The Vicious Cycles of Depression

Depression is a common mental illness that can severely impact a person’s ability to complete the tasks they need and want to do. It is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities that were once enjoyable. It can affect how a person thinks, feels, impacting one’s ability to engage in their usual daily tasks. These devastating symptoms of depression can lead to significant impairment in functioning at work, school, at home and in their relationships.

Depression can vary in its intensity and duration, from a short episode to a chronic illness that requires ongoing management. Depression is caused by a combination of genetic, biological, environmental, and psychological factors. Understanding these complexities is essential for effective treatment, which involves psychotherapy, medication, or a combination of both. Early intervention and support are crucial in helping individuals navigate their experiences with depression and interrupt the negative cycles that depression can cause.

Low motivation is a common symptom of depression that can significantly impact daily functioning and overall quality of life. Individuals may experience extreme low energy and motivation, making even simple tasks feel overwhelming or impossible. This lack of motivation often leads to disengagement from activities that were once enjoyable to the person, contributing to a cycle of isolation and worsening mood. People may struggle to initiate or complete everyday responsibilities, such as tasks at work or school, engaging in basic social interactions, or struggle with completing simple self-care and hygiene tasks, which can make feelings of worthlessness or guilt worse.

One of the most impactful symptoms of depression is that change that occurs in a person’s behaviour. With low mood, comes decreases to one’s activity level. These changes can have profound impacts and change the person who was once active, engaged and upbeat to someone who is isolated, withdrawn and struggles to take care of themselves.

A vicious cycle is created when these feelings of low motivation and fatigue are paired with decreased activity levels. As your activity level decreases, you start to stop doing the things you once loved and enjoyed, leading to fewer opportunities to experience positive emotions. This, in turn, perpetuates the feelings of depression, allowing the depression to persist and be maintained.

Physical symptoms of depression, such as fatigue and disrupted sleep patterns, also play a significant role. Lack of energy can reduce motivation to engage in self-care or seek help, while poor sleep can worsen mood and clear thinking ability. As a result, individuals may find it increasingly difficult to break out of the cycle. Additionally, people with depression may experience difficulty concentrating or making decisions, leading to decreased productivity at work or school. This decline can trigger feelings of inadequacy or failure, reinforcing negative thought patterns and perpetuating the cycle.

Depression often creates vicious cycles of inactivity that make the person’s mood worse and prolong recovery. One aspect of the treatment of depression that is critical is addressing and interrupting this cycle through increasing activity levels. This evidence based treatment for depression is called Behaviour Activation and comes from the Cognitive Behavioural Therapy model. When we engage in activities that are pleasurable, it increases our chances of experiencing positive emotions, allowing for increased motivation, confidence and energy. This is one of the ways to break out of the vicious cycle of depression.

Understanding these vicious cycles is crucial for addressing depression effectively. Therapy interventions for depression, such as cognitive behavioural therapy (CBT), can help individuals identify and challenge negative thoughts, interrupt the vicious cycles of depression, and gradually re-engage in life again.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario. Dana used cognitive behavioural therapy along with other evidence based treatment modalities to treat anxiety, depression, obsessive compulsive disorder and disorder eating.

Occupational Therapists Apply Psychotherapy to Real Life

October is Occupational Therapy (OT) month! This blog post will cover the role of Occupational Therapists in mental health treatment and why they are the best person to have on your treatment team when seeking support for your mental health challenges. With our unique expertise in promoting independence, Occupational Therapists provide valuable insights and interventions to help you manage and overcome your mental health challenges. Occupational Therapists play a crucial role in supporting individuals with mental health conditions. Read on to learn more.

An OT brings something different to the table than standard therapist. OTs believe that healing comes from doing, so we are naturally drawn to concrete, actionable goals. Whether it be engaging in an activity you really used to enjoy again, or working up the courage to order a coffee. Our therapy is based in doing.
One of the primary goals of occupational therapy in mental health treatment is to enhance your ability to engage in meaningful activities and participate in daily life. By focusing on a person's occupations (the things you do every day), occupational therapists can address the physical, cognitive, emotional, and social dimensions of mental health conditions.

An Occupational Therapist will frame your treatment around how your problem is getting in the way of the things you want and/or need to do. The things you want and need to do could be anything, from the little tasks such as getting dressed in the morning, to the bigger tasks of having family over for a dinner party. 

Occupational Therapists are unique practitioners in that goals are set collaboratively with the client and they tend to be concrete and action oriented. Although action orientated goals may sound intimidating, like jumping off the deep end into something you are scared to do, the tasks are always scaled to be just the right challenge. Not too hard and not too easy. We focus on the building up small successes to attain the client’s larger goal. 
To begin the treatment process, Occupational Therapists conduct comprehensive assessments to understand the unique needs and abilities of each individual. These assessments may involve evaluating cognitive and executive functions, analyzing daily routines, and assessing social interaction skills within various contexts.

Based on the assessment findings, occupational therapists collaborate with you to develop personalized treatment plans. These plans may include a variety of interventions, such as:
1. Activity Analysis: Occupational therapists break down daily activities into smaller components to identify potential barriers and develop strategies to overcome them. By modifying activities or adapting the environment, you can build confidence, enhance your coping skills, and restore a sense of accomplishment. This may look like analyzing food related activities such as grocery shopping, meal planning, eating, cooking in order to help manage the anxiety surrounding them for someone with an eating disorder.
2. Skill Training: Occupational therapists provide guidance and support in developing new skills or relearning lost ones. This may involve focusing on self-care activities like dressing, grooming, or cooking, as well as leisure pursuits or work-related tasks. Through skill training, individuals can regain independence and improve their overall well-being. Regaining skills or learning new ones helps in the process of self discovery and exploring self outside of mental illness. An important part in the recovery process is engaging in meaningful activities. 
3. Coping Strategies: Occupational therapists teach you practical techniques to manage stress, anxiety, and other emotional challenges. These may include relaxation exercises, guided imagery, deep breathing techniques, and time management strategies. This could also involve learning cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) or other psychotherapy based tools. By equipping you with effective coping mechanisms, occupational therapists empower you to navigate your mental health journey more effectively.
4. Environmental Modifications: Occupational therapists assist you in creating supportive environments that foster positive mental health outcomes. This may involve rearranging living spaces or workstations to optimize functionality, promoting safety, and reducing potential triggers for anxiety or depression.
5. Social Skills Training: Occupational therapists facilitate social skills development teaching assertiveness skills, anger management skills, and boundary setting to name a few. By nurturing healthy relationships and enhancing communication skills, you can increase your social support network, which is vital for mental well-being.

Occupational Therapists in mental health treatment also collaborate closely with other healthcare professionals, such as psychologists, psychiatrists, and social workers, to ensure comprehensive care. This interdisciplinary approach fosters a holistic understanding of your mental health needs and enables a more integrated treatment plan.
Throughout the treatment process, Occupational Therapists regularly evaluate progress and adjust interventions as needed. By providing ongoing support, education, and empowerment, occupational therapists empower you to take an active role in your mental health recovery.
In summary, Occupational Therapists play a fundamental role in mental health treatment by using our expertise in enhancing the functional independence and overall well-being of individuals. Through a range of interventions, we help individuals overcome challenges related to daily activities, develop coping strategies, and create supportive environments, all with the aim of promoting positive mental health outcomes.

ABOUT THE AUTHOR

Dana Etherington OT Reg. (Ont.), Psychotherapist is the owner of Cedar Tree Therapy, a psychotherapy practice for young adults that is located in Whitby, Ontario.

Unhelpful Thinking Styles

Unhelpful thinking styles are ways that our brain processes information that can contribute to feeling badly about ourselves, and add fuel to our shame and anxiety. These styles of thinking are automatic and often occur without our awareness. They filter our thoughts, beliefs, and experiences, leading to biased interpretations and judgments. Unhelpful thinking styles (otherwise known as cognitive distortions) can manifest in various ways, such as black-and-white thinking, overgeneralization, mental filtering, jumping to conclusions, personalization, and catastrophizing to name a few. We will explore each of these in more detail in this blog post. It is important to recognize and challenge these distortions in order to cultivate healthier thought patterns and promote emotional well-being. By understanding our unhelpful thinking styles and discovering ways to address them, we can gain a clearer understanding of ourselves, our emotions, and the world around us. our shame and anxiety.

Learning to name our unhelpful thinking patterns can be a helpful skill that we learn throughout therapy. Naming our thought patterns that are keeping us down is very helpful , we need to notice and name our problematic thinking styles in order to address them . Now, we all experience some of these unhelpful thinking styles from time to time. However if one or more of these ways of thinking are causing problems in your relationships, at school or work, or keeping your mood down , it’s time to address them with a therapist. 

As you read through, notice which unhelpful thinking styles you find yourself getting stuck in. Make a note of it and bring it up with your therapist next session to be able to dive deeper into this.

Black and White Thinking

Seeing things as all or nothing, with no room in between for possibilities.

For example: if I don’t give 100%, I’ve failed.

Mental filter

Only seeing and paying attention to certain types of evidence, mostly negative.

For example: Only seeing the dirty laundry your partner leaves on the ground and not that they emptied the dishwasher. 

Disqualifying the positive

Not taking into consideration any positives of the situation or saying the positives don’t count. 

For example: Receiving lots of positive feedback on a presentation you did but only remembering one critical comment.

Jumping to conclusions

Making assumptions without evidence that they are true. Assuming things are worse than they actually are.

For example: Meeting a new person and thinking they’re going to think i’m weird.

Catastrophizing

Blowing things out of proportion, seeing small problems as a “catastrophe.” 

For example: If I don’t get an A in the course, my life will be over.

Minimization

Shrinking something to seem less important . 

For example: Receiving a compliment on a shirt and saying, “Oh, it’s just a hand me down.”

Emotional reasoning

Using our emotions as facts. 

For example: I feel anxious so something bad must be about to happen.

Shoulding & musting

Using judgemental words (I should, I must) that make us feel guilty or like a failure. 

For example: I should be married with kids at my age. 

Labelling

Assigning labels to ourselves that put us in a box.

For example: I’m lazy because I don’t get up early. 

Personalization

Believing things are your fault for something that wasn’t. 

For example: My boss is in a bad mood, I must have done something to make them mad.

As you go throughout your day, if you find yourself thinking in a way that’s not helpful, see if your thought might fit into any one of the above categories. Notice what story you are telling yourself that might not be true . Changing your thinking patterns IS possible. It takes practice, persistence and a deep dive into it with your therapist. You  spend a lot of time in your mind, let’s make it a nice place to be. 

About the Author

Dana Etherington is the owner of Cedar Tree Therapy, a psychotherapy practice for young adults that is located in Whitby, Ontario.