Major Depressive Disorder (Depression) is often described as feeling stuck in a space of low energy, mood, and motivation. Depression is more than just feeling sad—it can also bring a deep sense of shame and failure that feels inescapable. Depression is essentially the opposite of motivation. Just as motivated thoughts and emotions lead to behaviors that generate more energy and positivity, depression works the other way, spiraling downward
What Depression Feels Like
Three main thoughts and feelings keep us stuck: hopelessness, worthlessness, and feeling like a burden. These thoughts diminish our motivation, and as a result, our bodies physically slow down as we do less. It’s hard to sleep when we’re supposed to, so we’re constantly tired. We don’t have the energy for exercise, but sitting around makes us feel even more drained. We achieve very little in this state, and at the end of the day, we feel critical of the little we’ve done. You can see how this becomes a vicious cycle.
When you can’t imagine life getting better because you feel nothing you do will make a difference, and you’re unable to ask for help—either because you don’t believe you deserve it or you feel that no one will want to help—it’s easy to understand how depression can lead to thoughts of self-harm or suicide. A rough measure of the severity of someone’s depression is how much hope they have that their life can change. Hope plays a major role in treating depression.
Symptoms of Depression include:
- Low energy; most tasks feel like an effort.
- Low motivation; difficulty starting chores or jobs.
- Loss of interest in hobbies.
- Food doesn’t taste as good.
- Avoiding friends and family.
- Changes in sleep patterns; difficulty getting out of bed in the morning.
- A general sense that nothing will improve.
Treatment Approach
From the above, we can see that unhelpful thoughts and feelings (hopelessness, worthlessness, and feeling like a burden), combined with a lack of physical activity, contribute to the downward spiral of depression. However, just like you can’t immediately stop a car speeding downhill, you can’t expect to simply reverse these behaviors and instantly feel better. The treatment approach to depression involves gradually easing out of the cycle, ensuring that the process doesn’t require more energy than you have.
Breaking the cycle of depression includes regulating your body’s energy levels by adjusting sleep, increasing physical activity (which may involve exercise), and becoming more aware of unhelpful thoughts. These are the thoughts that lead to feelings of hopelessness, worthlessness, and feeling like a burden. Not all thoughts, when explored, are simply a matter of perspective—sometimes we feel bad for valid reasons. However, by exploring these thoughts, we can often find solutions to the problems that make us feel bad. This reduces hopelessness and helps us find pride in ourselves.
How a Therapist Helps With Depression
One of the most impactful aspects of therapy for someone dealing with depression is the relationship you build with your therapist. When feelings of hopelessness, worthlessness, and being a burden weigh you down, a genuine connection with your therapist can directly challenge those emotions. It all begins with the therapist approaching your story with compassion and a sincere curiosity to understand your journey.
Before introducing any sense of accountability, the therapist’s first priority is to listen and empathize. After all, you can’t be expected to hold yourself accountable until your full story is understood. So, being a good listener is essential.
But therapy doesn’t stop there. Therapists also provide strategies to help you identify and challenge unhelpful thoughts. They guide you in exploring alternative perspectives—ones that may be just as valid as your current view but offer a more positive outlook.
Ultimately, beyond the therapeutic relationship, therapists empower you to reshape your relationship with yourself. Therapy is about cultivating self-awareness, challenging negative self-perceptions, and embracing perspectives that uplift and inspire.
Check Out this video by CGP Grey on what not to do.
The video below is based on a book by Randy J Paterson. PHD. How to be Miserable: 40 Strategies You Already Use. It provides a great example of how the behaviours that come to us naturally can really work against us.