Recently, almost everyone I’ve seen in clinic recently has reported feeling flat or low. It’s been a long winter, and here in the UK, we’ve spent most of it in lockdown. This means many of the things we would normally do to improve our mood have been impossible. We’ve also been more isolated than ever before. Given the circumstances, it makes sense that rates of depression and low mood would have increased.
Normally, at any one time, about 8 people out of 100 are suffering from depression. However, this is just the people who report it to their GP. Unfortunately, I suspect there are many more struggling who don’t realise they could or should seek help. If you’re unsure, see my recent post, Do I Have Depression?
CBT for Depression – What to Expect
The most important thing to know about depression is that it’s treatable. You will get better and there are lots of things you can do to improve your mood.
When someone comes to me with depression, we spend the first few sessions doing what’s called an assessment. This is a clinical term that basically means getting a good overview of what has brought you to therapy. It involves running through triggering events, past experiences, key problems and symptoms. This helps me understand the things causing emotional pain so I can support you in processing them during therapy.
Another thing we do is measure your mood using a self-assessment scale like the one available on the NHS website. We can then revisit and review this data at various points during treatment. When we’re feeling low, it’s normal to have a very negative outlook. Measuring your mood in this way makes it easier to recognise progress and see an improvement.
Boost Your Mood
The key principle of CBT for depression is that our thoughts impact how we feel and what we do. This means our thoughts play a critical role in maintaining a low mood. When we feel depressed, we often do less. This can make us feel guilty, self-critical or hopeless, all the things that exacerbate the situation and contribute to the downward spiral of depression.
When you’re low or depressed, you see everything through a negative lens. Talking things through from this perspective isn’t helpful. You need to lift your mood first, so we start by focusing on helping you do more mood-boosting activities. Normally, when we feel unwell, we rest until we’re better. This doesn’t work for depression. You need to do things so the feelings can follow.
This is so important, I’ve created a free Mood Builder to help you plan daily activities and rate your mood. I find what we write down gets done and tracking the impact of different activities will help you identify which ones work best for you.
At first, doing more enjoyable activities will be tough. You might feel weighed down, hopeless or like nothing is going to change. Having a therapist to support you can make a huge difference. Recording how you feel using the Mood Builder or a journal can also help you see improvements you might otherwise dismiss.
Challenge Negative Thinking
Later in therapy, we work on challenging negative thinking. We have thousands, possibly millions of thoughts every single day. Often, we don’t choose them, they are automatic or triggered by something we see or do or watch on TV. The bad news is lots of these automatic thoughts are unfair, biased and negative. We often make ourselves feel bad without even realising we’re doing it! With practise, we can learn a more balanced thinking style.
To ‘catch’ your automatic thoughts, you need to start paying attention to what is going through your mind. I believe we can all benefit from this kind of reflection. It helps us become more aware of what’s going on inside our heads. When we become more aware of our minds, we become more aware of our thoughts. This awareness gives us more control over how we respond and behave.
Examining thoughts in this way helps you reach a more balanced perspective that’s likely to be better for your wellbeing. Eventually, you’ll become more analytical of your thoughts and learn how to balance them out automatically.
This is one of the reasons I created the CBT Journal. As well as structured journaling sheets designed to bring awareness to the thoughts, feelings and behaviours that shape your daily life, it contains additional worksheets to help you alter negative thinking patterns.