2. The ins and outs of depression

This one hits home for me. Depression is something we don’t talk about enough because the stigma still exists. And as women, we’re way more prone to depression because of the pressure that still exists in our society.

Women are twice as likely to experience major depression than men. They are also three times as likely to suffer from anxiety or attempt suicide. There are a myriad of reasons as to why this is:

  1. Women live longer than men, and old age may be associated with loneliness and poor health, which could cause depression.
  2. Women experience more of a fluctuation in hormone levels than men do, which could be associated with symptoms of depression.
  3. Women are more likely to seek out a diagnosis of depression. They are more likely to consult a physician and more likely to discuss their feelings with the physician.
  4. Women may be more overloaded with work since they may feel they have to handle the family along with working a job. (see the Second Shift)

But let’s take a step back from the reasons and the statistics. And let’s talk about the depression part. The all-encompassing monster that is depression.

This monster gets to you faster than you can imagine. The constant negativity and rumination consumes you. These negative automatic thoughts refuse to go away. They sit. And brew. And then sit some more.

I’ve personally suffered in the hands of this monster. I was hospitalized twice because of heart issues. Once a year and a half ago. The second time is now. I’m actually writing this from the hospital bed.

On top of my medical issues, I also had personal issues. I had demands of the world on me. I had emotional rollercoaster rides. And because sometimes it just got so tough, depression set in. The hopelessness. The fear that I just wasn’t strong enough to handle it all.

To deal with these thoughts I researched every different type of therapy imaginable to find one that worked for me. I set out to find a way to change my thinking. I didn’t want to be in this pit forever.

The one therapy tactic that really stuck with me was CBT (Cognitive Behavioral Therapy). CBT is simple: it’s based on the premise that our thoughts, behaviors, and emotions are all connected. If we change our thinking, we can change our emotions.

The CBT Cycle

These negative automatic thoughts come into our heads constantly, and we often don’t know how to control them. That’s mainly because our emotions overwhelm us and sometimes become crippling. And from these emotions, we tend to behave in unhealthy ways which just set off a downward spiral of actions that aren’t good for you.

However, if we find a way to question our thinking instead of believing everything we think, we can change our emotions. If we change our emotions we can change our behaviors and be healthier people overall.

Yes I know, it’s easier said than done.

So this week, for 52 Weeks of Design for Women I’ll be focusing on a CBT application that can help you get your thoughts down and deal with distressing moments that feel out of your control.

Dealing with emotional overwhelm in your life

This week I designed Mindful, an app that helps you clear your mind and process your problems in a structured, healthy way. Let’s start with the principles that inspired this design:

1. Create mindfulness

2. Allow for clarity of thought

3. Create structure in an otherwise chaotic environment

4. Build lasting positive thinking habits

After you launch the app you start with a mindfulness exercise.

Mindfulness is an important practice to bring you back into the moment and out of your head. It grounds you in the present and helps clear your mind. In the example above, you start with a scene of water falling on rocks and observe this for two minutes. By staring at this scene and noticing all the details you awaken your senses and ground yourself in the moment.

Once you’ve cleared your head, you can start the CBT process.

This process is as follows:

Activating Event: What happened that is stressing me out?

Belief: What is my negative self-talk? What negative interpretations am I making?

Consequences: What am I feeling? What is happening in my body? What is my behavior as a result of my beliefs?

Dispute: What is a counter thought? Is there another way of thinking here?

You can go step by step in this process.

Mindful App menu with CBT Cycle

Activating Event

When you are ready to start CBT, the first step is talking about your activating event. What caused the stress? Why do I feel this way at all? Mindful gives you a clear canvas to write down your thoughts. For this example, let’s say you had a tough conversation with your manager at work.

Activating event: Here you write out what is bothering you.

Once you are finished, you can proceed to the next step.

Belief

This is often the toughest stage. During the belief phase, those negative thoughts are everywhere. You think you’re worthless or not good enough. You are mad at yourself or blaming yourself. Here you let it all out.

Belief: When you detail out your negative self talk and the dark stuff inside of you

From the words you use in your belief, Mindful will give you a list of cognitive distortions related to how you feel.

What are cognitive distortions?

Cognitive distortion are thought traps. It’s the irrational ways in which we think. Here are a few examples from Will Baum:

  1. All-or-nothing thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.
  2. Overgeneralization: You see a single negative event as a never-ending pattern of defeat.
  3. Mental filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.
  4. Disqualifying the positive: You reject positive experiences by insisting they “don’t count” for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences

With Mindful, based on the way you describe a belief, some of these patterns will be shown. For example if you write something like: “I always do well but this one experience has shown me that I’m a failure,” you will see that you are showing all or none thinking.

After you write out your beliefs, you get a list of potential cognitive distortions identifying the traps in the way we sometimes think.

Knowing what cognitive distortions you are facing is really important in grounding you back into reality and realizing that the emotion is stronger than we think.

Consequences

In the consequences stage you write out what happens as a result of your beliefs. How are you feeling? What do you feel like doing based on your beliefs? This is often an unhealthy behavior.

Consequences: What are you feeling? What happened (actions) as a result of your beliefs?

Dispute

This is the transformative step of CBT. This is the part where you write out a counter thought. You think of different ways of thinking of the situation grounded in reality.

Dispute: Changing the way we think with grounding counter thoughts.

This is often hard since you just can’t change the way you think, especially if you’re feeling all the emotions related to it.

Something that I do when I go through CBT is ask myself questions. I have a list of questions that I ask myself to change the way I view something.

When you press the “i” on this screen you see a list of questions to think of as you are processing the problem.

Questions to ask yourself as you are thinking about counter thoughts.

Building Lasting Positive Thinking Habits

Going through this process is useful when you want to get a grip on your thoughts and emotions. But sometimes, we plunge back down into that pit. We feel hopeless again and don’t know where to turn.

It’s important to be surrounded by positivity. That’s why on Mindful you can set a notification to get the positive things you write emailed to you. That way you can see the struggles you’ve been through or are currently going through and different ways of seeing them.

Get emails detailing your progress on the difficult things you’re dealing with.

This is Tough

I’ve been a part of support groups and grown tremendously through the love and care of others around me. I’ve seen others go through problems that seem incredibly large compared to mine and I’ve often been surprised how a simple smile can really change someone’s life.

I’ve been in the pit that is depression. When shit happens and you’re in the middle of it all, it becomes unbearable. But I rest assured knowing that I can change the way I think. That if I try hard enough, there is always a way.

What lives in the dark dies in the light.

As an analytical mind constantly questioning my thoughts, CBT has proven to be useful for me. It forces me to challenge myself and make myself well. This may not work for everyone, but for some it is a step in the direction of wellness.

We all want to make the world a better place. We pour ourselves into our work, nurture and love our relationships, and give back to the community.

But with all the love we give to others, we often don’t give even an ounce of it to ourselves. We constantly criticize and condemn ourselves. We sometimes feel overwhelmed emotionally and can’t see clearly. We stay in our own heads and sometimes, it’s cloudy up there.

What I’ve learned is that before we give love to the world around us, we must start with ourselves. We must realize that unless we are not well, the world around us will not be either.

Don’t listen to everything you think

This is part 2 of a year long series on design that improves the lives of women. Follow 52 Weeks of Design for Women to stay updated.