Everyone we talked to engaged in a conversation with themselves in their minds. Even when very young, some people said they thought negatively about themselves, and saw it as the truth. It was certainly a feature of depressive episodes that people talked very negatively to themselves. One young woman called this her internal ‘chatterbox’.
Describes how when she is depressed her thinking focuses on the negative rather than the positive.
Negative thinking can have so much power over people that they find it difficult to see such thinking as a distortion of reality, unless it was somehow pointed out. Indeed, people could slip into the negative thinking states of depression without realising it. As people began to recover from depression, they could better glimpse their distorted thinking.
Describes how his thinking was negative early on in life, but he only became aware of it when…
As part of recovering from depression, people attempt to better ‘manage their minds’. One popular approach to ‘managing the mind’ among participants is cognitive behavioural therapy (CBT). CBT basically argues that it is our tendency to think negative thoughts that creates our unhappiness and distress, and that we can challenge these thoughts and so feel better. In recent years there have been major investments by the Department of Health in getting new professionals to offer CBT much more widely than before.
It is important to say that just as with meditation, CBT is not for everyone, and doing CBT is very difficult in the depths of depression. One man in his thirties sometimes felt more like ‘giving in’ to the negative thoughts in the depths of depression, and it was a real struggle to gain ground over them. Antidepressant medication could help to lift the mood and make it easier to get control of the thoughts. Supervision by a health professional is important as there can be a danger that when people get their motivation back through medication before their thinking becomes more realistic, it can increase suicidal thinking.
Describes the varying success he has had with trying to defeat the negative voice in his head…
Explains how he became suicidal while on antidepressant medication. (Played by an actor)
Interestingly, people frequently picked up or developed their own techniques for challenging negative thoughts, even if they had never had CBT. For instance, one man had so much experience of depressive episodes, that by the age of 75 he had become very skilled at putting a positive spin on being depressed. Some described developing a much more useful voice in their heads over time. A woman in her twenties suggested life experience partly helped her to become more positive. Clearly, people who could challenge distressing thoughts felt better for it.
Explains how he considers depression a sign he is going to get better.
Growing experience of depression and life has helped her to develop a more positive view of herself.
There are a variety of ways to challenge negative thoughts. All methods involve first noticing the negative thought, and then doing something about it. For instance, in noticing his state of mind, one man found that his mind would race ahead into confusing and distressing territory when depressed.
Describes noticing how depression for him meant a racing and negative mind. (Played by an actor)
In trying to do something about it, a very simple technique a woman used involved just repeating the word ‘Stop!’ to herself when noticing a negative thought. Another approach involves seeing the negative voice as separate from the self, and looking for the humour in it, such as one man who characterised his negative voice as like a ‘slightly cantankerous family member.’
People who had had therapy could become very skilled in their approach. Interview DP06 became aware that she could examine a social scene in order to challenge her initial negative thoughts that she was to blame for someone else’s behaviour. Another woman was able to challenge the powerful feeling that she was a bad person and responsible for conflicts around her. One man was able to see the split in his thinking as ‘rational’ and ‘neurotic’.