Rates of depression differ around the developed world, but the incidence of depressive illness has risen dramatically since 1900.


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Rates of depression differ around the developed world, but the incidence of depressive illness has risen dramatically since 1900.

In the United States, 5.3% of the population will at any given time have depression, and the lifetime risk is 7-8% in adults, and higher for women.

In the United States, 5.3% of the population will at any given time have depression, and the lifetime risk is 7-8% in adults, and higher for women.


Forty years ago, the mean age for onset of depression was 29.5. Today it has halved to 14.5 years.

Forty years ago, the mean age for onset of depression was 29.5. Today it has halved to 14.5 years.


Prior to the 1980s, depression had been the cancer of the psychological world – widespread but difficult to treat. Everything from Freudian psychoanalysis to shock treatment was applied to the problem, with poor results.

Prior to the 1980s, depression had been the cancer of the psychological world – widespread but difficult to treat. Everything from Freudian psychoanalysis to shock treatment was applied to the problem, with poor results.


Then, a much-needed revolution in treatment of depression happened: cognitive therapy.

Then, a much-needed revolution in treatment of depression happened: cognitive therapy.


David D Burns’ bestseller, Feeling Good: The New Mood Therapy, provides a good understanding of how the cognitive therapy revolution came about.

David D Burns’ bestseller, Feeling Good: The New Mood Therapy, provides a good understanding of how the cognitive therapy revolution came about.


In the summer of 1973, Burns packed his family into their Volkswagen and traveled from San Francisco to Philadelphia. He was to begin work as a psychiatric resident at the University of Pennsylvania.

In the summer of 1973, Burns packed his family into their Volkswagen and traveled from San Francisco to Philadelphia. He was to begin work as a psychiatric resident at the University of Pennsylvania.


In the next couple of years, Burns did some award-winning research on the biochemical causes of mood disorders. Yet working with his own patients with depression, he wondered if there was not something missing in their treatment.

In the next couple of years, Burns did some award-winning research on the biochemical causes of mood disorders. Yet working with his own patients with depression, he wondered if there was not something missing in their treatment.


Aaron T Beck was also at the University of Pennsylvania, doing pioneering work on a new talking treatment for depression called cognitive therapy. Beck believed that most depression or anxiety was simply a result of illogical and negative thinking.

Aaron T Beck was also at the University of Pennsylvania, doing pioneering work on a new talking treatment for depression called cognitive therapy. Beck believed that most depression or anxiety was simply a result of illogical and negative thinking.


Beck observed that there’s a big contrast between how the depressed person feels – that they are a “loser” and their life has gone horribly wrong – and their actual life conditions, which are often very good.

Beck observed that there’s a big contrast between how the depressed person feels – that they are a “loser” and their life has gone horribly wrong – and their actual life conditions, which are often very good.


Fighting the plague

Clinical researcher Aaron T Beck concluded that depression had to be based on problems in thinking. By straightening out your twisted thoughts, you could get back to normal.

Clinical researcher Aaron T Beck concluded that depression had to be based on problems in thinking. By straightening out your twisted thoughts, you could get back to normal.


His first principle of cognitive therapy was that emotions are generated by “cognitions” – thoughts. How you feel at any given moment is due to what you are thinking about. Depression is simply the constant thinking of negative thoughts.

His first principle of cognitive therapy was that emotions are generated by “cognitions” – thoughts. How you feel at any given moment is due to what you are thinking about. Depression is simply the constant thinking of negative thoughts.


The majority of negative thoughts that cause emotional turmoil are usually plain wrong or at least distortions of the truth. Yet we accept them without question.

The majority of negative thoughts that cause emotional turmoil are usually plain wrong or at least distortions of the truth. Yet we accept them without question.


For psychiatrist David D Burns, this sounded a little too obvious and simple. But when he began working with Dr Beck and trying out cognitive therapy, he was amazed at how many of his chronic patients were relieved of their destructive feelings.

For psychiatrist David D Burns, this sounded a little too obvious and simple. But when he began working with Dr Beck and trying out cognitive therapy, he was amazed at how many of his chronic patients were relieved of their destructive feelings.


Studies began to mount up that cognitive therapy was a much quicker way to alleviate depression than other forms of psychotherapy. People who had been suicidal now looked forward to rebuilding their lives. Others with milder depression said they had never felt happier.

Studies began to mount up that cognitive therapy was a much quicker way to alleviate depression than other forms of psychotherapy. People who had been suicidal now looked forward to rebuilding their lives. Others with milder depression said they had never

Until cognitive therapy, depression was seen as an emotional disorder. Most therapy was about opening up and expressing what’s inside. This assumed that feelings “represent a higher reality, a personal integrity, a truth beyond question.”

Until cognitive therapy, depression was seen as an emotional disorder. Most therapy was about opening up and expressing what’s inside. This assumed that feelings “represent a higher reality, a personal integrity, a truth beyond question.”


Cognitive therapy’s revolutionary idea was to question the validity of emotions. Feelings always seem valid, like they’re the “truth”. But as David D Burns puts it, this is like trusting the funny mirrors you see in amusement parks to be an accurate reflection of yourself.

Cognitive therapy’s revolutionary idea was to question the validity of emotions. Feelings always seem valid, like they’re the “truth”. But as David D Burns puts it, this is like trusting the funny mirrors you see in amusement parks to be an accurate refle

Instead, we have to go to the root of those feelings: our thoughts. If the bad feelings we have in depression all stem from negative thoughts, treatment must be about challenging and changing those thoughts.

Instead, we have to go to the root of those feelings: our thoughts. If the bad feelings we have in depression all stem from negative thoughts, treatment must be about challenging and changing those thoughts.


“Cognitive distortions” include all-or-nothing thinking, overgeneralization, disqualifying the positive, jumping to conclusions and giving ourselves labels. By understanding these, we are led to the awareness that “feelings aren’t facts.” They are just the mirrors of our thoughts.

“Cognitive distortions” include all-or-nothing thinking, overgeneralization, disqualifying the positive, jumping to conclusions and giving ourselves labels. By understanding these, we are led to the awareness that “feelings aren’t facts.” They are just th

Only by looking at your wrong thinking that can begin to put your feelings into perspective. This is why, David D Burns suggests, “depression is such a powerful form of black magic”.

Only by looking at your wrong thinking that can begin to put your feelings into perspective. This is why, David D Burns suggests, “depression is such a powerful form of black magic”.


Depression is a form of black magic

When you are in a great mood, would you say that your good feelings determine what you are worth? If not, how can you say that feelings you have when feeling blue do determine your worth?

When you are in a great mood, would you say that your good feelings determine what you are worth? If not, how can you say that feelings you have when feeling blue do determine your worth?


Of course, not all emotions are distortions. Grief or joy, for instance, are often healthy and normal reactions. Sadness say, at the loss of a relative, is a condition of “the soul” whereas depression is always of the mind.

Of course, not all emotions are distortions. Grief or joy, for instance, are often healthy and normal reactions. Sadness say, at the loss of a relative, is a condition of “the soul” whereas depression is always of the mind.


These distinctions led two pioneers in cognitive therapy, David Burns and Aaron Beck, to conclude that depression is not an appropriate response to life but a disease of wrong, circular thinking.

These distinctions led two pioneers in cognitive therapy, David Burns and Aaron Beck, to conclude that depression is not an appropriate response to life but a disease of wrong, circular thinking.


The Catch-22 nature of depression is that the worse you feel, the more distorted your thoughts become. Most depression patients believe their situation is hopeless. They believe they are bad people, and their inner conversations are like a broken record of self-blame.

The Catch-22 nature of depression is that the worse you feel, the more distorted your thoughts become. Most depression patients believe their situation is hopeless. They believe they are bad people, and their inner conversations are like a broken record of self-blame.


Depressed people feel wretched even when they are loved, have a family, and have good jobs. You can have “everything,” but if self-love and self-worth have gone, you feel you are nothing. “The illusion of hell you create is very convincing,” notes David D Burns.

Depressed people feel wretched even when they are loved, have a family, and have good jobs. You can have “everything,” but if self-love and self-worth have gone, you feel you are nothing. “The illusion of hell you create is very convincing,” notes David D Burns.


Cognitive therapists refuse to accept the patient's negative view of their self-worth. They will often have a spirited back-and-forth with the patient, trying to point out the silliness or fallacy of their assertions.

Cognitive therapists refuse to accept the patient's negative view of their self-worth. They will often have a spirited back-and-forth with the patient, trying to point out the silliness or fallacy of their assertions.


Eventually, the patient learns to challenge their wrong thoughts when they are on their own. This is the beginning of feeling good about themselves. Their self-esteem naturally rises when they are able to turn off their inner critical voice.

Eventually, the patient learns to challenge their wrong thoughts when they are on their own. This is the beginning of feeling good about themselves. Their self-esteem naturally rises when they are able to turn off their inner critical voice.


The great benefit of cognitive therapy is that you don't need to take medicines. But for really serious depression, David D Burns says, the most effective treatment is a combination of cognitive therapy and antidepressants. The former improves your thinking, the latter lifts over

The great benefit of cognitive therapy is that you don't need to take medicines. But for really serious depression, David D Burns says, the most effective treatment is a combination of cognitive therapy and antidepressants. The former improves your thinking, the latter lifts over


The basic idea of cognitive therapy, that our thoughts affect our emotions and mood (not the other way around), goes back a long way. The ancient philosopher Epictetus taught that it’s not events that determine your state of mind, but how you decide to feel about the events.

The basic idea of cognitive therapy, that our thoughts affect our emotions and mood (not the other way around), goes back a long way. The ancient philosopher Epictetus taught that it’s not events that determine your state of mind, but how you decide to feel about the events.


This secret is shared by all happy people, yet it’s a skill that can be learned by anyone. This is the promise that cognitive therapy offers, and it’s validated by science.

This secret is shared by all happy people, yet it’s a skill that can be learned by anyone. This is the promise that cognitive therapy offers, and it’s validated by science.


To be happier, challenge your own thoughts

Feeling Good: The New Mood Therapy

Treating Depression Today

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