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Depression Treatment

Depression isn’t an inevitable consequence of unpleasant events

Cannot be explained as a disease

Is not caused by hormones, or brain chemicals

Although one or more of these may figure in depression, depression is much more than any one of them alone. Let’s look at the psychological component of depression – the way you think, and how the study of this has led to some of the most effective treatment for depression.

Shared thinking styles

Depressed people everywhere think in remarkably similar ways. Understanding what these thinking styles are and why they form a pattern, is a major key to beating depression for good.

Depression, to be ongoing, has to be maintained. Otherwise, depression will simply evaporate over time. This maintenance is performed by thinking styles that encourage any introspection to be emotionally arousing.

What’s the difference between depression and prolonged sadness? (Not a chemical imbalance!)

It’s natural to feel sad for a while when something sad happens. When this happens, we may find our energy levels drop and we become more insular to allow us to adjust to our changed life. This is what grief is for.

The chemical imbalance often cited as the cause of depression is just as often present in someone who is grieving.

The key differences between grieving and depression can be said to be:

  • The person not suffering from depression can “see beyond” the sadness. Even if they haven’t formed the thought, unconsciously they know that the sadness will lift. Depression often makes the sufferer think that ‘things will always be this way’.
  • The sadness, or depression, will only affect specific things, even if it is “always there” for some time. Although the mood may be constant, it doesn’t “colour” everything.

So it’s not the event itself that is sad, not life in general. And even if this thought or feeling arises, it is only temporary.

Depressive thinking leads to depression leads to depressive thinking again and leads to…

As I explain these thinking styles you will see how each helps to maintain depression, by altering how we perceive reality. It’s these thinking styles that make it so hard to see an end to the depression, as they limit our possibilities of thought. Once these patterns take hold, the emotional arousal they cause begins to affect us physically. If you are thinking now “Yes, but you don’t know my life” – remember: there is nothing so awful that you can imagine that someone somewhere hasn’t survived without becoming depressed. It’s not your fault if you are depressed, but there are concrete, effective things you can do about it. One of the things depression needs in order to survive is  “negative spin”…

“Nothing is good or bad but thinking makes it so.” William Shakespeare

To understand clinical depression, it is essential to understand that people don’t reflect reality (events, other people’s comments etc.) so much as interpret it. The same event can have completely different meanings to different people, even if their circumstances are the same. Depression is partly maintained by how we interpret reality. The ‘spin’ we put on things. Knowledge about how this happens can turn lives around. The cycle of depression gives rise to too many negative, emotionally arousing introspections which leads to over-dreaming, which leads to exhaustion and depression.

So, to recap, events don’t have any intrinsic ‘meaning’ until human beings add it.

Say a tree falls over in the forest, and no-one is there. It has no meaning whatsoever. Then along comes a walker, looks at the tree and thinks, “What a shame, such a beautiful old tree blown down in a moment.” Meaning=sad! At the same time a nearby householder looks out of his window and thinks, “What a piece of luck! That tree has blown down and the view is absolutely fantastic now.” Meaning=happy!

A local beetle considers it great luck because he and his family now have somewhere to live for the next 29 generations! Meaning=happy! So the meaning you attach to things is extremely important in determining how you feel.

Depression can turn good things into bad by applying a meaning that harms us. For example, if I phone someone and leave a message and they don’t get back to me I can tell myself this may be because:

  • ‘Maybe they are away’
  • ‘Perhaps they haven’t picked up their messages’
  • ‘Their machine isn’t working or they phoned back when I was out’
  • Or: ‘They didn’t phone back because they don’t want to talk to me because they don’t like me!’

Any of these reasons could be true, but depression will tend to make you choose 4), or a similarly depressing explanation. Depressed people often doubt themselves in all kinds of ways, but seldom in their judgment about their own interpretations of things. A common trait displayed by those suffering from clinical depression is not being able to tolerate uncertainty – having to assign a meaning quickly to everything that happens. The depression will take care of “filling in the gaps” in an explanation of events. High levels of emotional arousal will tend to make you assign meaning to things very quickly, as these levels of arousal are usually reserved for life-threatening situations.

Relax a little, relax a lot!

Tolerating uncertainty is a prime emotional skill. Established negative thinking patterns can mean that we lose this skill. One way to break out of the arousal-meaning loop is to relax your body and mind, and do it on a regular basis, at least while first dealing with depression. But the vital point here is that tolerating uncertainty is a skill, and as such, toleration can be learned.

When children are taught in schools about generating multiple possible meanings for why things happened (some of which don’t reflect badly on them) then they are less likely to depress as adults. They literally become more flexible in their thinking. This early teaching of emotional skills has been termed ‘inoculation for depression’. The more possible explanations you can generate, and the more effort you put into doing that, the harder it will be to assign an immediate and definite meaning to an event, and the less likely you are to experience a negative emotional reaction.

Depression literally distorts our perception so that ‘good becomes bad and bad becomes disaster.’ It’s clear that if we only have limited interpretations for why things happen, then change can seem difficult. Depression acts like a vicious circle because the more depressed we feel the more likely we are to frame events/ourselves/others in a negative light. The more we frame things negatively the more depressed we will feel. However, this doesn’t mean that the answer is only ‘positive thinking’! We need to look at ways at being more realistic, while at the same time breaking the vicious circle…

Your Sense of Control

Before moving on to how to break the cycle of depression, a little more on how your sense of control affects depression.

It is common for depressed people to feel helpless, with little control over things. Alternatively, feeling that everything relies on them.

This extreme perception of control, either too much or too little, helps maintain depression in the following way.

  • Too little control – the person stops doing things that could improve their situation, perhaps ceasing activities they used to enjoy.
  • Too much control – person tried to control things they can’t and may become angry or anxious when they realize things aren’t happening the way they wanted. They may also take responsibility for things outside their control. This adds to the emotional arousal that maintains depression.

‘Learned helplessness’, or feeling trapped

A common feeling that accompanies depression is that of being trapped in an intolerable situation. The depressed person can often see two alternatives, neither of which is possible, and without change the existing situation is too painful.

Depression causes this illusion

All too often, this feeling leads to suicide as the depressed person feels that their situation is insoluble by themselves or others.

In almost every situation, there is (at least one) acceptable alternative. Sadly, depression rarely lets people see it. This is why help from a correctly trained professional can be invaluable. They will be aware of the common thought patterns you may be experiencing, and have experience in helping you break out of them.

A nasty rat experiment

Rats, like people, can be ‘trained’ to feel and behave helplessly.

In one famous experiment, rats were held down in ice-cold water until they stopped struggling. This taught them, through experience, that effort was futile and that nothing they did made any difference.

Then, two groups of rats, the second being a group which had not undergone this experience, were left in cold water without being held.

The group which had previously been held began to drown, on average, much, much sooner than the second group of rats that had not been held down.

Some of the second group, which had not been held immobile, actually managed to escape!

Our depressive rats were behaving as if they were still helpless even when they were not.

This experiment has been repeated in many ways, some on humans.

THROUGH experience, you can think, feel and behave as if you are helpless in a situation, when in fact you are not. The very nature of this often means that you cannot find your own way out, and need outside help to do so.

Learned helplessness in everyday life

So how does this happen in everyday life? Well, perhaps after several bad relationships, you may get the feeling that ‘no matter what I do I’ll never be in the right relationship’.

Or someone whose parents divorce may develop the feeling that ‘I’ll always lose any people I become attached to!’ Being abused by a partner may lead you to imagine that you have no control in relationships generally.

Learned helplessness is exactly that – learned. Life experiences can cause ‘learned helplessness’ – by reducing your feeling of control as well as your available options in a situation, it can further add to the depression.

But because it is learned, this means we can learn to challenge it. New skills can break this pattern.

We can then increase our number of total available responses in a given situation, and so increase our feeling of control.

Control: if not on the outside, then on the inside

Remarkably, people can have very little external control but not become depressed because they feel they have some kind of internal control.

Some research done on survivors of imprisonment, and torture, in South American regimes has shown some incredible results.

It would be fair to say that these people had almost no control over their situation. Yet, in psychological terms, startling differences were found in the effects on the survivors.

The ones who were least traumatized and who had not become depressed during or after their captivity were the ones who had maintained a feeling of control even during torture.

When questioned they reported that they did this, for example, by screaming after counting to ten in their head before doing so. Or that they knew they would give information but would only give it at a certain time of day. They had little outside control but still maintained an internal sense of control.

It is this sense of control, which is so important. We may find ourselves in a situation where we have little control – such as waiting for the result of a medical examination, or waiting to learn whether someone still wants to be our lover. What can we do?

The only control we have during these situations has to be internal. By exercising control over different aspects, such as how or when we will react, we can retain a sense of control. (And control is a constant.)

We can learn to tolerate uncertainty and ‘be cool’ without knowing the result of something for a while, in the meantime managing our emotional response.

The illusion of too much control

The other end of the spectrum from ‘Learned Helplessness’ is taking responsibility for things over which you actually have very little, or no control.

This, as you can well imagine, can lead to major problems!

On being a “Rain God”

Take the real-life example of a depressed woman who felt guilty over a picnic that she had organized being ruined by unexpected rain.

hypnotherapy for depression cornwall waves rainbow on beach

The depressed woman somehow blamed herself for the fact that the picnic had been rained out, despite the following facts:

  • The forecast had said it would be fine.
  • Her friends had still appeared to have fun under a big tent in the field.

All this was filtered out by the depressive thinking styles she engaged in. She continued to see this event as evidence that she was a ‘walking disaster area’.

Depression can make us ignore evidence which ‘doesn’t fit’ with the depressive focus of mind.

All things to all people

Trying to be ‘all things to all people’ is a non-workable strategy. Nobody can exert so much control so that everyone likes them. We need to be aware of how much or little control we assume we have over different areas of our lives. It’s less depressive (and more realistic) to realise that in some situations you do have control but only up to a point. When a depressed person begins to generate alternative reasons for why things happen (or at least alternative possibilities) then the depression begins to lift. Depression requires a narrow, set focus to maintain itself, and these alternative reasons make that diminish.

‘All or Nothing’, or ‘Black and White’ Thinking and Depression

Most life events are not ‘completely disastrous’ or ‘absolutely wonderful’ but contain elements of both good and bad.

Depression makes people think in absolutes.

‘All or Nothing’, or ‘Black and White’ thinking is the thought pattern that allows us to generate a “flight or fight” response to danger.

It is still needed in the world today, but not many times a day in relation to non-life-threatening stress, as so often happens with depression.

Because ‘All or Nothing’ thinking is emotionally arousing, it causes over-dreaming and maintains depression.

hypnotherapy for depression Cornwall anxiety woman window

‘All or Nothing’ thinking is found in depressed people all over the World. This is because it is part of the most primitive of human responses which we know as The Fight or Flight Response.

When faced with a life-threatening situation, we must make a snap decision and act on it. There is no time for ‘maybe this’, or ‘maybe that’.

Either decision will create an emotional reaction to allow us to fight or flee to the maximum of our ability.

The importance of tolerating uncertainty when looking to overcome depression is the complete opposite of ‘All or Nothing’ thinking.

In a survival situation, there is no room for uncertainty, we simply have to decide to either run away or fight. Uncertainty causes hesitation, which would most probably increase our chances of being killed – and we are not going to hang around to find that out!

But these responses evolved for times that were much more physically threatening. These days they are rarely required, at least not to that extent and not most of the time.

Since ‘All or Nothing’ (‘Black or White’) thinking is another thinking style strongly linked with depression, learning not to always think in ‘black or white’ terms but to see shades of grey is immensely helpful in tackling depression. It greatly reduces, or stops the emotionally arousing thoughts that are necessary to maintain the depressed state.

The more we polarise our thinking the more likely we are to become depressed.  Because extreme either/or thinking stimulates the emotions much more.

Statements like “I’m a terrible person!” or “She’s perfect; she’s a saint!” or “I’m just a failure!” over-simplify life and cause massive emotional swings.

Few marriages, holidays or jobs were ‘complete disasters’ but had different elements within them.

From this, you would expect that people prone to depression also get much ‘higher’ when positively excited. And indeed this is true; research shows that people who suffer from depression often need less stimulation to get really ‘up’.

For a healthy emotional life, it’s not more extreme happiness we need, but balanced emotions.

It’s clear that people who experience extreme emotions (‘positive’ as well as ‘negative’) are much more prone to depression.

So, if you are ‘addicted’ to getting high levels of emotional stimulation from experiences, conversations, relationships and so on, it could be time you started doing with less.

For less depression, it’s not more happiness we need, it’s more calmness.

Spotting warning words

As an ongoing way of perceiving reality, ‘Black or White’ / ‘All or Nothing’ thinking is emotionally and physically damaging.

If you spot yourself using this style, challenge yourself to think differently. There are particular words that people often use when thinking in this way.

You can learn to spot them.


Of course, thinking and talking in an ‘All or Nothing’ / ‘Black or White’ way is much more emotionally exciting, and so may be difficult to give up. However, we all talk like this at times, particularly when excited or angry.

To look at how we can begin to incorporate the “grey”, take for example a child failing a maths exam.

They could say to themselves: ‘I’m just plain stupid!’ or they could say: ‘ I’m bad at maths but I’m pretty good at English’ (or sport, art, making people laugh or whatever it happens to be).

The first statement is Black or White while the second focuses on lots of different elements and is not indicative of depressive thinking.  The first statement, when spoken to themselves and others will strengthen this belief i.e. that they are stupid and bad at maths, rather than just having made a mistake during one exam.

We can all make inner statements about ourselves but that doesn’t make them true. Consider the following questions:

  • Can I be basically an intelligent person and still do something stupid?
  • Love my children and still get angry with them sometimes?
  • My partner does love me but sometimes can be insensitive?
  • Could one part of my life be difficult and other parts be easier and more enjoyable?
  • Part of my life may be difficult now but in the future can it get easier?
  • Some parts of an experience (such as a social engagement or holiday) can be awful but will other parts of it be OK?
  • Basically I’m an intelligent person but can I still do something stupid?
  • I love my children but can I still get angry with them sometimes?
  • My partner does love me but sometimes they can be insensitive?
  • Some parts of my life can be difficult but are other parts easier and more enjoyable?
  • Does part of my life feel difficult now but in the future will it get easier?

Becoming less rigid in our thinking allows us to avoid using ‘Black or White’ or ‘All or Nothing’ statements to depress ourselves without examining their validity. Using this ‘cognitive’ technique will literally allow you to spot what you are doing and therefore challenge its accuracy.

Remember: A major reason people depress is because of the way they perceive reality.

Once this begins to broaden, depression has little to cling on to and will start to lift. Depression often centres around one recurring belief, such as “I’m just not the sort of person other people like.”

So, if you can deliberately challenge this and come up with alternative evidence, you can begin to start to break down the depression.

An important note: trauma (PTSD) and depression

People who suffer from post traumatic stress disorder (PTSD) may find that they become depressed. The symptoms of PTSD are intrusive. Terrifying ‘flashbacks’ to the original trauma, which keep the brain in a high state of emotional arousal.

In this state, it is extremely difficult to think in a balanced way. Because as we have already seen, when emotionally aroused, the brain’s default mode of thinking is ‘all or nothing’. In addition, the thought that life will always be as difficult as it is when experiencing traumatic flashbacks is a depressing one in itself.

Happily, we can now stop flashbacks in a single hypnotherapy session using the ‘rewind’ technique. Often, removal of PTSD in depressed people is enough in itself to lift their depression.

Depression can be described as exhaustion brought about by a significantly stressful or emotional time. Excessive worrying and catastrophising, always imagining the worst, over-analysing, and inward-looking negative rumination all cause and maintain depression. Not to mention feeling demoralised.