In life, feeling sad from time to time is a totally normal experience. When we experience loss, we feel sad and grieve – whether it’s a loss of a loved one, a relationship, or an opportunity (like not getting a job that you wanted).

However, when sadness turns into prolonged episodes of depression, that is when we need to turn our attention to treating this issue. In order to treat depression, we need to understand what maintains it.

This post talks about ‘perpetuating factors’ of depression. That is, what maintains low mood?

For this post, I take a CBT (cognitive behavioural) lens because I find that this approach is one that is very actionable. We can use this information and apply it to our everyday life to improve how we feel.

Loss of reinforcing activities

When we are depressed and unmotivated, we stop doing a lot of the activities that gave us the good feelings: joy, mastery, social connectedness, and meaning.

Although this makes sense because we feel so tired and low, the problem is that the lack of enjoyable activities in our lives keep the depression going. Therefore, adding back these activities is important key to getting out of depression trap, and back on track.

In fact, this premise is what led tothe development of behavioural activation – an effective and researched backed treatment of depression. Behavioural activation is about slowly and gradually adding these activities back into a person’s life.

Emotional reasoning

The reason why we stop doing things that give us joy and meaning when we are depressed is because of something called ‘emotional reasoning’ (also known as ‘following a feeling’). 

Our behaviours often tend to follow how we feel. For example, if I feel like being social, I might call up a friend to hang out. If I don’t feel like cooking, I might order something on UberEats.

This strategy of following a feeling is not necessarily a bad one. However, when we are depressed, following our feelings can be tricky. This is because we often feel like staying at home lying in our bed doing nothing when we are depressed. Again, this can create a vicious cycle of feeling even crappier because we do what the depression tells us to do. Nothing.  

To flip this pattern on its head, we need to realize that how we behave can go before how we feel. For example, taking a walk even when you are tired can make you feel a little better afterwards.

Think of our body (and mood) as a generator – sometimes you have to give a little to get a little.

Attentional biases

When we are depressed, our attention tends to focus on possible threats in our environment. We are more attuned to the crappy things in our lives, and less focused on the positive side.

This can maintain our low mood because we are basically looking at life through a depressive lens. Because of this, we either ignore or discount positive or neutral information, and focus primarily on the negatives. For example, a person may punish themselves for forgetting to buy detergent even though they did all their other chores for the day.

When we focus on just the negatives, we are less flexible in the way that we think and behave.

Therefore, it is helpful to actively train our attention. Give our attention a chance to focus outside the negatives. Let the other inner voices speak besides the one that says: ‘you suck.’ It doesn’t mean focusing just on the positives. It just means noticing when we are focusing on just the negatives.

Negative core beliefs

In depression, there are often negative beliefs about ourselves, other people, the world, and the future.

A person with depression may have a deep belief that they are inherently worthless, unloveable, or ineffective. That is, they aren’t worth anything, nobody likes them, and they can’t do anything to change their situation.

These core beliefs usually get activated in different situations. For example, failing an exam might activate a belief of worthlessness. Another example is a friend not calling back leading to thoughts that other people don’t care about them.

It is important to challenge these thoughts and beliefs because they are huge culprits of continued low mood. If we constantly feel like a failure anytime we have a setback, we would never get anywhere.

The use of thought records can be a good way to deal with these type of negative thought patterns when they pop up.

Rumination and repetitive negative thinking

Ruminating is a type of repetitive negative thinking that is very common in depression. It is usually past-focused. For example, ruminating about past failures or things that have not gone right. Other examples include:

  • “Why did this happen to me?”
  • “Why can’t I do anything right?”
  • “Other people are doing so much better”
  • “I hate my life”
  • “Nobody cares about me”

Unsurprisingly, constantly ruminating about negative stuff maintains low mood. Lots of folks with depression find themselves ruminating in the dead of night, feeling hopeless and in despair.

One effective way to reduce rumination is through mindfulness. Mindfulness practice helps us stay in the present and notice when our minds are elsewhere. This helps us bring our focus back into the present moment in a non-judgmental manner.


Here’s a post on how to practice mindfulness in our daily lives.

Lack of hope and self-efficacy

One final factor that keeps low mood going that I will discuss is a lack of hope. Folks with depression feel like things will never get better. That they have no control over their situation. And this can sometimes create a self-fulfilling prophecy. After all, why would we do anything if we don’t think anything will change?

I encourage you to start small and build from there. The use of SMART goals for depression can be helpful way to slowly and gradually do things that make us just a little bit better. This can make us feel more effective in our lives, even if it is just making your bed or taking a small walk.

Certainly, it is a drop in the bucket. But with enough drops, we can fill the whole ocean.

Best wishes,

P

Photo by Christian Erfurt on Unsplash