Dear Dr. Yael:
I am a man in my 50s who, Baruch Hashem, has had a good life. I am married with children and grandchildren and was always a happy-go-lucky person, thankful for all the berachot bestowed on me.
This year, though, has been very difficult for me, with many family and personal problems. I have begun to experience something that I have never really had before: depression. Out of nowhere I begin to feel upset and anxious, and I do not know what to do to get rid of these feelings. I have never been a negative or sad person and I don’t know how to return to my old self. I try to think more positively but my mind always starts to find the negative aspects, and it often snowballs and makes me feel more and more depressed. I do not know how to get out of this cycle or how to be more upbeat. I do not want to feel this way, yet find myself returning to depressing thoughts more and more. Please help!
Without having a chance to sit and meet with you, it is hard to say exactly what your issue is. However, it is possible that you are experiencing either an adjustment disorder with depressed and anxious mood or feeling some dysphoria. Both of these disorders can be similarly treated. Your thoughts seem to negatively impact the way you feel and this in turn makes you think more negatively – and subsequently you feel worse. As you noted, it is a difficult cycle to end. The most important thing to do now is to go for professional help before you get worse. Here are some ideas I believe will be helpful:
One helpful Cognitive-Behavioral Strategy is to restructure your thoughts. In order to do this, you must ask yourself questions. For example, what’s the argument for and against a particular thought? What would I tell a friend in the same situation? Is there any way to look at this positively? Is thinking about this helping me or making the situation worse?
Try to rationally think about the truth. Chances are that you are having cognitive distortions that make you overgeneralize, thus painting a limited occurrence with a broad brush (e.g., believing that if just one problem arises, your life then becomes problematic or terrible). You might also be personalizing things, like when someone ascribes an external event to himself when there is, in reality, no connection between the person and the event. (An example of this is when a stranger or aquaintance is rude to you and you incorrectly conclude that you must have done something to cause the person’s rudeness.)
Another possibility is that you are making arbitrary inferences, creating – with no supporting information – a not necessarily correct conclusion (not necessarily the right one) in a certain situation. An example of this is when – despite no actual information to support his or her belief – a person believes that someone either does not like him or her or that the person believes him or her to be a horrible person. All of these cognitive distortions are untrue and unhealthy because it causes the one with this condition to have a negative self-view.
In therapy the first thing a client will learn is how to identify these problematic thoughts which in addition to increasing depression and anxiety, also reduce a person’s ability to cope with his or her environment. If you are theoretically able to identify when you are doing this and are then able to replace these thoughts with a more realistic view, you will begin to feel better.
The next step is for you to practice replacing these negative thoughts. Some therapists ask their clients to write down specific thoughts, when they took place and how he or she felt at that time. Then they are asked to think of a replacement thought that is more realistic to the situation and to rate how that thought would make them feel. It starts out as an exercise, but hopefully over time you will begin second-guessing these negative distortions and replacing them with more positive, realistic thoughts that engender more positive feelings. It is never helpful for anyone to think negatively, even if a situation is not a positive one.