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Depression Primer

Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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How Our Thinking Affects Our Feelings

Allan N. Schwartz, LCSW, Ph.D. Updated: Apr 26th 2006

One of the interesting things to note about depression is how quickly people can talk themselves into feeling awful. During the many years I have been a mental health practitioner I have been consulted by people suffering from feelings of depression. In many of these cases there were long family histories of various types of depression ranging from mild to extremely serious and suicidal. In some cases there were histories of having been abused by parents who were mentally ill, alcoholic or addicted to mind altering drugs. In other cases, people grew up in single parent homes as a result of either parental divorce or death. Yet, in some cases there was no apparent reason for depression. These people had grown up in healthy and happy homes and could remember nothing disruptive having happened during their childhood. Why were these people feeling depressed?

Let's look for the answer by examining a fictional or hypothetical case. For example, let's say that a young man, we will call him Bob, enters my office seeking therapy because he has recently been upset and worried about his life. He is physically healthy, athletic and has a girl friend he loves and with whom he lives. He describes a happy childhood and an intact family comprising mother, father, a brother and sister. He does acknowledge that he has a tendency to feel anxious and somewhat shy but not enough that it prevents him from living his life, at least, not until recently. Bob is a college graduate, handsome and quite pleasant. His parents have good jobs and a happy marriage that has been long lasting. He remains in touch with both his parents and siblings.

Bob is a recent college graduate with a bachelor's degree in business. When he was living at home, after graduation, he made an acquaintance that liked him and offered him a managerial position in his store. Our young patient accepted the job and was working successfully. However, he and his girl friend decided that they wanted to live together and move away from their respective families to foster a greater degree of independence. They were both attracted to the south western part of the United States where there was a greater emphasis on outdoor life and athletics. So, he gave up his job, moved with his girlfriend and established a home out west. He now had to find a job.

For Bob, this was the first time he had to search for work and go through the interviewing process. With great enthusiasm, optimism and confidence, despite his anxiety, he goes through his first interview on his job search. Our young man is shocked and dismayed when he learns, a week later, that he was not being offered the job. Suddenly, the world has changed for him. His confidence is gone and his anxiety is greatly increased. He stops exercising, sleeps late every day and does not want to get out of bed. His girl friend becomes concerned about his sad mood and urges him to see a therapist.

Why did our young man become depressed and how was therapy going to help him overcome his problems?

First, our young man, Bob, talked himself into depression. He entered his first interview with a set of naive beliefs based on his lack of experience. Having gotten his first job so easily, back home, he fully expected the same results now. When he was rejected for the job, he began telling himself that he was a total failure and would never find a job or be able to have a career and support a family. He convinced himself that he undermined himself during the interview because he felt so anxious. It never occurred to him that he was competing against others and that it takes time to find the right job.

Second, it was clear to the therapist that this was a case where cognitive-behavioral therapy with some education would be the best approach for this young man. Through the use of cognitive-behavioral therapy, Bob began to examine how unrealistic his thinking had been both before he started the job search and after the first rejection. He engaged in several types of thinking that cognitive-behavioral therapists have identified as problematic because they lead to bad feelings.

Bob's unrealistic styles of thinking:

1. All or nothing thinking: because he is a perfectionist, Bob convinced himself that he was a total failure just because he was unable to get the first job he ever applied for.

2. Overgeneralization: from his one unsuccessful interview, Bob was certain he would be rejected at all interviews.

3. Should statements: Bob was convinced that he "should" have interviewed better and that he "should" have presented himself better. These "should statements" caused Bob to feel increased frustration and guilt over the first interview.

By learning how to examine his unrealistic styles of thinking, including his need to be perfect, Bob was able to learn how to modify his thinking to me more realistic. In that way, he started to learn how to help himself feel better and avoid or minimize anger, frustration, guilt and depression. Ultimately, Bob was able to interview successfully and get the management job he desired.

I want to recommend an excellent self-help book on cognitive-behavioral therapy. It is written by David Burns, M.D. and is entitled, The Feeling Good Handbook. In this book, Dr. Burns clearly explains the main principles of this type of therapy and how the reader can apply them to their own lives. The many exercises in the manual are excellent and extremely helpful.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    tricking the beast is not so easy - ratking - Feb 14th 2009

    When I finally "woke up" after an 11 years' depression and wanted to requme my career as a translator, I discovered I was a has-been. Before my illness, I had translated 14 books and work had been easy to find. I thus felt and still feel the same thing as your character and not to let the beast (depression) overcome me I have devised my own behavioural strategies : I practice foreign languages,follow an English course and write a book. But something keeps me from sending résumés because I know I'll be rejected. And it's too hard !

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