SEVERAL WEEKS AGO THE SUN CAME UP AND I COULDN’T GET OUT OF BED. I had a meeting at nine o’clock in the morning and another meeting at noon. I tried to rouse myself three, maybe four times, and it became frighteningly clear that my body would not move. I told my wife that I was going to miss the early meeting and get myself up for the late one. As morning passed I felt the ominous emotional contradiction of sharpening anxiety and numbing depression. I knew that for the second time in a year my depression (actually, Bipolar 2) had beaten me again. The thought of another breakdown, another display of “weakness,” was too much and my thoughts and words became suicidal. My very strong and patient wife took me to my psychiatrist and I was placed on a 72-hour hold in a psychiatric hospital. My mind was very ill. There was no resistance. The three days in the hospital were the safest I had felt in years. To date, it is the most human and humbling experience of my life.
After the hospital, I enrolled in a seven-week outpatient program based on the cognitive model of depression. My fellow patients and I received a daily 90-minute lesson and then worked with two therapists in small groups. It was an incredibly effective program centered on the COG-Model pictured above. Here’s the basic idea. Each situation creates automatic thoughts in our minds. Those thoughts in-turn create emotions. Our emotions (action urges) then lead to behaviors, which in turn result in another situation. If our automatic thoughts about a situation are excessively negative, then a negative cycle begins. Emphasis is placed on changing our thoughts and behaviors since this is where we have the most control. As our thoughts and behaviors improve, so will our emotions and life situations.
Understanding how automatic thoughts lead to depressive behaviors, such as isolating, was a sort of epiphany. Anyone who struggles with depression, anxiety, or another mental illness will know how difficult it is to identify and eliminate negative thoughts during an episode. However, if we can identify negative and distorted thoughts (cognitive distortions), then we have the opportunity to respond in more positive ways that will not perpetuate a depressive cycle. The Cognitive Model allowed me to identify some core beliefs, or schemas, that made up my operating system. Ideas such as, “I am inadequate” and “I am a fraud.” Through continued work with a therapist I am working to change these core beliefs.
The COG Model is a clear and effective tool for managing depression and lifting one’s mood. The model was developed by Aaron T. Beck, M.D., and more information can be found here at the Beck Institute Blog. http://www.beckinstitute.org