CBT for Depression, Despair, Hopelessness


Depressive Thinking Drives Shame and Despair

Studies show that how a person thinks can deepen and prolong depression or speed recovery. When depressed, a person views him or herself as hopelessly flawed, the world as harsh and unforgiving, the future as relentless and bleak. This “depressive thinking” reflects an extreme negative bias in how beliefs are formed. It is unlikely that a person is ever “all bad,” “utterly incompetent” or will “never again” feel meaning and enjoyment. Yet, when one is depressed such final judgments are held as absolute truths.

Cognitive Strategies Help Reduce and Control Depressive Thinking

Mindfulness the practice of suspending judgments and focusing on the present moment, is used to help disengage from the grip of depressive thinking. Cognitive restructuring is used to replace depressive thoughts with more reasonable, balanced alternatives that support a range of healthy feelings and actions.

Avoidance & Withdrawal Limit Opportunities for Enjoyment and Success

Behaviorally, depression is characterized by inaction, what the person is not doing. When depressed, the person is not practicing skills and taking risks needed to gain enjoyment and meaning in life, such as facing challenges, developing social networks and working toward goals.

Behavioral Activation Promotes Recovery

Cognitive behavior therapy fights depressive inaction by promoting engagement in key life areas. Behavioral activation promotes opportunities for:

  1. practicing coping skills, like cognitive restructuring and mindfulness,
  2. addressing fear-related avoidance
  3. obtaining enjoyment and success

The therapist provides a great deal of coaching and support to help the person overcome depressive inertia. Structuring may be used to improve goal directedness, relationship effectiveness helps build confidence in relationships, and exposure helps reduce anxiety-related procrastination and withdrawal.

Acceptance & Mindfulness

In CBT you’ll be coached in accepting and adapting  to fixed, unwanted realities you can’t change—like your personal history, temperament, certain emotional discomfort, —and taking action where you can: like how you handle challenges and hardships, make the most of existing and future opportunities, and participate in shaping your life. Mindfulness is an acceptance skill that helps 1) respond to yourself with empathy and compassion,  2) observe yourself more clearly, 3) step back from and no longer be driven by distressing emotional patterns—like obsessive worry and rumination, compulsive urges, spikes of panic and rage.