Singing the Blues
Hello from Ho Chi Minh City, Vietnam. We just reached the month mark of working from home because of a new wave of Covid. It's not been easy. I live in a studio apartment and I rely heavily on restaurants for my meals. Stuck at home and forced to order in food all the time I've faced a hard road. Two weeks ago I spied depression for a bit and managed to fight it off, but this week it hit hard and I suffered for three days before I found a strategy that brought a cure. Luckily, in both instances, I found a coping technique that helped me overcome the mental anguish and returned me to a degree of normalcy. Today I want to discuss the two different strategies that helped me to escape the blues.
The first strategy that I employed two weeks ago involved a review of the lessons I had learned in therapy last year. I was working my way through some serious thinking, filling myself with thoughts of inadequacy and failure, figuring I wasn't capable of doing the things I needed to do when I had the thought to check my list of cognitive distortions, a list which I'll provide shortly.
Cognitive distortions are the things that our brains tell us that is inaccurate, untrue, and regularly hurtful to our wellbeing. Except for in a rare minority of clinical depressions, they are the cause for depression and by examining them and addressing them we can work our way through the funk to the other side.
Here is a list and descriptions of a baker's dozen of cognitive distortions:
1. Negative filtering (also known as “Disqualifying the positive”). This is when we focus on the negative, and filter out all positive aspects of a situation. For example, you get a good review at work with one critical comment, and the criticism becomes the focus, with the positive feedback fading or forgotten. You dismiss positives by explaining them away — for example, responding to a compliment with the thought, “They were just being nice.”
2. All-or-Nothing thinking (also known as “Black-and-White thinking”). Things are either all good or all bad, people are either perfect or failures, something new will either fix everything or be worthless. There is no middle ground; we place people and situations in “either/or” categories, with no shades of gray, or allowing for complexities. Watch out for absolute words like “always”, “never,” “totally,” etc. as indications of this kind of distortion.
3. Overgeneralization. We come to a general conclusion based on a single incident or a single piece of evidence. If something bad happens only once, you expect it to happen over and over again. Example: seeing one incident of rejection as part of a never-ending pattern of defeat and failure.
4. Mind reading. Without individuals saying so, we know what they are thinking and why they act the way they do. For example, you assume that somebody is having a critical thought about you, you don’t check this out, and this affects your actions and feelings towards them.
5. Fortune telling. We believe we know what the future holds, as if we have psychic powers. We make negative predictions, feeling convinced these are unavoidable facts. Examples of fortune telling: “I am going to fail,” “This situation will never change.”
6. Catastrophizing. This is a particularly extreme and painful form of fortune telling, where we project a situation into a disaster or the worst-case scenario. You might think catastrophizing helps you prepare and protect yourself, but it usually causes needless anxiety and worry.
7. Magnifying or Minimizing. We exaggerate the importance of some things (our mistakes, a critical reaction, somebody else’s achievements, things we haven’t done). Also, we inappropriately shrink the magnitude of other things (for example, our good qualities, compliments, what we have accomplished, or someone else’s imperfections).
8. Personalization. You see yourself as the cause of some negative event for which you are not primarily responsible, and you conclude that what happened was your fault or reflects your inadequacy. Personalization distorts other people’s reactions into a direct, personal response to you. For example, if somebody seems upset, you immediately assume it was because of something you said or did.
9. Comparisons. We compare ourselves to others, with ourselves coming out short. For example, “I’m not as smart (or good, competent, good-looking, lovable, etc.) as that other person.” Or, we compare ourselves to how we think we should be, or how we’ve been before. We might think that comparisons help motivate us, but they usually make us feel worse.
10. Shoulds. We have ironclad rules about the behaviors of ourselves and other people. For example, “I really should exercise. I shouldn’t be so lazy.” A more effective way to motivate ourselves is to identify positive results, rather than whipping ourselves with guilt. For example, “When I exercise, I feel better.” When we use “should statements” about other people (“He shouldn’t act that way!”), we often feel frustrated, angry, and resentful, since we can’t control others’ behaviors.
11. Emotional Reasoning. We take our emotions as evidence for the truth. Examples: “I feel inadequate, so there must be something wrong with me.” “I feel overwhelmed and hopeless, therefore the situation must be impossible to change or improve.” (Note that the latter can contribute to procrastination.) While suppressing or judging feelings can be unhelpful, it’s important to recognize the difference between feelings and facts.
12. Blaming. We blame ourselves for every problem, or hold other people entirely responsible for a negative situation or feeling. When we focus on assigning blame and figuring out who is “at fault”, we are usually ignoring the complexity of a situation. Also, blaming can result in staying stuck in negative feelings, rather than moving towards action and solutions.
13. Labeling or Name-calling. We generate negative global judgments based on little evidence. Instead of accepting errors as inevitable, we attach an unhealthy label to ourselves or others. For example, you make a mistake and call yourself a “loser,” a “failure”, or an “idiot.” Labels are not only self-defeating, they are irrational, simplistic, and untrue. Human beings are complex and fallible, and in truth cannot be reduced to a label. Consider this: we all breathe, but would it make sense to refer to ourselves as “Breathers”?
Understanding all of the possible cognitive distortions allows us to recognize the things that our brain tells us and begin to adjust how we respond to our own thoughts. It is something unique to humanity, that we have the ability to examine our own thoughts, a metacognitive skill that sets us above the animals much more dramatically than any other ability. But once we recognize that our thoughts are deceiving us, and we can identify how, we can then choose a reaction that is different from our normal behavior. We can pause ourselves long enough to make a conscious decision about how we react to any given thought rather than jerking our knee and acting on instinct.
This was the technique I used in my first bout with depression two weeks ago. At first, I didn't know for sure that I was thinking distorted thoughts, I only thought it might help to read over the above list as I had previously found that act alone proved helpful when in emotional distress. So I read over the list and I quickly saw I had engaged in half a dozen different cognitive distortions in the last five minutes. Victor, my old therapist, gave me a chart to fill out that involved identifying the distortion, the thoughts of the distortion itself, the emotions and reaction this gave rise to, and then a possible alternate reaction, what could I do instead that would break the cycle of habit that had led to the result of depression? What action could I undertake to escape the automatic response?
So I filled out this chart for the various distortions which I found myself engaged in and very quickly realized that I wasn't a failure, that my life wasn't destined for doom and gloom, that there was hope, and that there really was no reason to be depressed. And then I proceeded to return to the productivity that my depression had interrupted.
This week was worse, though, and an examination of my cognitive distortions wasn't sufficient to break me out of my bluesy funkiness. If I were to return to a jamming groove of living life I needed something more powerful than adjusting my thinking. I was down, trodden under, laid low by the feelings of despair and loss that plagued my soul. I felt the pain of sadness and the utter loss of interest in most everything. I didn't care, not about my books, about my work, about my music, about food. Nothing seemed good enough to expend the effort necessary to grab it. I was out of ideas and determined to hunker down and bear it, grit my teeth and stick out my chin. Mix my metaphors and bully up like a good old Brit' with a stiff upper lip. All the while suffering something that I didn't have to suffer if I could just figure out how to get out of it.
I had, in fact, determined that I was in a state that might require medication adjustments and that if it continued through the weekend I would spend the money and get myself an appointment with the p-doc. But then a new strategy presented itself. It was one I knew and had seen evidence of before. In one of my semi-weekly phone calls with my mother she suggested I get some more exercise. I had been taking short walks around my neighborhood, breaks in the day that punctuated the monotony of working and staring at the walls of my studio, but nothing like the hour of walking a day I usually did as my commute to and from work.
Inspired by my mother's suggestion I decided I would go on a long walk. Something comparable to my commute, take a different route and walk for half an hour or more. Walk until the sweat soaked through my shirt and I needed a shower to cool off.
This I did. I walked and I walked and I walked. And I bought some grapes and soda, not grape soda, and I walked some more. I got home and I took a shower and I sat down and I ate my grapes and I drank my soda and I read a book and I felt immensely improved. The walk had done the trick. The exercise had broken through the clouds of depression and lifted me from my funk. It proved my deliverance after three days of downright emotional discomfort.
And the thing of it is, both of these arrows were already in my quiver. I knew how effective they were, but I let myself suffer and struggle and be depressed before I remembered to implement them. Perhaps that is the reason for regular therapy sessions, as a reminder to use the coping skills and the lessons learned in practice. To provide a backstop against which you know that you need to fix yourself before you talk to your therapist so he doesn't tell you what you already know. But failing that, I must learn another lesson, the quick application of truths. Instead of waiting until my funk stretches into long periods of time, apply the techniques I've learned and get out of it right quick.
But that's a lesson for another week. Right now I am content with the reminder that addressing the cognitive distortions that plague me and exercising regularly serve to stave off depression more effectively than increasing the dosage on my meds or binging on carbohydrates. A hard lesson and one that I imagine I'll have to learn again before I figure it all out. But here's to another week of growth and learning. Thanks for tuning in.