As a therapist, my passion and purpose is found in supporting individuals struggling with depression and hopelessness.
Personally, I was impacted by depression as a pre-teen when a close family friend completed suicide the week before Christmas. The immediate feelings of grief, anger, and confusion as a suicide survivor were part of what carried me into my decision to pursue a career as a therapist.
Professionally, I began my journey of helping to treat patients struggling with depression through my work on a crisis team. Often, these patients were struggling to navigate a way out of the misery that they were experiencing as depression, loss, and sometimes overwhelming sadness. In the depths of their despair, we worked together as a team to find light in the shadows, hope for a future, and make change through what often felt like hard work. During my work in supporting patients to overcome depression, a topic for discussion is often the “depression spiral.”
What is a depression spiral?
The concept of a “Depression Spiral” has been conceptualized through the work of Aaron Beck MD – the father of Cognitive Behavioral Therapy. Dr. Beck described this spiraling into depression in one book as a chain reaction often triggered by some feeling of loss or disappointment, writing “As the chain reaction progresses to a full-blown depression, his self-doubts and gloomy predictions expand into negative generalizations about himself, his world, and his future. Since the chain reaction is circular, the depression becomes progressively worse. The various symptoms – sadness, decreased physical activity, sleep disturbance – feed back into the psychological system.”
Many individuals describe this cycle as feeling that their thoughts are out of control. An initial negative thought about a specific trigger can spiral into larger negative beliefs regarding the individual’s capabilities or life choices. Some individuals are able to recognize the spiral happening and reflect that “I know that the thoughts don’t make sense but suddenly I am thinking about them.” This is part of what can create a feeling of hopelessness or guilt as an additional symptom of the depressive episode. As the depressive episode continues, these thought spirals seem to become easier to fall into and harder to find a way out of.
“Hope for a way out”
There is hope for a way out of the spiraling depression experience and overall depressive episode. After having worked with individuals experiencing severe depression for many years, I have seen the capacity of individuals to start finding “detours” or stopping points for these depressive spirals. Individuals are able to learn skills that help them to question these thoughts when they happen and identify alternative thoughts that can help to reduce the negative impact of continued depressive thoughts.
Dr. Beck describes this as “by helping the patient to recognize how he consistently distorts his experiences, the therapist may help to alleviate his self-criticalness and pessimism. When these key links in the chain are loosened, the inexorable cycle of depression is interrupted, and normal feelings and desires re-emerge.”
The simple phrase that I often teach patients is to “Catch It, Check It, and Change It.”
This process involves Catching the negative thoughts when the depressive spiral is beginning, Checking the negative thought through evaluating all of the evidence and facts of the situation/trigger, and then Changing the thought as applicable to a thought that is more reasonable in regards to the individual/situation. This doesn’t mean that negative events go away or are ignored. It means that the individual is able to look at the event through a clearer lens that is not distorted by depressive spirals.
Through taking the time to evaluate negative thoughts or patterns, individuals can begin to see that these thoughts do not have to have power or influence in their lives. Individuals are able to begin arguing with these thoughts and thus are able to find hope for seeing themselves differently in the future.
How can therapy help?
Many individuals find that having a therapist can be very helpful in starting this process and developing these habits. A therapist is able to use reflective listening and gentle questioning to help individuals to begin gaining insight into depressive spirals and start the process of testing these thoughts for validity. As an objective observer to the thought spirals, the therapist can provide a mirror through which the individual is able to verbalize and analyze the thoughts that are contributing to feelings of depression and negative inner dialogue.
As the individual becomes more adept at noticing the negative thoughts when they occur and questioning them appropriately, they may begin to feel more empowered to change these thoughts in the moment and stop the thoughts from spiraling.
All that being said, it’s important to remember there is an ability to overcome depression and find long-term wellbeing.
As you find hope in possibly beginning this journey, I leave you with a final thought from Drs Ellis and Thomas: “The human spirit can overcome adversity; hope is the fuel that makes the spirit burn brightly. This is not false hope, mind you, but hope that is rooted in taking a stand, having a plan, and actively moving forward in spite of adversity.”