Depression, which can be thought of as a disorder of mood, is considerably more debilitating than the ‘feeling low’ most of us occasionally experience and can significantly interfere with being able to go about one’s daily life.
In the past, it was thought that depression was more likely to happen in people with a tendency to see themselves, the world and their future from a negative point of view. But studies have shown that this negative perspective may only be present during an episode of depression, so clearly something else is going on.
However, it now appears that there is a point at which we might ‘switch’ into or out of depression, according to how we focus our attention.
Several studies, according to researchers Seagall and Ingram, indicate that the key seems to be how a person reacts to mild everyday moods of feeling low or sad. For some people, these everyday moods reactivate a pattern of negative thinking, which itself then causes the mild low mood to become progressively worse, spiralling down into a state of depression. It’s as if the ordinary low mood throws a switch to move a person from an ordinary thinking pattern to a negative thinking pattern.
Whether this switch happens depends on how people handle a low mood. Professor Susan Nolen-Hoeksema found that people who tend to focus their attention inwards on the low mood (thinking about how low they are feeling, or trying to work out why they are feeling this way), may get caught up in this negative spiral. This is called ‘rumination’. In her words, “once you get into it [rumination], it leads a life of its own; it becomes a self perpetuating process…”.
People who focus their energies outwards, on the other hand, such as looking for something positive in the situation or keeping active, tend not to trigger this switch. These are known as distraction techniques.
However, when people use distraction techniques to mask their underlying rumination, this leads only to a temporary respite from rumination, rather than leading them safely out of it. In these circumstances, distraction techniques are unlikely to be effective in lifting depression.
So what helps? A therapy approach that has an attitude of mindfulness at its core is more likely to tackle this effectively, as the one thing that makes the crucial difference seems to be the relationship a person has with their negative thoughts and feelings, rather than what those thoughts and feelings are.
Repeatedly being able to step back from negative thoughts in a particular way (distancing or decentering techniques) seems to be the key to preventing that switch into rumination from being triggered.
Not all therapy approaches recognise this switch or directly address it. However, a mindfulness-based psychotherapy approach does, and so helps a person to directly develop the skills to deal with rumination plus employ distancing techniques.