Cognitive behavioral therapy

Cognitive behavioral therapy (CBT)

CBT can help you out-think negative patterns that may be keeping you from depression recovery — and from enjoying life.


  Negative thinking can slow depression recovery, and the reason is obvious: If you think negative thoughts, you’re more likely to stay depressed. But what’s less obvious is the way people with depression deal with positive emotions. Researchers have made a surprising observation: People with depression don’t lack positive emotions, they just don’t allow themselves to feel them.

This cognitive style is called “dampening,” says Chloe Carmichael, PhD, a clinical psychologist in New York. It involves suppressing positive emotions with thoughts such as, “I don’t deserve to be this happy” or “This good feeling won’t last.” For example, a new mother with postpartum depression might tell herself she doesn’t deserve to recover because she’s a bad mother for being depressed in the first place, Dr. Carmichael says.

Why do people with depression think this way? Carmichael refers to that negative voice as defensive pessimism — protection against getting high hopes dashed. “You don’t want to be the fool, so you resort to dampening positive thoughts to protect yourself from potential disappointment,” she says.

How CBT Can Help With the Negative Thoughts of Depression

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Cognitive behavioral therapy (CBT) has been found to help significantly with depression treatment. In CBT, you and your therapist work together to agree on patterns of behavior that need to be changed. The goal is to recalibrate the part of your brain that’s keeping such a tight hold on happy thoughts.

“An unexpected reaction to a major life event might be at the root of the dampening effect,” Carmichael says. “Through CBT, you and your therapist address it and work toward putting it into perspective.”

Regular CBT sessions and work you do on your own outside of therapy can help reinforce the new patterns, “To be able to recognize those negative thoughts and leave them behind can be very liberating,” Carmichael says.

5 CBT Techniques to Counteract the Negative Thinking of Depression

Carmichael has found that people with depression rarely respond well to self-study. For this reason, she recommends committing to CBT for at least six weeks. Your therapist will teach you CBT strategies that can help counteract the negative thinking associated with depression. She or he can also help you stay on track with practicing the techniques. Here are five CBT strategies you might end up working on with your therapist:

1. Locate the problem and brainstorm solutions. Journaling and talking with your therapist can help you discover the root of your depression. Once you have an idea, write down in a simple sentence exactly what’s bothering you and think of ways to improve the problem. A hallmark of depression, Carmichael says, is hopelessness — a disbelief that things can ever get better. Writing down a list of things you can do to improve a situation can help ease depressive feelings. For example, if you’re battling loneliness, action steps to try might include joining a local club based on your interests or signing up for online dating.

2. Write self-statements to counteract negative thoughts. After locating the root problems of your depression, think of the negative thoughts you use to dampen positive ones. Write a self-statement to counteract each negative thought. Remember your self-statements and repeat them back to yourself when you notice the little voice in your head creeping in to snuff out a positive thought. In time, you’ll create new associations, replacing the negative thoughts with positive ones.

Carmichael says that the self-statement shouldn’t be too far from the negative thought, or the mind might not accept it. For example, if the negative thought is, “I’m so depressed right now,” rather than saying, “I’m feeling really happy now,” a better statement might be, “Every life has ups and downs, and mine does, too.” The message tells you that it’s okay to bump up the degree of happiness you experience. At the same time, your mind applauds itself for keeping joy in check to protect from disappointment. “It’s okay to recognize that part of you that’s trying to do something healthy,” she says.

Sometimes self-statements become too routine and need to be refreshed, Carmichael says. She recommends to translate your self-statements into other languages that you might speak, or rephrase them, possibly even bumping up their joyful feelings a bit. “For example, the self-statement “It’s okay to explore my ups” might become “It’s okay to have a super ‘up’ day.”

3. Find new opportunities to think positive thoughts.

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People who enter a room and immediately think, “I hate that wall color,” might instead train themselves to locate five things in the room that they feel positively about as quickly as possible. Set your phone to remind you three times a day to reframe your thoughts into something positive. Carmichael recommends “buddying up” with someone else working on the same technique. That way, you and your buddy can get excited over having positive thoughts and experiences to share with each other throughout the day.

4. Finish each day by visualizing its best parts.

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At the end of each day, write down or type into an online journal the things in your life you’re most thankful for. Recording positive thoughts, and even sharing those thoughts online, can help you form new associations in your mind or create new pathways, Carmichael says. Someone who’s created a new pathway of thinking might go from waking up in the morning thinking, “Ugh, another workday” to “What a beautiful day it is.”

5. Learn to accept disappointment as a normal part of life.

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Disappointing situations are a part of life, and your response can affect how quickly you can move forward. Someone going through a breakup might blame him or herself or even gain weight, thinking, “What’s the point in looking good? I’ll never meet anyone else.” A better approach might be to allow yourself to feel disappointed and remember that some things are out of your control. Work on what is within your control: Write down what happened, what you learned from the experience, and what you can do differently next time, watching out for overly negative thoughts. This can help you move on and feel better about your future.