling in the drowning flow of negative thought.
This cognitive triad thing gives me great hope. Potentially, all we need do is to change our deeply-held beliefs – our sense of everything. The beliefs I have (see 1, 2 and 3 above!) are irrational; surely they can be replaced with something more useful.
But how is that possible? Perhaps a psychologist would suggest therapy but I’d rather tackle it myself. From what I have researched so far, the development of self-compassion (through loving-kindness mindfulness meditation) may be the answer. More on this to follow, but the extract from Neff and Costigan gives a flavour:
Research shows that treating oneself with care and compassion is a powerful way to enhance intrapersonal and interpersonal wellbeing. When we are mindful of our suffering and respond with kindness, remembering that
suffering is part of the shared human condition, we are able to cope with life’s struggles with greater ease. We create a loving, connected, and balanced state of mind and heart that helps to reduce psychopathology while
simultaneously enhancing joy and meaning in life.
I am determined to get rid of the depression that has hobbled me for so long. Perhaps practising self-compassion will help me do that, perhaps not. In which case I’ll keep looking, keep experimenting. Let’s see what works.