How cognitive restructuring rethinks depression

By

Ella Marcantonio

|

March 14, 2021

mentally healthy woman eyes closed rethinking depression with cognitive restructuring

Clinical depression changes not only the way you feel but also the way you think. It can feel as if someone went inside your brain and shut the lights off. As a result, you’re experiencing both your inner world and the outside world through a lens of darkness. But with support and proven tools, you can gradually turn the lights back on. One powerful set of tools taken from cognitive behavioral therapy (CBT) is called cognitive restructuring. You can use this modality to help free you from the negative thinking that makes depression so challenging.

For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
Noticing your negative thinking can shift your relationship to depression—and cognitive restructuring is one tool that can help.

Clinical depression changes not only the way you feel but also the way you think. It can feel as if someone went inside your brain and shut the lights off. As a result, you’re experiencing both your inner world and the outside world through a lens of darkness. But with support and proven tools, you can gradually turn the lights back on. One powerful set of tools taken from cognitive behavioral therapy (CBT) is called cognitive restructuring. You can use this modality to help free you from the negative thinking that makes depression so challenging.

The role of negative thoughts in depression

Before diving into cognitive restructuring and how it helps shift depression, it can help learn about the role negative thinking patterns play in this mental health challenge.

Negative thinking is part of being human. As humans, we’re wired with a negativity bias, meaning we notice and remember negative things much more than we do positive ones.

From an evolutionary perspective, this has kept us safe. It’s much more critical for our survival to remember not to eat the poisonous mushrooms than to recall that the red berries are delicious.

Negative thoughts aren’t inherently bad— but negative thinking that’s persistent or ruminative can make it difficult to function. Plus, a tendency towards negative thinking is a risk factor for both depression and anxiety.

Shifting negative thought patterns is a key aspect of treating depression with CBT techniques and tools.

So what might negative thinking sound like in your mind? If you’re a person with depression, you might experience negative thoughts like these:

  • “This is hopeless.”
  • “I’ll never get better.”
  • “Something’s wrong with me.”
  • “I’m weak for needing help.”

Meditation teacher and psychologist Tara Brach says thoughts like these are real but not true. They’re real because they’re really taking place in your mind and having an impact on you. But they’re not strictly true—even though this kind of thinking feels true, it’s not an accurate representation of reality.

Because thoughts like these aren’t exactly true, CBT calls them cognitive distortions. Moreover, they may be happening outside of your conscious awareness, arising almost automatically. That’s why they’re also sometimes referred to as automatic negative thoughts.

How thoughts influence mood and behavior

Even though automatic negative thoughts may not be true, their impact is very real. Imagine I’m setting out to take a 15-minute walk because I know it helps manage depression. But in my mind, I’m thinking, “I’ll never get better.”

This thought may cause feelings of sadness or hopelessness and a sensation of heaviness in my body. Because of these feelings and sensations, I may give up on my walk altogether.

This is an example of the cognitive triangle, a visual illustration from cognitive behavioral therapy that shows the relationship between what you think, feel, and do.

CBT offers a path that can shift your negative automatic thoughts to more productive ones. Instead of focusing on the negative thought, I could reframe it like this: “I’m going to focus on one positive step at a time.”

Changing the way you think enables you to shift your feelings and behavior, as well. This is how cognitive restructuring literally rethinks depression.

What is cognitive restructuring?

Put simply, cognitive restructuring is a process you can use to question, challenge, and shift unhelpful automatic thoughts.

Can questioning and shifting thoughts really help with depression? It may seem overly simple, but the answer is yes. Cognitive-behavioral approaches are some of the most effective modalities for addressing depression.

If you’re skeptical because it doesn’t seem possible to change your thoughts, that’s fair. We can’t always help the thoughts we have, and we have so many of them— over 6,200 a day, according to one study.

Consider the suggestion to shift your thoughts as a shorthand that also includes shifting your relationship with your thoughts.

Practicing cognitive restructuring doesn’t mean you won’t ever have unhelpful negative thinking or that it will improve noticeably right away.

But it will give you reliable tools to respond to negative thinking constructively so that negative thoughts have drastically less impact on your well-being over time.

Having the thought “I’ll never get better” and believing that it’s true is very different from having the same thought and pausing to challenge it or letting it pass without holding it as the ultimate truth.

7 ways to shift unhelpful negative thoughts

Cognitive restructuring is a process, not a single event. Remarkably, you can use these techniques to shift the patterns of your mind. Still, the process takes time and intention.

Here are 7 tools you can try right now. Experiment to find your favorites and then practice them as often as feels helpful.

1. Build awareness

What are the negative thought patterns keeping you stuck? Often these thoughts arise so quickly and automatically that we may not be aware of them.

One way to gain awareness is to look at a few recent situations in which your mood or behavior took a dip and ask yourself, “what was I thinking?” Try to identify the thoughts that coincided with or preceded the difficulty.

2. Know what to look for

Leaders like Albert Ellis, Aaron Beck, Judith Beck, and David Burns, who developed cognitive therapy techniques, spent many decades identifying common types of distorted thinking.

It’s often easier to notice unhelpful thought patterns when you know what to look for. Which of the below common automatic thoughts do you identify with?

  • All or nothing thinking: Thinking in absolutes without shades of grey.
  • Catastrophizing: Turning molehills into mountains Ex. “I was 5 minutes late— I’m definitely getting fired.”
  • Minimizing: Minimizing the importance of events or contributions Ex. My volunteer work doesn’t matter because it isn’t paid.
  • Emotional reasoning: Assuming that feelings reflect reality Ex. “I feel like a bad caregiver, so I must be a bad caregiver.”
  • Fortune telling: Making assumptions about the future. Ex. “I will never get better.”
  • Mind reading: Making assumptions about what others are thinking. Ex. “That person doesn’t like me.”
  • Personalizing: Taking the blame for something that’s outside your control. “My partner wouldn’t be angry if I did more to help.”
  • Discounting the positive: Minimizing positive events or contributions. Ex. “I got an A on my paper because I’m lucky, not because I’m a good student.”
  • Should statements: Things should be a certain way. Ex. “I have so much— I should be happy.”
  • Mental filter: Overly focusing on one negative aspect of an event. Example: “That person gave me 5 out of 5 stars, but called me long-winded. I can’t believe how badly I messed up.”

3. Question your thoughts

Your friend might say something like, “I’m such a failure.” From the outside, it’s clear this isn’t true. But telling someone to change their mind is rarely helpful on an emotional level. A more practical approach is a process to work through the thinking behind that belief.

The goal of questioning your thoughts isn’t to instantly change them. Instead, it’s to take a broader perspective and invite the possibility of change.

To get started, take one of your unhelpful thoughts and ask yourself the following:

  • What is it like to have this belief?
  • When I have this belief, does it influence my behavior?
  • How does this thinking serve me?
  • How does this thinking harm me?
  • Is this belief true? What evidence supports it? Is it possible it isn’t true?
  • What are some other perspectives?
  • How might a wise other, who cares about me, see this situation differently?
  • What would I tell a friend who had this belief?
  • How might I see this situation differently when I’m feeling my best?
  • What are alternative, more productive perspectives I might wish to adopt?

4. Track your thoughts

Because unhelpful automatic thoughts are fleeting, it may be difficult to remember them. And it can be hard to change what you can’t track. That’s why CBT often involves recording thoughts and looking at their impact.

This can be as simple as ABC: Antecedent, Belief, Consequence.

For the next week, try keeping a list similar to this one:

Antecedent (trigger)Belief (or thought)Cognitive distortion?Consequence
I missed a meeting.I’m a failure.All or nothing thinkingI’m feeling terrible.
I stayed up too late.I should be more careful with my health.Should statementI’m feeling bad about myself.

5. Put your thoughts on trial

Persistent automatic negative thoughts can feel like the truth, even as you begin to notice they aren’t serving you. Another great CBT tool is to put those thoughts on trial.

Start by writing down the thought. In one column, write all the evidence that supports that thought. In the next column, write all the evidence that supports reasonable doubt. Then objectively consider both sides and come to your own conclusions.

Sometimes you might feel too stuck to see negative thinking clearly. If putting your thoughts on trial feels inaccessible, consider enlisting input from a trusted friend or your therapist.

6. Practice cognitive reframing

If daily tracking isn’t for you, try taking 20 minutes to jot down some of your unhelpful negative thoughts and reframe them into something that still feels true but also feels more productive or positive.

Here’s an example to give you a framework to make your personal list:

  • I’m a failure. → Like lots of people, I’m having a hard time.
  • I’ll never feel better. → Each day I have at least a few moments of feeling okay.
  • Depression is forever. → Millions of people have recovered from depression.
  • I shouldn’t feel this way. → My feelings and experience are valid.
  • I need this to end. → I want to get better so I can help others.
  • My life is out of control. → I’m going to focus on the things I can control.

Need help figuring out how compassionate talk and positive reframing might sound? Learn more about self-compassion from Dr. Kristin Neff.

7. Choose a slogan or mantra

One of the reasons automatic negative thoughts are hard to change is because we think them so often that they’ve become well-worn pathways. Updating to new, more helpful thoughts requires persistent effort.

Try coming up with a personal slogan that represents a new belief you’d like to adopt. For example, if the thought “I’m not worthy” keeps dragging you down, you might choose the slogan “I matter as much as anyone else.”

Feed your brain this slogan as often as possible by repeating it to yourself. You can also write it down on post-its and place them where you’ll see them each day.

Takeaway

  • Negative thinking is part of being human, but persistent negative thinking patterns can be harmful to your mental health.
  • In depression, negative thought patterns are pervasive, automatic, and often not grounded in reality.
  • For this reason, CBT refers to them as automatic negative thoughts or cognitive restructuring.
  • Cognitive restructuring is one process you can use to shift unhelpful negative thoughts into more productive and beneficial perspectives.

By

Ella Marcantonio

|

March 14, 2021