Reversing the Downward Spiral of Depression
Depression often leaves us feeling hopeless and unable to see the “light at the end of the tunnel” everyone talks about. Depression may produce feelings of being stuck, as if no matter which direction or actions we take, we cannot escape falling deeper and deeper into difficult thoughts, feelings, and experiences. Sometimes depression is experienced as an emotion that will eventually pass, but other times, it can feel like being on a hamster wheel or sinking in quicksand. This process is often referred to as the “downward spiral of depression.”
The downward spiral
Varying factors contribute to the onset of depression, so everyone’s experience is unique to them. However, for most, the ability to step out of this spiral feels hopeless, defeating, and pointless. Finding successful relief from symptoms seems like a never-ending battle to pull yourself out of it before sinking deeper in.
Oftentimes, a downward spiral begins with the distorted perceptions, judgmental beliefs, and automatic thoughts that usually accompany an individual’s experience of depression. These thought patterns, or cognitive distortions, can lead us to paint the world, others, and ourselves in biased ways. Such harmful thoughts leave us feeling depleted, unmotivated, and even more hopeless.
Unfortunately, these feelings typically don’t motivate us to get off the couch to move our bodies, call a friend, or take care of ourselves in the ways we need. Furthermore, once we begin to halt positive or pleasant activities, our thoughts become louder and our brain is thereby rewarded, because now we’ve confirmed the thoughts that were present in the first place. This leads to more negative feelings, which leads to less engagement in activities that feel good, resulting in more negative thoughts. Before you know it, the spiral is spinning out of control.
Take for example an individual, “Sally,” who, while struggling with periods of depression, experiences frequent and automatic negative thoughts (i.e., cognitive distortions) that she is not good enough at her job. Specifically, Sally believes she is not smart enough or skilled enough for her position and often feels she has been placed in her prestigious role due to luck. These thoughts paralyze Sally with fear and further prevent her from taking the necessary risks in her job that would showcase her unique skill set and help her grow. Because of this, promotions are passed along to her co-workers, managers reward other team members, and Sally is rarely mentioned in their weekly staff meetings for courageous or vulnerable acts. This leaves her feeling even less confident in herself and less important to her team. As Sally slowly sinks deeper into a downward spiral and attaches truth to these beliefs, she experiences more feelings of hopelessness, embarrassment, and shame. She also notices these beliefs and thoughts becoming more present in other areas of her life, such as relationships and family. She begins to believe her perceived unworthiness must be true, which causes her to isolate more and spend even less time engaging in social activities or work-related events that might force her to further confront these perceived truths. Sally sinks deeper into the thoughts, feelings, and behaviors that initiated her depression in the first place.
When we begin to paint the world in a specific way, such as Sally did, our brain naturally resorts to looking for reasons, or confirmations, to further support these views. When these thoughts become too loud or too frequent, the feelings they produce may prevent us from engaging in activities that feel good and increase our desire to engage in activities that promote isolation, low energy, and even more negative thoughts. Eventually, depression begins to have a domino effect on our lives, with consequences in various areas as it travels deeper down the spiral.
Reversing the spiral
Similar to the way depression can spiral downward into an abyss of negative thoughts, difficult feelings, and limited positive behaviors in subtle ways, reversing the spiral often takes place through small, committed actions. Where you learn to stop the spiral is unique to your own goals and experiences, but little things, such as increasing physical activity or engaging in thought challenging, can provide relief and encourage the halt of the downward spiral. Following are some suggestions.
Increase positive behavior
When someone feels depressed, little motivation or energy exists to encourage them to engage in satisfying activities. Without any positive reinforcement, or positive feelings that result from pleasant activities, negative thoughts are given more space and feel more persistent. Unfortunately, feelings often take time to catch up to our behaviors. This means that as much as physical activity, calling a friend, or spending time out in public may seem uncomfortable, awkward, or draining at first, the feelings to pay attention to are the ones you feel afterwards. Research supports the idea that positive and healthy behavior produces more positive feelings, increases serotonin levels (the “feel good” neurotransmitter), and creates experiences for more realistic thoughts.
Get clear about the physical activities that make you feel authentically good. Maybe for you this means taking a walk on the beach, having a coffee date with a friend, volunteering at the animal shelter, or spending time at a bookstore reading magazines or new books. This could also mean taking a shower, cleaning your house, or heading to the grocery store with your partner.
Allow thoughts to be thoughts and feelings to be feelings
When we attach too much meaning or reasoning to thoughts, it becomes difficult to separate or defuse from them. By looking at unhelpful thinking patterns or cognitive distortions as stories that aren’t always necessarily true, our ability to detach and recognize thoughts as thoughts becomes easier. You are not your thoughts. Rumination, or focusing on meaning and thoughts, leads individuals into deeper spirals, and this is how they become stuck.
Are your thoughts based on subjective (or depression-skewed) interpretations or are they objectively known facts? Look at your thoughts as subjective interpretations that aren’t necessarily true. Are the thoughts you are experiencing 100% true, 100% of the time? Is there evidence that this thought is reality and not actually a story being created by depression? Instead of attaching yourself and total truth to thoughts, allow yourself to notice the thoughts as thoughts while stating, “I’m having the thought that I am not good enough.”
Sometimes, challenging our negative thoughts doesn’t always work. If this is the case, attempt to step outside of your brain for some time and focus on the physical things in front of you. Engage your five senses in a way that allows you to reconnect to the present moment and engage in positive behavior that can stop the spiraling. This might look like listening to soothing music or meditation, taking a walk, or cooking and eating a nourishing meal. Remember that thoughts and feelings are harmless, even if they feel uncomfortable.
Once you start working on one part of the downward spiral, the ability to continue reversing the effects of other pieces of the spiral will feel more achievable, more realistic. Although no “quick fix” exists in treating depression, it can be useful to understand and become aware of the effects of the downward spiral that present within one’s unique experience. It is also helpful to reach out to your loved ones, friends, or therapist to help navigate some of the thoughts, feelings, and behaviors that often make depression feel like a limitless cave. Treating yourself with kindness and compassion as you navigate depression will assist you as you gradually move through that tunnel toward the luminous and often difficult-to-see light at the other end.
References
Hayes, S., & Smith, S. (2005). Get out of your mind & into your life the new acceptance & commitment therapy / Steven C. Hayes with Spencer Smith. (New Harbinger self-help workbook). Oakland, CA: New Harbinger Publications.
Lejuez, C, Hopko, Derek, & Hopko, Sandra. (2001). A brief behavioral activation treatment for depression. Behavior Modification, 255-286.
