Depression
What is Depression?
Depression is a concern that many people experience. So much so that it can be tempting to downplay how serious it is. Depression symptoms include feelings of sadness that won’t go away and a loss of interest in activities that used to bring delight. If you are experiencing depression, you may notice physical symptoms of depression, including changes in sleep (more or less), appetite (more or less), relationships, and your ability to focus.
Perhaps you are feeling like you are somehow “less than” for experiencing these things. Maybe you think, “I should be smart enough to figure this out,” but white-knuckling your way to better hasn’t parted the gray clouds. It may help to think of depression as a medical condition like any other. You may get better on your own, but professional attention often helps.
Negative thoughts tell you the glass is half empty—and always ready to tip into your lap.
Depression & Negative Thought Patterns
When clients come to me complaining of ongoing depression, I want to know about their feelings and their thoughts. Particularly, I am interested in their self-talk, especially if it touches one or more of three major areas.
Self
Negative thoughts about yourself are harsher than you would say to a Disney villain.
“I will never amount to anything. Why try?” Or, “I know why I wasn’t invited. It’s about me.”
Future
Negative thoughts involve fortune-telling, but with a dark crystal ball perspective.
“This emotional pain I am feeling is here to stay. All that’s ahead is a gloomy corridor of sadness.”
World
Negative thoughts tell you the glass is half empty—and always ready to tip into your lap.
“I won’t get the job. Things just don’t work out for me. The deck is stacked. It’s too scary to even try.”
Restructuring Thoughts
As a therapist engaging in treatment for depression, I am always scanning for these thoughts. When I hear them, I approach that part of the person with care and genuine curiosity.
“Now that is a powerful statement,” I might say. “I wonder where that thought came from.” I am not quick to refute it. I just want to know more. What event triggered it? Where does that thought lead? How fast does their brain cycle through these well-rehearsed negative thoughts? What do they feel? Can they feel it in the moment?
I also want to know how much truth they think is in the thought. Is the thought helpful? What are some other ways we can make sense of the event they experienced?
Get Moving
When we feel depressed, we tend to isolate. Our brains may tell us that sitting on the couch scrolling on our devices will make us feel better. But that seldom works.
There is a phrase in cognitive-behavioral therapy (CBT) that says, “Action precedes motivation.” Sometimes we need to get moving, regardless of what our brains or emotions are telling us. One therapist I know encourages clients to “Do it like a robot.” That means telling your legs to start moving even if your brain is yelling, “No! It’s too hard! Let’s wait until we feel like doing it.”
I work with clients to make a plan for small victories they can get credit for. Because action begets action, and inaction and withdrawal create more of the same. Deep down, you know it’s true. If you treated yourself three times this month by buying a caramel crafted press (your favorite!) at Caribou Coffee, you may be more likely to get it again than brew your own cup at home.
My absolute favorite for clients to reduce emotional distress is selecting an activity that gets them out of the house and connects them with someone else. This way, they get a chance for a one-two punch of activity and relationship-building.
But don’t worry—we start slow, taking into account your daily activities and what feels within reach. Imagine a client used to enjoy hiking. Well, what about that was enjoyable? Did they feel like they had accomplished something good? Is it possible to do it with friends?
Antidepressants
In many cases, clients who work with a doctor to determine an appropriate antidepressant medication report encouraging results. They see the best outcomes with a two-pronged approach:
Antidepressants help balance out chemical imbalances in the brain. A playing field that isn’t level is even less fair if it’s in the brain.
Interventions in therapy help clients reset and retrain their brain to think and behave in more helpful ways.
Medical Conditions
It’s always a good idea to talk with a doctor to explore whether a biological or medical condition might be contributing to depression. Don’t be shy about describing any of the following that can affect mood:
Ongoing illness
Recurring pain
Hormone fluctuations
Plus, be sure to inform your doctor (and me) about:
Thyroid issues
Pregnancy and childbirth (to evaluate for Postpartum Depression)
Head injuries (even if they were a long time ago)
Alcohol or substance use
Don’t spare the details. Your health professional will also want to know about:
The duration of your depressive symptoms
When your symptoms are more poignant (such as during long Minnesota winters)
Relationship Issues
What if your emotional distress is linked to a relationship, particularly a romantic one? As a therapist, I specialize in Emotionally Focused Therapy (EFT), an empirically validated approach to strengthen emotional bonds. If you are noticing that the distress in your life seems to bubble up from a sense of discord in your relationship, I would love to work with both of you. Together, we focus on addressing attachment issues that may be fueling depressive symptoms. Moving from feeling isolated to feeling cared for and seen in your relationship can profoundly impact your heart, regardless of whether you are having a good or bad day.
You Are Not Alone
Whether your depression stems from negative self-talk, relationship struggles, or life stressors, you don’t have to face it alone. Therapy provides a safe space to explore your thoughts, challenge unhelpful patterns, and take small but meaningful steps toward recovery. Tiny steps can make a significant difference. If you don’t feel like you have the energy to take the first step, that’s okay too. They’ll work to help you find strength you didn’t know you had and a hope that helps light the way forward.
