Unhelpful Thinking Styles

The information here is consolidated from half a dozen documents from various sources that I have found over the years as I’ve learned about depression and how to battle it.

People experiencing depression or anxiety (or both) often have automatic ways of thinking which can exacerbate the emotional state. Because these thinking styles are automatic they can be difficult to change, but simply identifying when they occur is a good step on the road to changing our default thinking mode.

All or nothing thinking

Viewing things in absolute, black-or-white terms, without recognising any middle ground.

  • success or failure
  • perfect or worthless
  • either I do it right or not at all

Blaming

Focusing on who is to blame for a problem rather than what can be done to solve it.

Mental filter

This is a sort of tunnel vision in which you focus on only one part of a situation and ignore the rest. Usually it involves focusing on only the negatives and ignoring the positives.

Jumping to conclusions

It would be nice to think that whenever you have a hunch about something is is correct, but the reality is that often we are wrong in our hunches. If we rely on this type of thinking it can lead to problems. There are two key types of jumping to conclusions:

  • Mind reading: Imagining you know what others are thinking, feeling or intending to do. This is a very common way of thinking.
  • Fortune telling: Predicting the future. Making negative predictions about how something will turn out.

Emotional reasoning

Assuming that because you feel a certain way then what you think must be true. Have you ever felt anxious about something and thought to yourself, “I know this isn’t going to work out well” yet everything turned out just fine? This is emotional reasoning. “I feel, therefore it is” is not valid logic.

  • I feel embarrassed so I must be an idiot.
  • I feel anxious, something bad is going to happen.

Labelling

Assigning global, negative labels to yourself or other people. By defining yourself or other people by one specific behaviour, usually one you consider negative, you are ignoring all the other positive aspects of yourself or others.

  • I’m such an idiot.
  • I’m completely useless.
  • They’re so inconsiderate.

Over-generalising

Drawing sweeping conclusions based on a single incident. Seeing a pattern based upon a single event, or being overly broad in the conclusions you draw.

  • Everything is always rubbish.
  • Nothing good ever happens.
  • Things never turn out well for me.

Catastrophising

Blowing things out of proportion. Viewing a situation as terrible, awful, horrible. Taking what might be a slight problem and viewing the most extreme negative version of it.

  • What if… !!!
  • Oh no …

Downplaying positives

Minimising or dismissing your positive qualities, achievements or behaviours by telling yourself they are unimportant or do not count. This may include exaggerating the positive qualities of other people while downplaying your own attributes.

  • That doesn’t count, I was just lucky.
  • They didn’t really mean it, they were just being polite.

Shoulds and musts

Focusing on how things or people ‘should or ‘must’ be. Treating your own standards or preferences as rules that everyone must live by. It is not always unhelpful to think, “I should get my work done on time”, but if the ‘shoulds’ or ‘musts’ become unreasonably demanding it leads to guilt and disappointment.

Personalisation

Blaming yourself or taking responsibility for something that wasn’t completely your fault. Telling yourself that events relate to you when they may not.

  • This is my fault.

Intolerance of uncertainty

Struggling to accept things being uncertain or unknown.

  • What if something bad happens?

Serotonin and Depression

This post is an attempt at summarising and explaining a paper called 5-HT and depression: is the glass half full? Authored by Trevor Sharp and Philip J. Cowen which was published in Current Opinion in Pharmacology, 2011 volume 11 pages 45–51.

The theory that abnormally low levels of the neurotransmitter serotonin (also called 5-hydroxytryptamine, 5-HT) can cause depression is now 50 years old.

The theory arose when it was noticed that depressed patients had low serotonin levels in cerebrospinal fluid, and also that the first effective antidepressant drugs had the effect of increasing the amount of serotonin in the gap between neurons (the synaptic cleft). Since then the old tricyclic antidepressants have been replaced with medications that more accurately target serotonin, the ‘selective serotonin re-uptake inhibitors’ (SSRIs) which have fewer adverse effects and tend to be more effective at relieving depression symptoms.

Despite the progress since 1967, up to half of the patients prescribed antidepressants do not get enough relief from their symptoms, and pharmacologists still don’t clearly understand how changes in serotonin translate to altered mood.

That 5-HT (serotonin) is associated with mood and depression has been shown by pharmacological studies and also positron emission tomography (PET) studies looking at the distribution of 5-HT receptors in the brains of depressed patients. Other studies have shown that artificially restricting dietary intake of the amino L-tryptophan can cause a return of depression symptoms in patients with a history of depression. This is significant because L-tryptophan is the precursor (chemical building block) of 5-HT. Similar L-tryptophan depletion in people who have a high family incidence of depression but themselves have not had depression caused a less severe lowering of mood.

Genetic components

Depression does run in families, with a moderate to high heritability (heritability is a measure of how likely a trait is inherited, low means less likely and high indicates it is more likely to be inherited in a population).

One particular gene, slc6a4, which codes for the 5-HT transporter protein, has been well studied. Levels of the 5-HT transporter can vary by up to sevenfold within the general population. Individuals with low levels of this 5-HT transporter have increased risk of depression when associated with stressful life events. The region of this gene where it is regulated (i.e., ‘the volume control’) is rich in methylation sites which can result in semi-permanent changes to gene expression as a result of environmental influences (such as a stressed or depressed mother during pregnancy, stressful events, childhood trauma).

Neuronal Repair

Current thinking is that increased synaptic 5-HT activates a downstream gene programme that leads to enhanced neuronal plasticity which has failed because of the adverse effects of stress and other environmental and genetic factors.

In effect, some sort of stress derails the ongoing repair and maintenance of brain ‘circuitry’ which can be overcome by bumping up serotonin levels in neurons.

This idea of serotonin enabling improved neuronal plasticity in depressed patients dovetails nicely with ideas of how psychological treatments (such as counselling, CBT, DBT) function to help treat depression. Psychotherapists help a patient to reframe situations and learn more positive ways to view situations. With increased serotonin levels enabling neural repair and realignment of neural pathways, learning is facilitated and so the therapy and drug treatment work together.

serotonin effects

I don’t want to know the future

The notebook I’m currently using for writing has some notes in the back of it written in mid-2008 when I was trying to find a way forward from being in a state of burnout. Looking back on the almost ten years since then I’ve come a long way, yet am now glad I could not see much of the path ahead at the time.

In June 2008 I applied for a job as a technical writer for a software company but was unsure if I would get the job so tried to plan how to cope with the next six months in the job I already had. As it turned out I did get the new job, which was a real blessing and gave a reprieve from the stress I had previously been carrying. What I didn’t see but is now obvious to me reading what I wrote back then, is the warning signs of depression.

The change in work enabled me to recover somewhat but two years later the black dog returned and this time there was no denying it. At least his forced me to seek help, beginning a long journey of trying to find a medication combination that worked for me. By this time I’d moved on to what in many ways was a dream job for me, but it came with the downside of a 24/7 roster. In time the shift work messed with my body clock enough to make the next cycle of depression much worse than any before, necessitating a week’s stay in a psychiatric hospital. Recovery that time was long and painful, at least a year before I could consider myself ‘normal’ and not a joyful normal at that.

This is why I’m glad I could not see the future for me in 2008. If I could have seen what was ahead I probably would have given up or run away and hidden from the world. But if I had known what was to come, could I have taken steps to avoid it?

On this I’m not sure. Certainly I’ve learned signs to watch for  so now seek help sooner than I did in the past. I also know some of the circumstances and situations that can precipitate depression so take steps to avoid or reduce the effects of those situations. However, life always carries a certain amount of stress and my depression has a definite cyclic pattern so I doubt that I could have completely avoided it.

The approach I now take is to have fences to keep the black dog out, a stick handy to push if back if it gets too close, and I try to live as fully as I can when it is not around. Yet I still hear it barking in the distance.

Suicide and salvation

I know this is likely to be a touchy topic.

Soon after the tragic death of Matthew Warren I found a list of ‘helpful links’ which included an article from the ministry of John MacArthur, Grace to You. The article is titled: Can someone who commits suicide be saved? and frankly caused my hackles to rise.

Suicide is murder of the self

As such it is clearly sinful to commit murder. God has stated unequivocally that murder is sin (Exodus 20:13), very cut and dried – perhaps we can leave the topic there?

There can be many motives for murder, summed up by author John Lescroart as: love, lust, lucre, and loathing. To kill another person is something most of us recoil from as being utterly abhorrent and we struggle to comprehend how someone could do such an act. What then can be the motive for the violence of annihilating self?

Again, there can be many motives: financial troubles, pain/illness, shame, romance problems, substance abuse, mental illness.

All sin can be forgiven in Christ

Suicide is a grave sin equivalent to murder (Exodus 20:1321:23), but it can be forgiven like any other sin. And Scripture says clearly that those redeemed by God have been forgiven for all their sins–past, present, and future (Colossians 2:13-14). Paul says in Romans 8:38-39 that nothing can separate us from the love of God in Christ Jesus.

So if a true Christian would commit suicide in a time of extreme weakness, he or she would be received into heaven (Jude 24). But we question the faith of those who take their lives or even consider it seriously–it may well be that they have never been truly saved.

That’s because God’s children are defined repeatedly in Scripture as those who have hope (Acts 24:15Romans 5:2-58:242 Corinthians 1:10, etc.) and purpose in life (Luke 9:23-25Romans 8:28Colossians 1:29). And those who think of committing suicide do so because they have neither hope nor purpose in their lives.

Is considering suicide sin?

The ‘Grace to You’ article claims that a person who repeatedly considers suicide is practicing sin in their heart based on Proverbs 23:7 in the NASB translation. However, in other translations, such as the ESV and NLT, the idea of “as he thinks in his heart, so he is” does not come across so clearly. I do get the point though – a suicidal person is constantly thinking of committing a sinful act of self murder so surely they are wilfully playing with sin.

The issue here is not so much about suicide per se, but a question of whether repeatedly considering any sinful act is a sin in it’s own right (i.e., is the thought of the sin a sinful act?)

Furthermore, one who repeatedly considers suicide is practicing sin in his heart (Proverbs 23:7), and 1 John 3:9says that “no one who is born of God practices sin.” And finally, suicide is often the ultimate evidence of a heart that rejects the lordship of Jesus Christ, because it is an act where the sinner is taking his life into his own hands completely rather than submitting to God’s will for it. Surely many of those who have taken their lives will hear those horrifying words from the Lord Jesus at the judgment–”I never knew you; Depart from me, you who practice lawlessness” (Matthew 7:23).

So though it may be possible for a true believer to commit suicide, we believe that is an unusual occurrence. Someone considering suicide should be challenged above all to examine himself to see whether he is in the faith (2 Corinthians 13:5).

(I am choosing to publish this draft that I started in 2013 as it stands despite it being very incomplete. My rationale is that it maps some of my thinking at the time which I want to keep a record of [14 February 2018])

Your Money or Your Life

I have a dilemma – my job is negatively affecting my health, but we really need the income to stay afloat as a family.

My current work is at the NZ National Poisons Centre giving phone advice to both the general public and medical professionals for acute poisoning exposures. As with all jobs, there are good and bad days, interesting parts and boring parts. Unlike many jobs, we work rostered shifts covering 24 hours a day, 7 days a week. This is the aspect of the work that is messing with my health.

I suffer from depression which can be severe for months at a time when I am not well. A key element in trying to stay well for any mental health illness is to maintain stable, adequate sleep habits – not easy with this job.

My training and most of my work experience is in science, a field known for crappy pay rates. The job I currently have pays better than any I have previously had and more than any position I am qualified for that I’ve seen advertised in the last year.

(an incomplete draft that I’m choosing to post as is, 14 February 2018)

Christians Get Depressed Too

I have recently finished reading Christians Get Depressed Too by David Murray (the Kindle version). The overall thrust of the book is to correct the common idea amongst Christians that depression is caused by sin or a broken relationship with God and that taking antidepressants is to exhibit a lack of faith.  Murray outlines the various factors which appear to contribute to depression and presses the point that for many people their depression has an organic, physiological  cause.
David Murray also points out that the biblical counselling movement falls short in it’s common assumption that pharmaceutical treatments for depression are simply masking the real problem. While from a neurochemical perspective there is grounds for thinking that current drug treatments do not necessarily target the true physiological cause of depression, they certainly do have more than just a placebo effect.

Something I do appreciate is the author’s reassurance that for most Christians who are depressed being ‘unspiritual’ is not the main issue and that going overboard on reading the Bible and praying is unnecessary. In fact it may compound the problem by causing the person to get even more introspective when they would do better to get out and simply be around other people.

It is a fairly light read but an OK introduction to the topic. For all that, it is a good summary and I think pastors in particular would do well to read it.

The ache of love won

It is 5 minute Friday, and this week’s prompt is Ache. I had gotten into the habit of saying “easy peasy” but with this prompt and what is on my heart this 5 minutes could seem very long. Just to reassure folks, what I describe here is from the past, it is not my current state of mind.

Ache

The week didn’t start well and went downhill. Not “steadily downhill”, more like in gut-wrenching plummets. By the end I simply wanted it to end.

Not just work, not just the kids squabbling, not just the cold, wet, gloomy weather – everything.

And I knew how. Few of my waking moments had been devoid of considering how. Lots of possibilities, none nice but then the aching void screamed out for an abrupt end.

With heavier heart than I ever thought possible I kissed them goodnight, prayed for each and committed them into Jesus’ care. Aching with pain and despair I wept over the youngest.

What was I about to do? Would this destroy his life, a life only just begun?

In the end the ache of love won. I am still here.

Stop

Sorry for the rawness, but these things do need to be discussed sometimes.

Seeing, I do not See

This is why I speak to them in parables, because seeing they do not see, and hearing they do not hear, nor do they understand. Indeed, in their case the prophecy of Isaiah is fulfilled that says:“‘“You will indeed hear but never understand,
and you will indeed see but never perceive.”
For this people’s heart has grown dull,
and with their ears they can barely hear,
and their eyes they have closed,
lest they should see with their eyes
and hear with their ears
and understand with their heart
and turn, and I would heal them.

(Matthew 13:13-15 ESV)

Some days I am convinced Jesus spoke these words directly about me. I have a wonderful family, a good job, was out in the sun at a beautiful beach and yet could not rouse my heavy heart to respond to God. How to remove such heaviness and get my soul to a place of feeling ‘normal’ even?

At such times reading the Bible becomes a ritual devoid of meaning – eyes navigate the page but it is like reading some arcane academic journal which registers in syntax but carries no meaning. Praying is similarly stuck – at least in this there is the reassurance of Romans 8:26 when inarticulate groaning is all I’m good for. What I need is some way of reliably moving myself from torpor to transcendence, something that does not require any existing ‘spiritualness’ as a starting point.

While I do not think it is a full answer, making note of the blessings I can notice does help. It is a nice mechanical thing to do – I can generally find one thing to note reasonably easy and then it gets incrementally easier from there as I pause with each blessing noticed and thank God for it – albeit mechanically! However, sometimes the passionless thanks slowly moves into more enthusiastic thanksgiving and praise as I stumble along looking for the gifts I already have, still asking and yearning for the normalness I most want.

Seeking to understand with my heart

My goal is not primarily to list blessings, this is merely a tool. I need healing, to get that I need to turn to God and to get that I need to understand with my heart. A part of this is to understand what God has already done for me. By counting blessings I force myself to look, see and notice what God has done and sometimes can even see what He is doing.

Another important element in understanding with my heart is to learn and trust in what God promises to do. The only reliable source of such knowledge is from God’s word, so while Bible reading may seem mechanical and ineffective it remains important.

I have read that George Mueller said his first priority each day was to get his soul happy in God – this came before praying, otherwise his prayers were not effective. Apparently his way to do this was by reading the Bible and meditating on it.

According to my judgement the most important point to be attended to is this: above all things see to it that your souls are happy in the Lord. Other things may press upon you, the Lord’s work may even have urgent claims upon your attention, but I deliberately repeat, it is of supreme and paramount importance that you should seek above all things to have your souls truly happy in God Himself! (George Mueller’s Strategy for Showing God)

I am wondering if I need to add a preliminary step; taking note of the blessings of God to help my heart move into thanksgiving and then open the Bible and meditate upon God’s words to us and His promises in which I can trust.


Photo: nstanev (iStock)