Chronic depression: How you think about it is a key to addressing it

In my work as a Calgary psychologist and a Cochrane psychologist, I often encounter clients in depression counselling who tell me they have been suffering from chronic depression. This typically means that the individual has regularly met the diagnostic criteria for depression as a disorder. That is, they have experienced symptoms such as depressed mood and lack of interest and pleasure in their life for an extended period of time.

In helping clients address their chronic depression, as a psychologist specializing in cognitive behavioural therapy (CBT) I take a two-pronged approach: Helping clients change their thinking in regard to their issue and helping them take action to address it. This double-barreled approach is particularly relevant with an issue such as chronic depression which can last for so long that many people feel hopeless about addressing it.

In the following sections, I will discuss how using a CBT approach can help a person move beyond the pessimistic notion of having to live with chronic depression and toward a hopeful mindset of being free from it.

A common belief about chronic depression: It’s something you have to live with

Many people who suffer from chronic depression assume that it is something that they are stuck with, that they cannot do anything to overcome it and that therefore they must learn to live with it. People who have this belief often point to factors causing their disease such as genetics or a built-in chemical imbalance. Because they believe there is nothing they can do about genetics or chemical imbalances, they resign themselves to living with depression and finding ways to manage it.

Although this way of thinking about chronic depression is understandable, the facts do not support it. In the next section, I will discuss the evidence regarding whether someone suffering from chronic depression can do anything to do address it.

The facts about chronic depression: It’s not something you have to live with

Although the belief that there is nothing a person can do to address their chronic depression may be intuitively appealing, it is not supported by the evidence. That is, although genetics and chemical imbalances both play a role in depression, it does not follow that there is nothing a person can do to address their depression.

In terms of genetics, it is true that some people are more vulnerable to being depressed due to genetics but that there are many things the person can control which can prevent themselves from actually becoming depressed despite this vulnerability. As for biochemical imbalances, there is evidence that depression is associated with imbalances in brain neurotransmitters such as serotonin and norepinephrine. However, there is also evidence that people can take steps to address their depression and, in turn, correct these chemical imbalances. In short, the presence of such imbalances does not mean the person is fated to suffer from depression indefinitely.

How you think about chronic depression will affect your ability to address it

Your beliefs about whether you can do anything to address your chronic depression will play a fundamental role in whether you are able to address it. The reason is that expectations of success in addressing any issue have been found to have a significant impact on whether you are successful in doing so. Positive expectations lead to the person being consistent in taking the appropriate steps necessary to make progress. Negative expectations lead the person not to take these steps consistently. The thinking is, “Why bother taking steps to address my issue if it’s not going to make any difference?”

Applying this notion to chronic depression, thinking you can do something to address your depression leads to your having positive expectations about being able to address it. This results in being consistent at taking the steps necessary to address it. In contrast, thinking that you can do nothing to address your depression leads to your having negative expectations about being able to address it. This results in your not being consistent at taking the steps necessary to address it.

The bottom line: Knowing that you can take steps to address your depression is fundamental to your being able to address it.

May you think about your depression in a manner which will allow you to be successful in addressing it,

Dr. Pat