Depression, Anxiety and Cognitive Therapy
Depression and anxiety are mood disorders. A mood disorder is a disruption or disturbance of mood caused by distorted negative thoughts that are triggered by environmental (external) circumstances or caused by a complex imbalance in the chemical activity in the brain.A mood is a subjective experience, an individual's response to his or her own perception of an event or situation. That event might be negative thus generating a feeling such as sadness or that event might be positive thus generating a feeling such as joy or happiness. A "mood" is the way you feel “inside”. It is your emotional state at a given time.
Moods or emotional states do not just happen. They do not simply descend upon a person. Emotional states are the outcome of thoughts and often those thoughts are subconscious. When you almost drive off the road and experience that feeling of fright, you are not aware of the thought that signaled you for danger. The thought might have been "I'm going to crash." but you are not consciously aware of thinking that thought. As an adult, you have had many experiences that generate thousands of thoughts many of which are stored in the subconscious. This warehouse of stored thoughts is available to you during every waking moment. You go through the process of pulling a particular thought out as needed to interpret an event. The thought might be accurate or it might be inaccurate. In either case it will trigger an emotion.
Cognitive behavioral therapy is successful in the treatment of depression, anxiety, anger, etc. because the thoughts and beliefs of the individual are the target of this therapeutic approach. And as you can see from the above information, beliefs and thoughts are key in determining mood states.
Cognitive therapy is successful in the treatment of bipolar disorder.
Clinical depression or major depression is believed by some healthcare professionals to occur in families from one generation to the next, although some people develop clinical depression with no prior family history. Clinical depression (a serious type of depression) is related to changes in the structure of the brain and its functioning. Present with this serious classification of depression and also present with the less serious depression disorders are negative thoughts, negative core beliefs, and low self-esteem. Major depression is often treated with medications and once the extreme depression state has subsided, the individual is a candidate for cognitive therapy. An individual diagnosed with a depression disorder is not likely to require the same medications prescribed for the more serious depression and would benefit from cognitive therapy.
According to the National Institute of Mental Health (NIMH), depression disorders cause feelings of worthlessness, helplessness, and hopelessness. There is also the perspective that feelings of worthlessness or low self-esteem are causative in depression disorders. Persistent negative thoughts and negative feelings can cause some people to feel like giving up which further complicates assessing the primary cause of depression.
The spiral of depression and anxiety disorders begins with beliefs, which influence thoughts and those thoughts in turn generate an emotional state. People with low self-esteem who a have persistent negative view of themselves and the world are particularly prone to depression and anxiety. Your sense of self and your beliefs are critical to the way you construct the meaning of yourself, your life, and the world around you.
For example, if you view yourself as worthless and unlovable you will interpret the events in your daily life filtered through those views casting a shadow of negativity. This view is a thought distortion as no person is all good or all negative. Isolating negative beliefs and challenging the negative thoughts those beliefs generate, is one of the ways cognitive therapy works. If you change the belief, you will change the thought, and change the feeling.
In the above example, The 17 Steps to Happiness cognitive based Program©™, would guide you to “reality test” your views and when those negative are uncovered, you are guided to change those beliefs to a realistic view and feelings of self-empowerment and higher levels of self-esteem.
Cognitions refer to the psychological result of past experiences, learning, and perceptions. Your thoughts play a crucial role in mental health. Cognitive therapy is not like switching from negative thinking over to positive thinking. It is much more complex than that. Changing the ways in which you think is a systematic process of recognizing and undoing years of the repetition of negative thought patterns. Many of the negative thought patterns become automatic thoughts because they have been repeated so often.
We have hundreds even thousands of thoughts every day. When your thoughts are negative and distorted, there is a disturbance in mood and a disruption of your life.
Your thoughts create your interpretations of events and situations around you. This is how crucial your thoughts and thinking patterns are in terms of well-being or in terms of disruption and disturbance. Thoughts will become distorted just to fit your view of yourself and the world whether your view is unrealistically positive or unrealistically negative. This “view” of yourself and the world is another name for your core beliefs.
It would follow then that if your core belief of self is negative you would interpret events and situations in your environment accordingly and the result is low self-esteem, and if your core belief of the world is distorted and negative you would have a pessimistic world view and you will find verification for the distorted beliefs you carry with you. It is almost a guarantee.
The Negative Cycle goes like this:
Negative core beliefs --->
Negative thoughts --->
Negative feelings --->
Negative self-image --->
Distorted interpretation of events --->
More support for negative core beliefs --->
More negative thoughts --->
More negative feelings, and on and on and on.
People who repeat this maladaptive pattern will continue to interpret situations and events with distorted thoughts and in turn will sink into depression and anxiety.
Clinical research has proven that cognitive therapy is effective in treating depression and anxiety.
Medication and the intervention of mental health professionals can be an important aspect of treatment for severe depression and anxiety but there is also a place for cognitive therapy simultaneously with the medical and mental health treatments.
But, for moderate to mild depression and anxiety, clinical research has proven that cognitive therapy works, in most cases, better than or as well as medication therapy. Again, restructuring and changing the faulty belief system and distorted thinking patterns are necessary for effective treatment of anxiety and depression.
The cognitive behavioral therapy techniques utilized in The 17 Steps to Happiness Program©™ are based on the premise that your feelings are the direct result of your automatic thoughts. Feelings do not emerge from events, persons, situations, or your environment. Feelings come from inside of you.
The cognitive behavioral techniques people are learning by going through The 17 Steps to Happiness Program©™ focus on changing what they believe and the way they think. The focus is not on changing the external environment because in most cases it is difficult or even impossible to change the people and circumstances around you. It is not likely that you can change the way a stranger will respond to you in a social setting or change the way a meaningful friend treats you. But you can change the way events affect you.
All the possibilities lie in the changes you make in your core beliefs ad your thinking patterns and the subsequent changes in your feelings and attitudes brings about the changes in your life.
By restructuring your core beliefs and learning to think differently real changes in feeling take place for people with anxiety and depression. With medication the symptoms are being affected and reduced but this is a temporary fix. Unless changes, real changes occur, nothing will be any different.
Below are the basics of cognitive therapeutic techniques for the treatment of anxiety and depression:
• Realizing how your core beliefs about yourself and the world began
• Identifying your core beliefs
• Understanding how, over time, those beliefs contributed to your thinking patterns
• Identifying the irrational or distorted thoughts/assumptions through which you interpret situations
• Learning problem solving skills and reality testing with which to question those distortions
• Learning to systematically restructure distorted thoughts replacing them with non-distorted thoughts and thinking patterns
This might sound too good or too easy to be true. It is not easy but it is true.
The points above provide a general outline and there will be different degrees and types for work based on the individual. For most people depression is triggered by distorted thoughts in reaction to external events.
The chart below demonstrates the relationship between thoughts, feelings, and your reactions:
Situation: You are invited to a partyAutomatic Thought: If I go to that party I will be so uncomfortable
Feeling: Anxious & Nervous
Reaction: Don’t go to the party
Situation: You are not invited to a party
Automatic Thought: They don’t like me. I knew it.
Feeling: Depressed & Angry
Reaction: Withdraw and be alone for weeks
Situation: You are not chosen to speak at a group meeting
Automatic Thought: I’m not good enough
Feeling: Shame & Depression
Reaction: Quit the group
Situation: You meet a guy at a bar
Automatic Thought: I must look really ugly again.
Feeling: Shame & Hopelessness
Reaction: Leave and start crying
The realization that there are thought distortions in explaining the event to yourself and the guidance to reality test those automatic thoughts or assumptions, is the first step to restructuring maladaptive thought patterns into adaptive thought patterns that fit the actual circumstances or at least leave room for more than one explanation.
Cognitive Behavioral Approach to Depression
Depression results from erroneous and maladaptive information processing and the biased thinking results in faulty assumptions and beliefs. Gaining insight and understanding of the contents of the perception of a person who is depressed will reveal the cognitive disorder behind the depression and anxiety. Therein underlies a consistently negative view of self, the future, and the world and from such negative views emerges the feelings and behavior of depression.For example, negative memories and cognition cause sadness, depression, and/or anxiety. These negative and disturbed mood states cause deeper negative and disturbed mood states and furthers negative and distorted thinking and the cycle goes on and on.
The Cognitive Behavioral approach to the reduction and/or elimination of mild to moderate depression has been scientifically proven to be as effective in reducing symptoms of depression as medication therapy. According to mental health professionals Cognitive Behavioral Therapy is one of the most promising innovations for the treatment of depression.
The advantage of treatment or self-treatment of mild to moderate depression with methods based on Cognitive Behavioral Therapy (CBT) is that feelings are eliminated or modified due to changes in the thought patterns and the behavior patterns of those suffering from signs of depression.
Cognitive Behavioral Therapy treatment methods attempt to change behavior by modifying thoughts, interpretation, assumptions, and behavioral responses to events and situations in the evolution of daily life. The focus of CBT is on restructuring cognitive patterns from inaccurate, negative, and maladaptive to more realistic and undistorted patterns. With the successful changes in maladaptive thought patterns and thinking, behavior changes will follow.
The 17 Steps to Happiness Program©™ Coupled with Cognitive Behavioral Techniques

The 17 Steps to Happiness Program©™ guides the person experiencing symptoms of depression in identifying and monitoring automatic-negative thoughts and the subsequent negative feelings in order analyze and then to restructure them into attitudes that will generate a more positive self-concept and lessen the burden of depression. For example, people suffering from depression are said to be negative thinkers with low self-esteem. Where are the negative thoughts generated except from within the person? Where does the low self-esteem come from if not the negative thoughts about oneself that generate feelings of worthlessness, helplessness, or powerlessness?Studies have concluded that deficits in generation of alternative tasks and problem solving techniques are common in depressed persons.
Conservative problem-solving styles are absent in depressed persons and social problem solving is positively related to social competence and inversely related to maladjustment and psychopathology.
Being overwhelmed with logistical problems which cause stress and negative perceptions of life necessitates effective problem-solving skills and effective problem-solving performance.
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