Depression and anxiety impact millions of people on a daily basis. For some, the symptoms are troubling but not so severe that they\u2019re unable to function. For others, the symptoms can be debilitating, resulting in lost work time, damaged relationships, and even the ability to hold down a job. Numerous different prescription medications are available to help reduce symptoms of anxiety and depression. However, even though a pill may be easier, less expensive, and more convenient to take, most experts agree that therapy should be the predominant form of treatment for both depression and anxiety. One of the most effective \u2013 and widely researched \u2013 types of therapy is Cognitive Behavioral Therapy. This is because negative thoughts and beliefs always play a powerful role in depression and anxiety.\r\nThe Basis of CBT\r\nOften referred to as simply \u201cCBT\u201d, this type of therapy was developed nearly half a century ago by Dr. Aaron Beck. Dr. Beck was a psychiatrist who recognized that his depressed patients\u2019 thoughts and feelings were strongly connected. They all held negatively distorted \u201ccore beliefs\u201d that significantly impacted the way they viewed themselves, their experiences (and the world in general), and their future. These underlying beliefs triggered faulty assumptions and irrational or unrealistic thoughts that Beck referred to as \u201cthinking errors\u201d. Examples of thinking errors include:\r\n\r\n \tAll or nothing thinking (e.g. statements that involve \u201calways\u201d or \u201cnever\u201d)\r\n \tDiscounting the positive while focusing on the negative\r\n \tJumping to conclusions\r\n \t\u201cShould\u201d statements (\u201cI shouldn\u2019t have said anything!\u201d)\r\n \tCatastrophizing (e.g. viewing a situation or event as much worse than it really is or will likely be)\r\n \tMaking something personal when it isn\u2019t (e.g. your boyfriend breaks up with you because you\u2019ll be attending colleges on opposite sides of the country, but you insist it\u2019s because he doesn\u2019t care about you any more)\r\n \tEmotional reasoning (e.g. making a decision based on feelings rather than facts)\r\n \tOvergeneralizing (e.g. making a sweeping generalization based on one incident or limited information)\r\n \tLabeling (e.g. you make a mistake on a report and call yourself an idiot)\r\n\r\nAs humans, we\u2019re all prone to thinking errors from time to time. However, for those struggling with depression or any type of anxiety disorder, these irrational and negative thoughts occur on a very regular basis - if not constantly. That underlying pattern fuels depression or anxiety (or both, as they often occur together). And of course, maladaptive behaviors (e.g. using alcohol to cope, or avoiding situations that make you feel anxious) occur in reaction to the negative thoughts and feelings. It doesn\u2019t take long for it to become a vicious circle that continues to reinforce itself.\r\nAn Example of Negative Thought Patterns and Depression\r\nJustin, 32, has a degree in accounting. He has been struggling with depression since high school. One of his core beliefs is that he\u2019s a loser. Recently, a close friend didn\u2019t return his call and he didn\u2019t get hired for a job he\u2019d been pursuing for some time. He was quick to attribute these incidents to his \u201closer\u201d status in life, saying to himself, \u201cOf course Dan didn\u2019t return my call; he\u2019s got much better things to do than bother with a loser like me\u201d and, \u201cWhat an idiot I was to even bother interviewing! No worthwhile company wants to hire losers!\u201d Did you notice Justin\u2019s \u201cthinking errors\u201d? You see, he\u2019s jumping to conclusions rather than considering alternative possibilities. In reality, Dan hasn\u2019t had time to return any social calls because his demanding boss gave him an extra project with a tight deadline. The job fell through because, even though Justin had all the qualifications, the company president\u2019s nephew had also applied for it. Now, you\u2019d think that if Justin knew these two facts, he\u2019d feel a lot better about both situations and realize they had nothing to do with him personally. Right? Not necessarily. Even if he felt better temporarily, the negative patterns that dominate his thinking will quickly twist \u201creality\u201d in another irrational direction. His defeatist mentality triggers more negative thoughts and depressed feelings. He tells himself, \u201cNephew or not, nothing ever works out for a loser like me\u201d or \u201cWhy bother? There will also be a work project or favorite nephew that takes priority \u2013 that\u2019s how things work in my crappy world!\u201d\r\nAn Example of Negative Thought Patterns and Anxiety\r\nWhile Justin is a perfect example of how negative core beliefs and thought patterns fuel depression, Sarah\u2019s story illustrates how they can also play a significant role in anxiety. Sarah has been suffering from social anxiety disorder for as long as she can remember. Extremely timid as a child, she still struggles to keep her nerves calm in the vast majority of social situations. Bullied for being chubby during grade school, Sarah \u2013 now a tall, slender, attractive young woman \u2013 is convinced that people are quick to notice her physical flaws and social ineptness. As a result, she avoids most social situations and works at an animal shelter; one of the few places where she feels at ease. Recently, Sarah was required to attend a work-related social event. Held up in traffic, she was several minutes late. Moments after she arrived, she noticed several individuals huddled near the refreshments, laughing and whispering to each other. She felt her face flush and her heart begin to pound as she thought to herself in horror, \u201cThey\u2019re making fun of me because I was late and looked like an idiot when I came in!\u201d Sarah found the host, told her she wasn\u2019t feeling well, and hastily left the event. As she drove home, she played the humiliating incident over and over in her mind. What Sarah didn\u2019t know was that none of those individuals had even noticed her. They were laughing and whispering in response to a very funny story that one of them had been telling when Sarah got there. Sarah spent the rest of the evening and the entire next day reliving her embarrassment. Of course, this reinforced her anxiety about all social situations. Unlike Justin, if Sarah had known the real cause for the whispering and laughter, she probably would have felt better and stayed at least a little longer. However, her painful assumption that it was about her reinforced her determination to avoid social events; the anxiety she feels in such situations simply isn\u2019t worth it. Perhaps you know someone like Justin or Sarah. Getting him or her to look at anything in a more positive light is like trying to hold running water in your hand. Or, maybe you can relate to one or both of them because you also tend to assume the worst and feel awful as a result, rather than doing a \u201creality check\u201d first. CBT helps you learn to identify, challenge, and change distorted beliefs and negative, irrational thoughts to ones that are more empowering, realistic, and positive. It also teaches you healthy coping skills and behaviors. When you change the way you think about yourself, it changes the way you react to and perceive the world around you. As a result, depression and anxiety no longer rule your life.\r\nPutting a Stop to Automatic Thoughts\r\nWith both depression and anxiety, automatic thoughts fuel the fire. Justin was quick to attribute negative situations to his belief that he\u2019s a loser, while Sarah assumes any laughter or whispering is about her. These automatic thoughts feed their negative emotions. In CBT, these automatic thoughts are addressed. Most people don\u2019t even realize that these thoughts occur countless times throughout each day \u2013 until it\u2019s brought to their attention. Once in awareness, you can begin to stop them in their tracks when they pop into your head.\r\nChallenging and Changing Core Beliefs\r\nAutomatic thoughts are tied to your core beliefs. Core beliefs that often occur with depression include:\r\n\r\n \tI\u2019m a failure\r\n \tI\u2019m worthless\r\n \tI don\u2019t get to be happy\r\n \tNothing good ever happens in my life\r\n \tMy life is cursed\r\n \tI\u2019m unlovable\r\n \tI\u2019m powerless to improve my situation\r\n\r\nThe core beliefs associated with anxiety are often tied to a profound sense of helplessness. For example, the sense that everything is beyond your control or the belief you won\u2019t be able to handle \u201cit\u201d. \u201cIt\u201d can represent a vast array of things, such as a 3-hour flight, a performance, an unwanted impulse, a negative outcome, and so on. \u201cIt\u201d often becomes the metaphorical mountain your mind makes out of the molehill before you. In many cases, these beliefs begin in childhood. For example, a child who was frequently abused by one or both parents will often mistakenly come to believe that she deserved it because she\u2019s unlovable or worthless. To further ingrain that belief, her parents may have even said that to her on multiple occasions. Children don\u2019t have the ability to look at the bigger picture or challenge the validity of hurtful things they are told. They take it at face value and assume it\u2019s the truth. Other beliefs develop more subtly. For example, a string of bad luck can make a young man vulnerable to depression start to expect more of the same. Rather than recognize that many factors were beyond his control, he adopts the belief that his life is truly cursed \u2013 that no matter how hard he tries, nothing will ever work out. One of the primary goals of CBT is to challenge these core beliefs. A skilled therapist will help you \u201cexamine the evidence\u201d. For example, in order for Justin to challenge his belief that he\u2019s a loser, he needs to look at all the things in his life that don\u2019t support that idea. His list might include the following:\r\n\r\n \tHe has several close friends who care about him and value his friendship\r\n \tHe was a straight \u201cA\u201d student who earned a full scholarship to a prestigious college\r\n \tHe graduated from college with honors\r\n \tHis current employer offered him a raise when he got wind that Justin was looking for a new job\r\n \tHe has helped a lot of people through his volunteer work over the years\r\n\r\nDoes that sound like a \u201closer\u201d?\r\nOf course, Justin will also have a long mental list of things that, in his mind, fully support his core belief. For example, the two girlfriends who dumped him in college, the two high-paying jobs he didn\u2019t get, and the various hurtful things people have said or done to him over the years. However, a skilled therapist will help him see how he looks at \u2013 and misinterprets \u2013 these types of negative events through his \u201cI\u2019m a loser\u201d filter. In time, Justin will be able to catch himself when he jumps to erroneous, painful conclusions and starts to get stuck in negative thought patterns. Sarah, on the other hand, might challenge the evidence another way. For example, her therapist may encourage her to try something: The next time she\u2019s in any type of social setting and notices two or three people laughing about something, she could casually ask one of them if they\u2019d care to share. Most likely, the other person will say something like, \u201cOh, Josh was just telling us the funniest story about his cute new puppy\u2026\u201d Sarah can take this as evidence that her fears are rarely \u2013 if ever - warranted. Her therapist can also help her to identify and change the negative \u201cself-talk\u201d \u2013 both before and during social interactions \u2013 that feeds her anxiety. By learning new coping skills, changing her thinking, and trying out new behaviors in various settings and situations, Sarah can begin to enjoy socializing without so much anxiety.\r\nLearning to Not React\r\nIt\u2019s often said it\u2019s not what happens to you, but how you react to it that matters in life.\u00a0\u00a0 You see, your reactions are a result of your thoughts and feelings \u2013 the meaning you give to a particular event or situation. And with depression and anxiety, those meanings are negative, painful, or scary. Cognitive behavioral therapy can help you learn to look at things from a new perspective \u2013 changing the meaning and becoming less reactive as a result. Prior to CBT, Justin\u2019s typical reactions would be stop exploring new job opportunities (and stay stuck in an unfulfilling job) and get angry at his friend. Sarah\u2019s were to avoid or quickly leave anxiety-provoking social situations. After therapy, however, they\u2019ve both learned to look at things in a more positive light and react more appropriately. Cognitive behavioral therapy is, of course, more involved than this article can possible convey. However, hopefully this will give you some idea of how this type of therapy can help you defeat the negative, distorted thoughts and beliefs fueling your anxiety or depression. Your thoughts are powerful, but CBT can teach you how to change them in a way that enables you to live the happy, fulfilling life you deserve.