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Facing Depression

What is depression?

Depression is a feeling of intense sadness, hopelessness, helplessness, and worthlessness that persists for weeks and significantly interferes with day to day functioning.

What does depression look like?

Depression can look different for different people. Some people are mildly depressed, while some experience severe depression. Common symptoms of depression may include persistent sadness, feelings of hopelessness, worthlessness, helplessness, or guilt, irritability, loss of interest in activities once enjoyed, difficulty concentrating, remembering details, and making decisions, fatigue, insomnia, overeating, loss of appetite, physical complaints (e.g., body aches, headache, digestive problems), and thoughts of suicide or suicide attempts.

How does depression affect us?

Depression can have major adverse effects on life, affecting work, relationships, and health.


Depression can affect your work or productivity. For example, you may take more frequent sick days, lack focus or motivation, produce insufficient work products, be passed up for a promotion, or receive disciplinary action.


Depression can affect your relationships. For example, you may experience decreased sexual interest towards your spouse, arguing or fighting with your spouse, friends, children, or coworkers, over-dependency on relationships, and withdrawal from others.


Depression can affect your health. For example, you may turn to drugs or alcohol, not follow through with medical care (e.g., going to the doctor, taking medication for other medical problems), avoid exercise, have difficulty sleeping or eating, or overeat. You may experience various aches and pains or a weaker immune system.

How can we treat depression?

Depression is treated in many ways, and a holistic approach is often used which includes a combination of medical, environmental, cognitive, and behavioral strategies. Here is a cognitive strategy that can be helpful in facing depression:

  1. Identify situations that tend to trigger feelings of depression, and how depressed you are.

    Do certain situations tend to make you feel depressed? Maybe you get more depressed at family or social gatherings, or on holidays. Or maybe it’s around certain people you think are more accomplished than you. Depression runs on a continuum from mild to severe. For example, some who have lost a loved one feel depressed, but they are able to go to work, be with others, and carry on normal every day activities. Others under the same circumstance may feel very depressed and have a hard time with any of the normal daily routines. Individuals with depression can rate their depression on a scale of 1 to 100, with 1 being no depression and 100 being severely depressed.

  2. Figure out specific thoughts that are driving your depression.

    Certain thoughts make us more depressed. Often times, these thoughts can come automatically in particular situations, as discussed above. Sometimes the situation occurred a while ago, but thoughts about the situation, and yourself, fuel your depressive feelings. When the thoughts contain errors, or inaccuracies, this could lead to feelings of depression. See the posting on Thought Errors for a list of common thought mistakes. You may have several automatic thoughts, but there is usually one predominate thought, or “hot thought”. Since this hot thought is strongly contributing to your depression, it should be examined to see how valid it really is, as described below.

  3. Find evidence for and evidence against your “hot thought”.

    Try to think through whether there is evidence that supports your hot thought. It was mentioned that hot thoughts often contain Thought Errors, but there may also be some truth in your hot thought. Next, try to think through evidence that contradicts your hot thought. Are there exceptions or situations where the hot thought would not be true?

  4. Come up with an alternative, more balanced, thought to replace your “hot thought”.

    If you have looked at the evidence for and against your hot thought, and you have found that your hot thought may not be entirely accurate, it makes sense at this point find an alternative, more balanced thought to replace it.

  5. Re-rate your depression.

    On a scale of 1 to 100, with 1 being no depression and 100 being severely depressed, re-rate your depression over the situation you were originally depressed about.

It is usually best to go through this process by writing everything down.

The hope is that in going through this process, you have been able to more clearly identify the thoughts that are driving your depression, and judge whether or not they are valid based on evidence. If they are invalid, you can develop an alternative way to think about your problem, which can lower your depression about the situation.

Points to remember

It is often your thoughts that lead to emotions like depression and anxiety. If you can change how you think, you’ll change how you feel.

It’s not uncommon to need some support when first starting to address your depression. A skilled therapist can help. I utilize cognitive behavioral therapy (CBT) to treat depression and anxiety in adults, adolescents, and children in Southlake and surrounding areas.

Feel free to contact me any time to discuss how I may be able to help you.

Dr. Michael Messina

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