Cognitive Strategies for Depression

Keeping Your Balance

Keeping Your Balance
Module 5
Cognitive Strategies for Managing andPreventing Depression

Feelings and Thoughts

2

Making the Connection

3

Improving How You Feel

5

Thought Diary

7

Module Summary

8

The information provided in this document is for information purposes only. Please refer tothe full disclaimer and copyright statements available at www.cci.health.gov.au regarding theinformation on this website before making use of such information.

forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 1Cognitive Strategies for Depression

FEELINGS AND THOUGHTS

People often believe that the feelings and emotions they experience are determined byexternal events, situations, and the behaviour of others. For example, we may hear
ourselves say, “My boss made me so nervous,” “My partner made me so angry,” “Thistrip down south made me feel so relaxed,” or “I’m depressed because I didn’t get the job
I wanted.” What is the assumption underlying these statements? That someone orsomething other than ourselves was directly determining the feelings we experienced.
We come to these conclusions automatically without asking ourselves if this assumption
is true. However, if we stop to analyse the process that links an external situation to ouremotional responses, we will find that there is a step in between.
How Our Thoughts Influence Our Feelings
What really makes us feel and respond the way we do, is often not the situation or the words and actionsof another person, but how we perceive that situation or that person’s actions. It is how we see somethingor someone and what we think about it or them that really influences how we feel. It is our thoughts andbeliefs about an event that significantly influences our emotions and actions.
Just as we are not always conscious of the way we walk or how we drive a car, we are often not aware of
our thinking. Some of our thinking is so habitual that it is automatic, and just like driving, when things areautomatic, we might not be conscious of them. Our automatic thoughts, however, play an important rolein our emotional well-being.
Here’s an example. Suppose you went to a party and your host introduces you to Mike. As you talk tohim, you notice that he does not look directly at you but often looks around the room. How would you
feel if you thought, “Boy, this guy is so rude! He won’t even look at me while I’m talking with him! Hownasty!” What if you thought, “Mike must think that I’m really unattractive and uninteresting. I must be areally boring person. Nobody wants to talk to me!” What about if you were to think, “Mike’s probably
waiting for a friend to come. Maybe he’s getting a bit anxious.” You probably realised that you felt threedifferent emotions as a result of those three different thoughts. Often, we are not aware of our thoughts
and beliefs because they are so automatic and happen quickly. But they are there, and they affect the way
we feel.
Feelings are not Thoughts
When we first try to distinguish thoughts from feelings, it can be easy to confuse them. We might be used
to talking about thoughts and feelings as being part of the same experience, but it is more helpful toseparate them and remember that feelings are not thoughts. For example, you might hear a person saying“I think I’m anxious,” but they’re probably thinking “Everyone will laugh at me,” and feel anxious. Morecommonly, you might hear someone saying something like “I feel that my partner doesn’t appreciate the gift
I bought for him,” when they are actually thinking “My partner doesn’t appreciate the gift I bought for him,”
and feel hurt.
Try the exercise on the following page and see if you can identify the possible feelings and thoughts in eachof the scenarios. Remember to try and make the distinction between thoughts and feelings.

forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 2

Cognitive Strategies for Depression

MAKING THE CONNECTION

Part One
Instructions: Read the following scenarios and identify the feelings that may result from the self-statements.
SCENARIO 1:
You’ve had a rather long and tiring day at work where you were helping a colleague move boxes ofstationery and office equipment. You arrive home to find the front door ajar and two sets of muddy
footprints (your son’s and his dog’s) on your cream-coloured carpet leading from the front door all the way
to the back door.
A) You say to yourself:

Possible Feelings:“What! N@!^#*M!! I’ve had such a tiring day at work and now I comehome to this!?!! What have I done to deserve this! We just had thecarpet cleaned last week! That naughty boy! All he cares about ishimself! That inconsiderate, selfish brat! I’m gonna ground him for 2years!!!”B) You say to yourself:“I’ve told him a thousand times not to bring the dog into the house andhe never listens to me. My kids don’t obey even the simplest
instructions. I must be the worst mother in the world. If I can’t even get
this right, I must be a terrible failure.”

Possible Feelings:

SCENARIO 2:
One evening, your parents ask you to go over to their house for dinner. As you arrive, you noticed that it
was all dark and there were no lights on. You knock on the door and ring the doorbell but no one comesto answer the door. You turn the doorknob and find that the door is unlocked. You step in and find thatthe house is in total darkness. Suddenly, you hear a chorus of voices shouting, “Surprise!” The lights comeon and you see a group of your friends and relatives singing “Happy Birthday” to you.
You say to yourself:“Wow! I didn’t even remember that it was my birthday! What a really
nice surprise! Hey, even uncle James and aunt Bertha came and they live inthe country! Everyone must think I’m pretty important to throw me thisparty!

Possible Feelings:forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 3

Cognitive Strategies for Depression
Part TwoInstructions: Read the following scenarios and now fill in the self-statements that lead to the feelings
experienced.
SCENARIO 1:
You arrive home to find a note from your flatmate telling you that they have moved out. You look aroundand find that everything that belongs to them is gone. Moreover, their share of the rent has not been paid.
A) You say to yourself:
Feelings:
AngryB) You say to yourself:

Feelings:
Hurt

SCENARIO 2:
You just finished cooking dinner for you and you partner. Your partner calls to say that he/she will not behome for dinner because he/she has to work late.
A) You say to yourself:
Feelings:
DisappointedB) You say to yourself:

Feelings:
ConcernedforCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 4

Cognitive Strategies for Depression

Improving How You FeelWe’ve talked about the way our thoughts affect how we feel. If we are feeling happy andexcited, chances are we have been thinking positive thoughts and about positive things.
On the other hand, if we are feeling anxious, depressed, and upset, it is very likely that wehave been thinking negative thoughts. We call these unhelpful thoughts (simply because
they lead to unpleasant feelings or unhelpful actions!). All of us, at times, think things thatmake us feel sad or distressed, and that is a normal part of life. However, if you feeldepressed over a period of time, you might need to examine your thinking in order toimprove how you feel.
What sorts of thoughts are unhelpful? Unhelpful thoughts are those that tend to focus on the negative
aspects of a situation, or those that overestimate the chances of a negative event occurring, or those thatplace unrealistic demands on yourself or others. These are also often known as unhelpful thinking styles
because they are patterns of thinking that have become a habit and contribute to a person feeling unhelpful
negative feelings.
What Can I Do?
Plenty! There are lots of things you can do to help yourself feel better, and this next suggestion has been
proven to be pretty effective. If unhelpful thoughts lead to distressing emotions, then it might be quite
reasonable to say that the most effective thing to do would be to change those unhelpful thoughts tohelpful ones! Yeah? Okay, so, how can you do that?
On page 7, a Thought Diary is provided for you to guide you in organising and changing your thoughts.
First, write down an event or a situation in which you experienced a strong negative emotion, such asdepression. Next, try to identify exactly how or what you felt. Then, ask yourself “What am I thinking?
What conclusions am I making?” to see how and why you are feeling distressed. Remember, unhelpful
thoughts will lead to you feeling upsetting emotions.
The next step is to challenge your thinking by exploring other possible explanations and looking at asituation from different points of view. You might ask yourself, “What other ways are there of viewing thissituation? How might someone else view this situation? What other explanations could there be?”The final step is to ask yourself, “How can I revise my original thoughts to take into accountthese other possible viewpoints?” Then, think of an alternative explanation. This becomes
your new, balanced, and helpful thought. A balanced and helpful thought or belief is one thattakes into consideration alternative viewpoints and helps you feel better. Replace youroriginal, unhelpful thought with this new, balanced, and helpful belief. Once you have done
this, you will probably find that you feel better and your mood will be improved.

forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • TrainingPage 5

Cognitive Strategies for Depression
Below is an example of how you could fill out a thought diary. Each column includes prompts so that you
can work through the process easily. Try to be as specific as possible. Then, use the thought diary
provided on the next page to work through this process with an example from your own experience.

My Thought Diary(Example)
What happened?

What was I thinking?

How can I think differently?

This could be an actual What thoughts were going through your What other ways are there of viewing
event or situation, amind when the event occurred?
the situation? What evidence do I havethought, mental
that show that this thought is notpicture orcompletely true all of the time?
recollection, leading tounpleasant feelings.
When mypartner camehome thisevening, shesaid ‘hi’ butdidn’t give me
a kiss like she
usually does.

“She must be tired of me
moping around and feelingdepressed.”

She might have had adifficult day at work andwas just feeling tired anddistracted.

“She probably doesn’t careabout me anymore. Maybe
she doesn’t even love meanymore.”

She might have wanted to
put the groceries away or go
to the toilet.
She has been telling me that
she understands mystruggles and will support
me through this period.

Note: If you would like more detailed
information about the use of cognitive
strategies to manage depression, take alook at:Back from the Bluezfor
Centrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 6

Cognitive Strategies for Depression

My Thought Diary
What happened?

What was I thinking?

How can I think differently?

This could be an
What thoughts were going through What other ways are there ofactual event or
your mind when the event occurred? viewing the situation? Whatsituation, a thought,
evidence do I have that show thatmental picture or
this thought is not completely true
recollection, leading
all of the time?
to unpleasantfeelings.

How did I feel?
What did I do?

Describe how you
feel and include any
physical sensations
you experience, as
well as your actions
and behaviour.

forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 7

Cognitive Strategies for Depression

Module Summary•

What really makes us feel and respond the way we do, is not the situation or the words andactions of another person, but our thoughts and beliefs about the situation or person•

If we are feeling depressed, anxious, or upset, it is very likely that we have been thinking
negative thoughts. These are called unhelpful thoughts because they lead to unpleasant feelings
or unhelpful actions•Unhelpful thoughts are those that tend to focus on one aspect of a situation (usually a negativeaspect), or those that put a negative label on yourself, overestimate the chances of a negative
event occurring, or those that place unrealistic demands on yourself, others, or the world•

Use a Thought Diary to help you work through the process of challenging your thoughts•

Write down an event or a situation in which you experienced a strong negative emotion••

Next, identify exactly how or what you felt
Then, ask yourself “What am I thinking?” to see how and why you are feeling distressed•

Challenge your thinking by exploring other possible explanations and looking at the situationfrom different points of view
The final step is to revise your original thoughts and replace them with an alternative andbalanced explanation•Keep Going ...

In the next module, we will discuss
cognitive changes in mania and look at
how cognitive strategies can be used toprevent a full-blown manic episode.

forCentrelinical
C Interventions Module 5: Cognitive Strategies for Managing and Preventing Depression• Psychotherapy • Research • Training

Page 8