Thinking Errors in Depression

[Article revised on 26 April 2020.]

Thinking errors, also called cognitive biases or cognitive distortions, are irrational patterns of thinking that can both cause, and be caused by, depression: the more depressed you feel, the more you are bugged by thinking errors, and the more you are bugged by thinking errors, the more depressed you feel.

To break this vicious circle, you need to identify your thinking errors and successfully challenge them.

You may need help with this, so maybe ask a trusted friend or relative to read this chapter and discuss it with you.

Seven common thinking errors in depression are:

1. Arbitrary inference: drawing a conclusion in the absence of supporting evidence.

For example,

The whole world hates me.

Questions to challenge arbitrary inference:

• Why do I say that?
• Why would that be the case?
• Can I think of anything that goes against this statement?
• Is anyone else in the same predicament?

2. Over-generalization: drawing a conclusion on the basis of very limited evidence.

For example,

My sister did not come to visit me. The whole world hates me.

Questions to challenge over-generalization:

• Could there be other ways of explaining my evidence?
• Is my evidence strong enough to warrant that conclusion?
• Is my conclusion too broad?
• Can I think of anything that goes against my conclusion?

3. Magnification and minimization: over- or under-estimating the importance or significance of an event.

For example,

Now that my cat is dead, I’ll never have anything to look forward to.

Questions to challenge magnification and minimization:

• Has this ever happened to me before? How did I cope?
• How would other people cope in a similar situation?
• Am I seeing this in the right light?
• What are some of the other good things in my life?

4. Selective abstraction: focusing on a single negative event or condition to the exclusion of other, more positive ones.

For example,

The nurse hates me. She gave me an annoyed look three days ago. (But never mind that she spent an hour with me this morning.)

Questions to challenge selective abstraction:

• Why would this be the case?
• Am I looking at all the evidence?
• Are there some more positive things that I can focus on?
• What are other people telling me?

5. Dichotomous thinking: ‘all or nothing’ thinking.

For example,

If he doesn’t come to see me today, then he doesn’t love me.

Questions to challenge dichotomous thinking:

• Could there be any other reasons? (What else could have held him back?)
• Does it have to mean that?
• Is it really all black and white? Or could there be shades of grey?
• Can I think of anything that goes against my conclusion?

6. Personalization: relating independent events to oneself.

For example,

The nurse went on holiday because she was fed up with me.

Questions to challenge personalization:

• Are there any other possible explanations?
• Is my explanation the most likely explanation?
• What evidence do I have for this?
• Am I reading too much into things?

7. Catastrophic thinking: exaggerating the consequences of an event or situation.

For example,

The pain in my knee is getting worse. When I’m reduced to a wheelchair, I won’t be able to go to work and pay the mortgage. So I’ll end up losing my house and dying in the street.

Questions to challenge catastrophic thinking:

• Are things as bad as they could be?
• What is the most likely outcome?
• What action can I take to prevent this outcome?
• Could any good come out of this situation?

Depressive realism

While it is true that people who are low in mood can suffer from grave thinking errors, the scientific literature suggests that many people with depressed mood can also have more accurate judgment about the outcome of so-called contingent events (events that may or may not occur) and a more realistic perception of their role, abilities, and limitations—a phenomenon that is sometimes, and controversially, referred to as ‘depressive realism’.

On the face of it, this suggests that people with depression are able to see the world more clearly for what it is, while normal people are only normal in so far as they are deceiving or deluding themselves.

If so, the concept of depression may—at least in some cases—be turned upon its head and positively redefined as something like ‘the healthy suspicion that modern life has no meaning and that modern society is absurd and alienating’.

For many health experts, this is the sort of irreligion that calls for anathema. Yet the question of the meaning of life is the most important that a person can ask, and the realization that life might or should be lived differently is bound to provoke a depressive reaction, a harsh winter that opens out onto a beautiful spring.

We must be careful not to confuse our human nature with inadequacy, or the tender shoots of wisdom with mental disorder.

Neel Burton is author of Growing from Depression and other books.