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March 26, 2009
Cognitive distortions: Dealing with inaccurate thoughts
By Gabrielle J. Melin, M.D.
We will continue our series on cognitive behavioral therapy (CBT) and how it can help to manage your depression.
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Cognitive distortions can be so ingrained that they become "core beliefs" that you live by. An example is "I have never been successful at anything, so why even try?"
Some specific examples of cognitive distortions are:
- All or none thinking. You see things in black and white. If you don't finish something perfectly, then you're a complete failure. Things in life are either wonderful or terrible.
- Over generalization. You may conclude that since a single negative event occurred in the past that it will occur over and over again. Say you have a disagreement with someone important in your life and you conclude that this person doesn't understand or care about you. You then over generalize by assuming that this person never cared, never will and then may conclude that no one every will understand or care.
- Jumping to conclusions. You interpret something negatively (incorrectly) even though you have no facts or evidence to support the conclusion. One way to reconcile this would be to check out the situation and gather information instead of assuming.
- Mental filter. You focus on one negative detail so intently that your whole outlook on the situation is negative. If you make a good meal and overcook the bread, then you only focus on the "bad" bread instead of the rest of the meal that was enjoyed.
- Rejecting the positive. You reject positive experiences and hold firmly that they "don't count" for one reason or another. You don't allow yourself to enjoy positive feelings as you tell yourself that a bad or negative feeling is sure to follow. You end up feeling bad about feeling good.
In my next blog post, I'll conclude with five other thinking errors that can worsen mood.
Do you identify with any of the examples above? If so, cognitive behavioral therapy may be a tool that can help you to effectively manage your depression. Discuss this option with your health care provider. Depending on the severity of your depression, medication or other types of treatments may be recommended in addition to or other than therapy. And please share with the group if you've found cognitive behavioral therapy helpful.
38 comments posted
November 16, 2009 9:03 a.m.
Thank you so, so much. I've never come across these things before, yet this article is me in a nutshell - kind of unusual when you realise that these behaviours are not 'normal'. Am going to discuss CBT with my doctor, as medication just doesn't seem to be making any lasting difference with me. Thank you again.
- Gia
November 4, 2009 7:40 a.m.
What is your opinion on neurofeedback?
- Steve
November 1, 2009 10:22 a.m.
Thank you.
- Linda
October 23, 2009 1:12 p.m.
Thank you for this article. To all the commentators, thank you for sharing your feelings/ experiences that really explain the 5 "cognitive distortions." I started "cognitive behavior therapy" two years ago and it has helped me more than 15 years of "psycho-dynamic therapy," although it helped too. I got some therapy at my local hospital's outpatient ward for mental health. The PhD student doctors cared less, but it helped some. It amazes me how much of the 5 cognitive distortions I do. Many years of physical child abuse have ingrained negative beliefs into my core. But, medication and therapy are helping. I haven't trusted enough to be in a relationship, but finally at 40 I am partnered and happy. My partner is my very best thing. I wish she'd go to therapy, she has terrible PTSD also. But, at least I go and have gotten out of a bad job situation where I allowed them to treat me like shit. I am on Lexapro and a few other drugs for over 10 years now. I've tried to get off them a few times and sunk into serious depression; I guess I'll never get off of them. That's fine though, as long as I can be a decent partner and eventually earn a living. I have gained 20 pounds, which is weird for me. I can't believe I have such a great partner now and really want to stay functional. It scares her I take 5-6 different prescriptions so I don't talk about them much. It helps to read and, now finally, talk here. Thank you all.
- Elise
October 19, 2009 4:41 p.m.
I have been cronically depressed since 8 years old. I have had cognitive therapy several times and finally went into three years of intensive therapy after a suicide attempt and am taking antidepressants. Now at 72 years old I have finally overcome the thoughts and feelings that took me to the dark place in which I dwelled for several years. My life has been hard with several overwhelming events occurring, such as my son's suicide, the death of my husband and subsequent marriage and divorce from my second husband but I believe I'll be okay. I socialize (sometimes I force the activity), exercise and stay away from alcohol. If I have a bad day I know that it doesn't have to be forever. I have a spiritual life now and a friendly, loving God. I will be okay.
- marge
October 16, 2009 9:25 p.m.
Is there a doctor that really cares out there? I can't get any sleep without medication. The medications [ambion] makes me crazy and I end up getting up several times in the night doing different things. I am currently taking welbutrin that works ok but not quite enough. I was taking lexapro, the weight gain was terrible and I didn't want any kind of physical contact at all! I over think every sentence! I can't remember anything short term. I am in pain most of the time but I have started to excersise and it is helping alot. I am successfull because I work hard and take it very seriously! It is very hard for me to stay on any task at all! I normally delegate it to someone else, start something else, so that someone else to finish it! Some days I cry thinking about all of the evil in the world and all of the mistakes I have made. The mistakes never go away and if they do, when I sleep they come back. Is there real help out there? It feels good to get it out.
- Nicole
October 11, 2009 11:25 a.m.
I've been depressed since I can remember. I was born to 2 parents, neither of whom wanted me and I got stuck with my bitter, angry, violent and cruel parent. I've tried so hard to feel "normal" (without pain in my heart) for so long now I'm about to give up. I've been hospitalized at one of the best psychiatric treatment centers in the world and spend over 30 years in therapy. I've come to the conclusion that there is no way or no one who can help me. I'll die with this feeling, hopefully sooner than later, never at my own hand. I hope and pray that someday there may be help for people like me but I hope and pray more that we can stop the cycle of parents abusing and neglecting their children. I found it ironic that you never even mentioned the fact that the way you are made to feel as a child has everything to do with depression. Rose
- Rose
October 8, 2009 5:07 p.m.
where can i find help for cognitive distortions if i have no money or insurance ? i can't talk myself out of this mood, i've been on zoloft for 10 yrs. or more. i wish there was a place to go and hide.
- nancy
October 6, 2009 1:22 a.m.
I have suffered for the last two years from major depression, brought on by extreme verbal abuse at a company where I worked. I quit almost two years ago and am feeling better, but I still find that I have little motivation, no drive and no goals for my life. The point I would really like to make here is that before this happened to me, I could not understand at all when friends or acquaintances told me they were suffering. I didn't know how miserable one can be. I would like to point out to people who have never experienced it that it is not something that you just "snap out of." "Cheer up!" people say. I've heard Christian ministers say that depression can be cured by belief in God. Well, it can't be cured like that, no more than gout can be cured by God. People with depression need support and a caring atmosphere where they do not feel that they are being looked at in a negative light all the time.
- Richard
September 30, 2009 6:54 p.m.
I have been going thru a anxiety phase since December, 2008. I know it is linked to my family and children. I had to think hard, about when I became the most anxious! I have done a lot of thinking and the few conclusions that I have come to, are: 1. We are all told that we must always be "Up" and "happy", or we are depressed. Then the advertisements tell us to medicate ourselves to be happy. I firmly believe that there will be times when we "will not" be "up or happy!" 2. BE HONEST WITH YOUR FEELINGS! Too often, we try to appease and accommodate everyone, EXCEPT ourselves. Honor your feelings! Admit what you're afraid of, and what has happened to you! If you don't admit it to anyone, else, do it for yourself! 3. Incorporate some form of spirituality into your life. To know that God wants you to be happy and to Prosper, is indeed uplifting! 4. Finally, "BE TRUE TO YOURSELF!" GIVE LOVE, AND RECEIVE LOVE! YOUR LIFE IS USUALLY A REFLECTION OF YOURSELF! I've found that people who are hardest on themselves, have higher ethical and moral standards. So, I've come to the conclusion, that I can't do the same things as others, or I'll feel guilty. I know, because I have evolved thru all of those things that I mentioned! Each day, you must remind yourself of positive things, and soon they will become a habit; IF, there are no chemical embalances!! Take a risk! God Bless Each and Everyone of you! Bill, find a church f
- Justicia
September 28, 2009 1:43 p.m.
My husband lost three jobs in an 18 month span. He felt that it was the economy and politics, but I noticed that all said he had trouble with communication and being obstinate. He is a nice person, but I have noticed that he can totally misinterpret a conversation, especially if it is a confrontation. Is there any help for this type of problem?
- Susan
September 23, 2009 10:18 a.m.
the question i'm asking myself today, is why is it that the negative things i do, my mistakes, are so much more important to me than my successes?
- marie
September 20, 2009 6:12 p.m.
Hi! I suffered alot but, I feel okay most of the time. The list is quite long now and I really haven't had good help with the problems which sometime bother me except for taking positive directions such as taking classes in aqua aerobics and advocating for personal civil rights. With the types of deficencies I will not be able to blog once more to remember this sight and blogs written during the month of May.
- Mary
September 20, 2009 12:10 p.m.
I am a 48 year old male and I've been depressed since early childhood.I've been diagnosed with Dysthymia and currently on 2 meds and have tried several and they always "poop" out over time. I've been to 3 therapists and had success with none. Therapy seems pointless to me especially since I still physically feel miserable. All the therapy in the world won't do squat unless I feel better 1st! My thinking will be clouded because I physically feel really down and lack the energy to get off the recliner let alone do or think anything positive. I feel hopeless but I am not giving up I will continue to trudge along day after day until something works or I die.
- Ron
September 17, 2009 5:32 p.m.
These symptoms describe my boyfriend's latest attitude freakishly well. I believed he was depressed before but this hits the nail on the head. He won't believe me though. He starts fights from the most innocent things said every day and does not back down. It's chewing me up and pushing us apart...
- Bri
August 23, 2009 8:35 p.m.
My husband and I suffer from bipolar. We cycle several times a day or other issues. Medicine stops working and/or the symptoms change. We study our illness, done CBT & DBT, it is helping. My husband was hospitalized for 3 weeks, this month after not sleeping several days & continuous cycling. Been medicine resistent for 22 years. Because we are different, friends & family don't understand. I have PTSD from severe child abuse & OCPD (recently diagnosed). We realized he has PTSD from abuse but has pushed the pain, fear and betrayal down so that he took for granted he was supposed to be strong, over excel in order to be loved and worthy of being human. He's terrified of losing & can't trust anyone, so he is alone. He's so used to being a 'good boy', continue to achieve & be hurt by others, be the giver & not be able to ask for what he needs despite being disabled. Now we are trying to get him into IOP & a doctor again. It's survival.
- Claire
August 18, 2009 6:02 p.m.
To all who have posted comments: the fight is never over, the day will come where we are all at peace and in no pain, emotional or otherwise. My mother suffered from depression for most of her life and although she hid it well she later became addicted to sleeping pills and overdosed and passed in January 2009. I do not believe she committed suicide but simply needed help. Now her 9 siblings, three adult children and husband are left grieving and I suppose will carry her depression on...unresolved grief is horrible. I beg those of you who feel that there is nothing more to live for, to PLEASE get help or find distratctions for yourself, hobbies, pets, movement, heal broken relationships, etc. God Bless you all...
- Margarita
July 16, 2009 7:12 p.m.
I read most articles and I really like them. I also read most readers posts. I have noticed that most people have missed anther kind of treatment, and it's the most important cure for depression and other disorders...it's spiritual treatment. If this type of cannot cure/heal your illness it can at least help you and enable you to cope with your struggles and enjoy your life no matter what... Good luck to everyone.
- Adam
June 29, 2009 12:08 p.m.
Hello, I was at one time extremely depressed. I found that I had to slow myself down and listen -- to myself. I learned to do this by breathing slowly, then listening to my thoughts, then making a decision - even the smallest decision, for instance, "should I wash my hands?" Then I would ask myself, "Is this good for me?" If the answer was yes, I would wash my hands. If the answer was no, I would choose not to do it. Little by little I learned to make good decisions for myself, from the tiniest decision to larger ones. I learned to listen to my thoughts. I also learned that when I felt good, that was the time to be extremely attentive to a negative thought; for if I kept or reinforced that negative thought, that was when I would begin to be depressed again, and could begin to loop down and up again.
- Patty
June 18, 2009 12:33 p.m.
I suffer from major depression and I have done out-patient congnitive therapy. Everytime I get down my therapist reminds me to recall my cognitive therapy and use those skills to get me through the down times. I am currently down and doing my best to rely on these techniques to get me through this time. I identify with several of the examples in this article. Cognitive behavioral therapy has helped me tremendously.
- Karen
June 16, 2009 4:23 a.m.
I am a 58-year old, divorced man and have suffered major depression since I was about 10. (I didn't have a name for it then.) In my senior year of high school, I attempted suicide twice. The other side of my life was loving to listen to and play music. I love to draw but go through months - sometimes years - not doing anything creative because I have no interest. I was married for 30 years and have two adult children. Neither of them will talk to me at this time because I accused them of siding with their mother. I have been seeing therapists and taking medication since 1969. I even underwent ECT and think that was a horrible idea. My short term memory is very poor (though I have a good long term memory). At this time I am having two major problems (in addition to the ones I just see as "being me." My short term memory is horrible. I have to write down the things I need to remember. I repeat tasks and forget others completely. (I won't go into detail but I've had three open heart surgeries, have been diagnosed with chronic depression and continue to cut myself and attempt suicide. I live on SSDI.) The other problem is that I get into a state of fury and write horrible, angry emails to people I love. If I sleep that night, I awake barely remembering what I've done. I take Zoloft and Valium but still see suicide close by. I live alone, have no friends and sometimes run out of food for days (13 is my record). Thank you.
- Bill
June 6, 2009 9:31 a.m.
I know from my personal experience that CBT can be very helpful in conjunction with pharmacalogical treatments. I have had depression most of my life and have been diagnosed with major depression for the past 25 years. During that time I have had few periods of remission. Thankfully I'm in my longest period of remission now (3yrs) and my whole way of thinking has changed. I now want to get as much enjoyment in all aspects of life before the depression comes back...and I recommend others do the same when they are fortunate enough to be out of the darkness. 3 to 4 things I believe made this period of light possible: 1. 2 yrs of CBT 2. I made significant life changes 3. Continued agressive medication exploration (it takes 5 prescriptions, but well worth it) 4. I began smoking small amounts of marijuana through-out the day. I know the last step is controversial & would be criticized by MD's, but I know it has been as effective if not more effective than the other steps. My spouse agrees (& she doesn't even smoke). I've not been happier in twenty years, I'm self employed & have never been as productive and most importantly, I've never been a better husband or father (according to my spouse). I do have to hide it from my child and that remains the largest negative. I don't advocate getting baked all day, but instead just a little throughout the day has tremendous mood uplifting abilities with what seems to be less side-effects than the prescription drugs I take. GOOD
- veteran
May 26, 2009 11:06 p.m.
To some extent I agree with the article. I have bipolar and although i dont think every morning when I get up how I am going to feel (mindset) I usually end up being depressed or elated whithout me having to think it over.
- Kristi
May 25, 2009 3:54 a.m.
I also wonder why we do this. I have been in therapy, I have been on a couple of medcations that do not agree with me.... yet, when it stick my head out... I seem to be so easily scared back into my "cave." Even if I deffend myself, it wears me out. I know there are cirumstances and events in my history that seem to trail back ....the repeated disregard has a negaive impact on me. Recently, in the past 3 years I have had some serious health problems... I'm only 45 now. It is sad to me when my body fails me, and the members of my family aare toxic .... which influences my adult chilren. I do give up. I hurt. I can't get I spend a of time now on FB..... I was in school, but this semester withdres for medical problmes. I believe Celexe causing me to be agoraphic and making my hair fall out. ? Dr.'s are not sympathent really.... I am tired of drugs :)
- Renee
May 21, 2009 4:37 p.m.
Thank you for this clear, concise article about thinking distortions. I do probably like 4 out of 5 of these, and it's incredibly helpful to read these and examine them against my day-to-day thoughts.
- Janet M
38 comments posted