Depression Treatment: Talking Back to Depression

John Folk-Williams Health Guide
  • In an earlier post, I described one of my first steps in recovery: writing out an inventory of each symptom of depression I experienced. Until I did that, every time depression hit I felt helpless before a huge overwhelming force. Once I wrote down the details of exactly what I experienced, though, this massive thing suddenly seemed a little more manageable.

    After that step, I needed to come up with a strategy to deal with each of those symptoms. Which one should I start with?

    In my case, there wasn’t much doubt about that. Self-esteem had flat-lined long ago, and a poisonous inner critic worked overtime to keep it from reviving. The phrase “loss of self-esteem” just sits on the page, but for me that meant nonstop torture, an endless monologue delivered by this vicious inner voice.

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    That was the first symptom I experienced way back in boyhood, even before full-blown depression arrived. From an early age, I accepted as true everything that voice told me: you’re bad, worthless, stupid - generally a rotten specimen of humanity. That inner belief set me up for decades of depression.

    It was clear that I had to take on that symptom first. Unless I could stop the trash talk, I couldn’t begin to deal with anything else.

    For a while, I tried the method of repeating positive statements - affirmations of my worth as a person. I listed out all the things I could do well, praise I’d heard from friends, all the gifts of love and family in my life. Whenever a negative thought came up, I tried to blank it out by thinking of something good.

    But this approach never worked because it felt so mechanical. The good things in my life were all there, but just repeating them didn’t help me confront the inner voice and try to refute all the bad beliefs. It just substituted happier thoughts for destructive ones.

    I needed to think in more realistic terms. After all, I really did make mistakes from time to time, disappointed people, failed to do a job well. Like anyone else’s life, mine had its ups and downs. There was no use pretending everything was rosy all the time. That wasn’t much different from thinking that everything was miserable all the time. Neither one can always be true.

    That’s where the methods of cognitive therapy came in. By focusing on the way my thoughts worked, this approach gave me a set of tools I could use to talk back to the inner voice. Staying with it required a strong personal commitment and patience. This therapy can lead to a new way of thinking, but it only gradually becomes a habit.

    To begin, I started with another list, this time an inventory of the negative statements I made about myself throughout the day, but I didn’t stop there. I also had to write about the specifics of each one. What exactly happened at that moment that led me to think I could never do anything right? Was I recalling a past incident or reacting to something I was doing just then?

    If I simply rehashed - and re-experienced - all the emotions and self-condemnation of that moment, I wouldn’t learn anything new. That might just trigger the same response all over again. So facts first - here’s a quick example.

  • I started with a description of the feelings in one incident: Someone in the office got angry at me because I screwed up a report. I couldn’t say a word to her because I was horrified. This was my worst nightmare - I was thinking: they’ve found me out! Now they know how bad I really am ... and so on.

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    Those aren’t the facts of the event itself. Those are my emotional reactions. This is what actually happened:

    I finished project X and wrote a report, then emailed it to person Y. Y read it and thought something was missing . She told me and asked me to add it to the report. I assumed she’d been angry, but, in looking at the facts, that may just have been my interpretation. I never asked what she was feeling, she didn’t raise her voice or look tense. And the incident wasn’t very important. Why was I - and this inner critic - making so much of it?

    The specifics of each incident gave me something to work with, but only if I could start with the facts and re-evaluate to see if my response had anything to do with reality.

    That’s a simple example and a small step in changing my thinking, but a lot of small steps keep you moving ahead. If I have a problem at the office like that again, I’m a little better equipped to focus on facts and not leap to universal condemnation of myself. That’s one less hammer blow for that inner voice of depression.

    The incident could be a lot worse - like my inner voice during a major bout of depression - but the technique is the same. The inner voice says:  Why can’t I stop it? Why am I so stupid and inadequate that I can’t deal with it? It will never end. I’ve got this for the rest of my life. ... and on and on.

    After it’s over I write down exactly what happened. When did this episode start? Was there a triggering event? What exactly were the symptoms? Did they all come on at once or was there a sequence? What did I first feel? How long did the episode last? When did it end? Did it stop after I did something or just by itself? On a scale of 1-10, how bad was this?

    Getting these facts straight gives me a little emotional distance. I can see more clearly what the inner critic is doing. Yes, I had this specific episode of a serious illness in this context with these symptoms. The voice, on the other hand, has no use for facts. It makes the same sweeping judgment all the time and tells me never to expect anything better.

    After a while, I could feel deep down that the voice didn’t make any sense, that it was wrong. My inner belief about myself really started to change, and that was a great turning point. That took a lot of years to accomplish - partly because I didn’t start using this method until late in life. Fortunately, it doesn’t always take that long. Everyone’s experience is different. Some people get results in a few months.

    Have you tried an approach like this to get at that inner voice? Or have you had a different method? It would be great if you could share your experience here.

Published On: December 26, 2009