The beginning of my journey with Cognitive Behavioural Therapy

I’ve wanted to open up about my struggle with depression for a long time, but many things have held me back. For one, it’s hard to put such deeply personal and emotional experience into words at all sometimes, let alone post such experiences on the internet for friends & strangers to read. Even if I did find the courage and words to express what I’ve been going through, I haven’t wanted to be seen as looking for sympathy or attention. I’ve never related to the phrase “misery loves company” - I’m more concerned with not dampening people’s mood & and dragging others down with me. One consequence of that mindset has been to isolate myself when I get in a funk, and while some alone time is necessary, as a ritual coping device it’s just not healthy. I would much rather post an inspiring quote, a reminder to hang in there, or start a conversation about something positive that might be helpful to others who are also battling their own minds, rather than wallow or discuss my own issues directly. But it’s a fine line. At a certain point I feel it can be taken as hypocritical - I don’t want people to think I’m all sunshine & rainbows when that's not the case - I'm not fake, but there's so much I don't share that I guess I'm only real to a certain degee. When I haven’t figured my own shit out I am somewhat limited in the positivity & “advice” I can give while remaining authentic. Does that make sense? Like, you wouldn’t take financial advice from someone who was perpetually broke, so why should people listen to ME about how to not be depressed?!

The truth is, I have made a ton of progress over the years and DO have some helpful things to share, but I lacked the confidence  to really open up about it publicly. I've had some intense discussions privately about depression & suicide with friends & followers from all around the world in response to what I've posted about mental health - the heartfelt & overwhelming response has motivated me to do more but it's taken time to figure out how.

The final issue holding me back has been worrying about coming off as ungrateful; I’m fully aware that I have a pretty amazing life! I share a beautiful home with my loving partner, I have no shortage of top shelf cannabis, food, & friends, I freelance full time in the cannabis industry and am part of a vibrant cannabis community online & in real life while living in a cannabis friendly city in a country that is about to legalize recreational cannabis. DREAM LIFE for a stoner, I know!

But how could I be so fucking lucky and also spend the winter waking up crying several days a week and not be able to shake it off or figure out why? It was frustrating to not understand myself, and believe me I’ve put in years trying to figure it out. There are always some good days, but too often I couldn’t just push my sadness aside & get on with it. Too often my emotions dictated my thoughts and consumed all my energy. I wouldn’t have been able to articulate that last sentence a few months ago - Cognitive Behavioural Therapy helped lift me out of my rut and taught me the powerful (and changeable!) relationship between our thoughts, feelings, and actions.

I don’t remember what sparked my interest in CBT in the first place, but I searched it on YouTube and spent several days watching lectures about it’s history, core concepts, and efficacy. I wanted more! I was intrigued by the concept of monitoring your thoughts to identify the dysfunctional ones, essentially having a tool to effectively analyze emotions rationally. Reconciling my emotional state with my logical mind has always been a point of frustration for me, so this idea was very appealing! I learned that CBT is clinically proven to be as effective as prescription anti-depressant medication but with longer lasting positive effects and none of the negative effects of pharmaceuticals. I had a pretty good handle on the basics before coming across an interview with Dr. David Burns. According to his website:

“ His best-selling book, Feeling Good: The New Mood Therapy, has sold over 4 million copies in the United States, and many more worldwide. Feeling Good is the book most frequently “prescribed” for depressed patients by psychiatrists and psychologists in the United States and Canada. Surveys indicate that American mental health professionals rate Feeling Good as the #1 book on depression, out of a list of 1,000 self-help books.”

I was sold. Having dealt with depression for over 15 years, noticeably worse in the winter, I was desperate to try something new. Anything. I’ve made a lot of progress over the years, but I needed something major to shift my perspective. I found Feeling Good at BMV books - they had a surprising number of copies of several editions! I couldn’t decide which to buy, so I googled the difference between the two I was considering - the original edition and an updated version called the “Feeling Good Handbook.” Apparently the original has a more in depth introduction to the basic concepts and history of CBT and largely focuses on depression, whereas the handbook has a bit less of the introductory stuff & includes significantly more about anxiety. I do not suffer from anxiety so I chose the original. It was brand new for only $9 - best $9 I’ve ever spent!

Chapter One is a detailed overview of Cognitive Behavioural Therapy. I had learned a lot of what is in it from my YouTube research, but it was still worth reading as it is a good primer for the following chapters.

Chapter Two is called “How to Diagnose Your Moods: The First Step in the Cure” (19). The first exercise you are asked to do is fill out the Burns Depression Checklist. This checklist is widely used by mental health professionals & Dr. Burns calls it a “reliable mood-measuring device that detects the presence of depression and accurately rates it’s severity” (19). See chart below.

BDS.png

 

Dr. Burns notes that if you answer 1 or higher on any of the “Suicidal Urges” questions to see professional help immediately. Please don't delay in getting the help you need if you are thinking about harming yourself. You CAN get better, but you have to be alive!

National Suicide Prevention Hotline: 1-800-273-8255

As someone who has lived with depression since the age of 15, I have been to my share of psychologists over the years & have filled out this checklist many times. But there was a striking difference this time. I scored higher than ever before because for the first time my depression had started to affect my self-esteem. I didn’t even notice it happen, it was like a huge dark cloud that rolled in so gradually I didn’t notice how dark it had gotten until I could hardly see. I’ve always been self-critical, which in healthy doses is actually quite useful, but I had only recently started to notice how negative my self-talk was. When I was feeling good it was easy to see that there are a lot of things I like about myself, but in the depths of depression I hated myself & couldn’t see the positives. There is no one in the world I would speak to as harshly as I spoke to myself & it had started to wear on my fundamental self  perceptions. Years ago I succumbed to my seemingly endless cycle of depression and told myself I better get used to it because this is just who I am. I got comfortable and way too complacent about my mental health & told myself I just had to ride it out, but instead of remaining manageable, it had clearly gotten worse.

Chapter Three changed my life. It’s titled “Understanding Your Moods: You Feel the Way You Think” (28). That phrase pretty much summarizes the foundation of CBT. The following chart illustrates the relationship between events, thoughts, and moods. It appears in Feeling Good, but this image was found in an article on Cognitive Distortions on SamuelThomasDavies.com - it's a good read if you want more info!

World-Thoughts-Mood.png

 

Essentially, our moods are not a direct result of external events happening in the world, but rather are created based on our interpretation of them. Dr. Burns explains:

“Every bad feeling you have is the result of your distorted negative thinking. Illogical pessimistic attitudes play the central role in the development and continuation of all your symptoms. Intense negative thinking always accompanies a depressive episode, or any painful emotion for that matter. Your moody thoughts are likely to be entirely different from those you have when you are not upset” (28).
He goes on to say “you are probably skeptical of all this because your negative thinking has become automatic. For this reason I call negative thoughts “automatic thoughts.” They run through your mind automatically without the slightest effort on your part to put them there. They are as obvious and natural to you as the way you hold a fork” (29).

….YES! This resonated with me very strongly but still doesn’t offer a solution. If anything, thinking of negative thoughts as “automatic” seems to imply that we do not have control or agency over them.. But just wait!

Dr. Burns made a made a list of 10 “Cognitive Distortions” that are common to people suffering from depression and anxiety. The following list is copied from PositivePsychologyProgram.com but comes directly from pages 42-43 of the original edition of “Feeling Good.”

10 cognitive distortions:

1. All-or-Nothing Thinking / Polarized Thinking

Also known as “Black-and-White Thinking,” this distortion manifests as an inability or unwillingness to see shades of gray. In other words, you see things in terms of extremes – something is either fantastic or awful, you are either perfect or a total failure.

2. Overgeneralization

This sneaky distortion takes one instance or example and generalizes it to an overall pattern. For example, a student may receive a C on one test and conclude that she is stupid and a failure. Overgeneralizing can lead to overly negative thoughts about oneself and one’s environment based on only one or two experiences.

3. Mental Filter

Similar to overgeneralization, the mental filter distortion focuses on a single negative and excludes all the positive. An example of this distortion is one partner in a romantic relationship dwelling on a single negative comment made by the other partner and viewing the relationship as hopelessly lost, while ignoring the years of positive comments and experiences. The mental filter can foster a negative view of everything around you by focusing only on the negative.

4. Disqualifying the Positive

On the flipside, the “Disqualifying the Positive” distortion acknowledges positive experiences, but rejects them instead of embracing them. For example, a person who receives a positive review at work might reject the idea that he is a competent employee and attribute the positive review to political correctness or to his boss simply not wanting to talk about his employee’s performance problems. This is an especially malignant distortion, since it can facilitate the continuance of negative thought patterns even in the face of lots of evidence to the contrary.

5. Jumping to Conclusions – Mind Reading + Fortune Telling

This “Jumping to Conclusions” distortion manifests as the inaccurate belief that we know what another person is thinking. Of course, it is possible to have an idea of what other people are thinking, but this distortion refers to the negative interpretations that we jump to. Seeing a stranger with an unpleasant expression and jumping to the conclusion that she is thinking something negative about you is an instance of this distortion.

A sister distortion to mind reading, fortune telling refers to the tendency to make conclusions and predictions based on little to no evidence, and holding them as gospel truth. One example of fortune telling is a young, single woman predicting that she will never find love or have a committed and happy relationship based only on the fact that she has not found it yet. There is simply no way for her to know how her life will turn out, but she sees this prediction as fact rather than one of several possible outcomes.

6. Magnification (Catastrophizing) or Minimization

Also known as the “Binocular Trick” for its stealthy skewing of your perspective, this distortion involves exaggerating the importance or meaning of things or minimizing the importance or meaning of things. An athlete who is generally a good player but makes a mistake may magnify the importance of that mistake and believe that he is a terrible teammate, while an athlete who wins a coveted award in her sport may minimize the importance of the award and continue believing that she is only a mediocre player.

7. Emotional Reasoning

This may be one of the most surprising distortions to many readers, and it is also one of the most important to identify and address. The logic behind this distortion is not surprising to most people; rather, it is the realization that virtually all of us have bought in to this distortion at one time or another. Emotional reasoning refers to the acceptance of one’s emotions as fact. It can be described as “I feel it, therefore it must be true.” Of course, we know this isn’t a reasonable belief, but it is a common one nonetheless.

8. Should Statements

Another particularly damaging distortion is the tendency to make “should” statements. Should statements are statements that you make to yourself about what you “should” do, what you “ought” to do, or what you “must” do. They can also be applied to others, imposing a set of expectations that will likely not be met. When we hang on too tightly to our “should” statements about ourselves, the result is often guilt that we cannot live up to them. When he cling to our “should” statements about others, we are generally disappointed by the failure of the others to meet our expectations, leading to anger and resentment.

9. Labeling and Mislabeling

These tendencies are basically extreme forms of overgeneralization, in which we assign judgments of value to ourselves or to others based on one instance or experience. For example, a student who labels herself as “an utter fool” for failing an assignment is engaging in this distortion, as is the waiter who labels a customer “a grumpy old miser” if he fails to thank the waiter for bringing his food. Mislabeling refers to the application of highly emotional, loaded language when labeling.

10. Personalization

As the name implies, this distortion involves taking everything personally or assigning blame to yourself with no logical reason to believe you are to blame. This distortion covers a wide range of situations, from assuming you are the reason a friend did not enjoy the girl’s night out because of you, to the more severe examples of believing that you are the cause for every instance of moodiness or irritation in those around you.


How many of these can you relate to? At different times and in different situations I admittedly have fallen prey to all of these distortions. Being aware of these irrational thought patterns is a start, but the magic came when I completed one of the exercises in Chapter 4..

If you are still reading and intrigued by what I’ve written so far, I can’t encourage you enough to try the following exercise. JUST DO IT! It was challenging and painful, but this tool afforded me a massive breakthrough in understanding my depression & ultimately improved my mind set in a significant and long lasting way.

You are instructed to keep a record of your dysfunctional thoughts. Start by creating a chart like the one below, found on page 66. The first row is my explanation of what to write in each column, the second row is one example of a situation used to bother me.

 

 

SITUATION

EMOTIONS

(0-100)

AUTOMATIC

THOUGHTS

COGNITIVE

DISTORTION

RATIONAL

RESPONSE

OUTCOME

Briefly describe the situation that has you in a heightened emotional state.


Sometimes we have real things to be sad about like the loss of a loved one, job, etc. If this is the case, you're supposed to be sad - grieving is different from recurring depression.


The purpose of this exercise is to examine our thoughts to see if they are dysfunctional.

Specify all of the emotions that this situation makes you feel, and rate them by intensity on a scale of 0-100.


There is no official scale of emotional intensity- just put down what feels right to you. This is just for YOU, so be honest with yourself.

What automatic thoughts accompany these emotions? Ask yourself how you are interpreting these thoughts & keep questioning what that means.


DIG DEEP.



Identify which of the 10 cognitive distortions are present in each automatic thought.


Some will only be subject to one or two, more complex issues or severe depression/anxiety might encompass all 10.

Again, the more honest you are able to be with yourself, the better.

Write a rational response to each of the automatic thoughts. This is easier to do when you're thinking clearly & NOT in a funk, but don't wait to try this out. if you're struggling here, think of what you would say to a dear friend who is having these thoughts. We are often more kind to our loved ones than we are to ourselves.

Rewrite the emotions you wrote in the 2nd column & reassess each one's intensity after filling out the other columns.

The goal is not to have 0’s for everything, that isn't realistic. But by analyzing your distorted thoughts you are able to see things a little more clearly. Even a slight lessening of intensity is a win. Keep going!

Example:


I feel lost & like I don't know what I'm doing with my life.

Frustrated: 40

Sad: 30

Self hatred: 20

Hopeless: 20

Anxious: 20

Shame: 10


Total: 140

I'm never going to figure out what I'm doing. I don't know what I really want therefore i don't know what to do on a daily basis to move forward. I'm useless, I should have this figured out by now.

-all or nothing thinking

-overgeneralization

-mental filter

-disqualifying the positive

-magnification

-labelling

-should statements

You may never feel confident with long term plans, but that's okay. Many successful people change their careers several times. Life changes so fast, it's better to go with the flow anyways. You may not have everything planned out, but you do know SOME of what you want - breaks those goals down into small manageable pieces & get to work!

Frustrated: 10

Sad: 10


Self-Hatred: 0

Hopeless: 0

Anxious: 10

Shame: 0


Total: 30

         
           
           

Seems pretty simple, right? But it works! I have been trying to work on my issues for over a decade, but this made me realize it was like I had been trying to clean a messy room in the dark… CBT turned the lights on! The difference in my mind state was noticeably better immediately after analyzing 6 various situations that I spent the winter ruminating about. I will still get sad some days, it's unrealistic to aim to be happy forever, but now I have this powerful tool just waiting to spring into action if I catch myself slipping into dysfunctional thought patterns. I feel empowered, healthier, lighter, and more capable of helping other people who are suffering. I really am Feeling Good!

I always felt like my depression was unique - like it was this perfect storm of inherited biological malfunction combined with unaddressed childhood trauma compounded by ongoing life fuckery until it was this tangled & heavy mess that no one could ever sort out or understand, including myself. But this book could have been written for me directly. It was humbling to think that these same ideas & exercises had helped MILLIONS of other humans. In a depressed state, the phrase “you aren't alone" is often not that helpful. Knowing that others are suffering doesn't make me suffer any less. But in this case, I really felt like I wasn't alone in my depression & it was truly comforting. Sure, my personal history is unique, but my depression is not. These thought patterns and distortions have literally played out billions of times throughout human history. It's a dark part of the human experience that we don't always talk about, but its it's more important now more than ever.

So what are you going to do?

You aren't alone.

You aren't broken.

There are things you can do to help yourself.

Just keep pushing through the pain.

YOU GOT THIS!

Let me know what you think of this post & if it was helpful in the comments here or on instagram! ❤ Thanks for reading!