Cycle of Depression Handout
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Sometimes, it can be challenging to help clients break the cycle of depression. However, once they do, clients can feel more empowered as they alleviate their symptoms of depression and live a more fulfilling life.
This article explains the depression cycle, provides examples of how to break the cycle, and includes a free cycle of depression handout that you can download and save to your electronic health record (EHR) to share with clients.
What is the cycle of depression?
Depressive disorders can be chronic and sometimes recurring mental health conditions that cause significant impact on a person’s life and well-being. Many clients describe feeling a lack of motivation, finding themselves socially withdrawing, and wanting to spend their time sleeping.
Thinking about depression as a cycle helps clients to conceptualize the cognitive impact that stressors or triggers have on their thoughts, feelings, and behavior.
Here’s what this cyclical pattern typically looks like:
Stressor
Examples include grief, failing an exam, losing a job, being rejected, ending a relationship, chronic illness, divorce, or family problems.
Symptoms of depression
This includes low mood, loss of pleasure, changes in sleep and appetite, loss of energy, etc.
Thoughts
This may include negative self-talk, like “Nobody likes me,” “It’s all pointless,” and “I’m a failure.”
Feelings
Examples of feelings someone might experience include worthlessness, despair, gloom, rejection, sadness, hopelessness, loneliness, and feeling disheartened.
Behaviors
This includes social withdrawal, self-harm, drinking or taking drugs, skipping school or work, canceling plans, being inactive, not returning calls and texts, neglecting daily tasks including self-care, sleeping more, etc.
Physical and mental effects
For example, fatigue, low energy, worsened mood, weight loss or gain, tearfulness, lack of motivation, difficulty concentrating, slow reactions, increased or decreased appetite, etc.
Once a depressed person feels the effects of depression, it reinforces their symptoms, thoughts, and behaviors—and the depressive cycle continues on a loop.
The trouble with the cycle of depression is that clients can get stuck, and it can be hard to see the impact depression is having in their lives. It can feel all-consuming and exhausting to manage depression and to think objectively.
That’s where therapists come in—helping clients break free from the depressive cycle.
Cycles of depression and anxiety explained
Here are some examples to illustrate the cycle of depression and anxiety:
Sara recently lost her mom to cancer. She thinks to herself that life is pointless without her mom and calls into question her own mortality. She feels sadness, loneliness, despair, and gloom. This causes her to become socially withdrawn, canceling plans with friends, skipping the gym, and missing out on a family birthday party.
She feels like it takes all of her energy to go to work. When she gets home, she misses dinner and goes straight to bed, sleeping for 10-12 hours a night. Over time, this cycle exacerbates her symptoms of depression, which then compounds her thought that life is pointless, and she repeats the pattern.
Anxiety follows a similar pattern, with symptoms of worry and fear leading to behaviors such as avoidance.
Dave went through a divorce last year, but his friends have suggested he start dating again. He feels anxious about going on dates, but occasionally matches with people on dating apps. When he matches with someone, he experiences feelings of overwhelm, his heart races, and he has sweaty hands.
He decides to avoid the messages asking him on a date, and instead, grabs a few beers and plays computer games all night. His anxiety is relieved, but he has reinforced a cycle of avoidance to overcome anxiety.
How to break the cycle of depression
Breaking the cycle of depression not only improves depression symptoms and energy levels, but it can enhance a person’s motivation to persist.
Some ways to break the cycle of depression include:
Behavioral activation scheduling
Using an activity scheduler is a great way to commit to doing activities that boost mood. You can download and use this free Depression Activity Scheduling Worksheet to support clients with depressive disorders.
Getting outdoors
Anything from going on a hike, being in nature, or tending to a garden can be uplifting and give people a sense of perspective.
Movement
Going for a walk is an easy and effective way to boost your mood. This may lead to a more strenuous workout, leading to a more positive health impact.
Laughing
Watching a comedy show with friends, streaming a comedy movie at a friend’s house, or reading a funny novel can break the cycle of depression by promoting laughter and lightheartedness.
Medication
The recommended treatment for major depression often includes a combination of therapy and medication. You may want to check in with your medical provider for additional support.
Finding meaning or purpose
Revisiting core beliefs or values in therapy may be a helpful way to remember what’s important in life. This may include volunteering, creating art, or having new experiences. These activities can all create a sense of meaning and purpose, which can boost mood and provide a helpful distraction from depression.
Healthy habits
Focusing on good quality food, hydration, and adequate exercise can help support the body when feeling depressed and help boost mood with the release of endorphins. Try to also limit caffeine, which may further disrupt sleep and mood.
Avoid alcohol
Alcohol is a depressant and can exacerbate symptoms of depression.
Strengthen social support
Even though it may feel like a chore, making time for friends—even if it's a phone call—will help to alleviate depression. And, in some instances, friends may spot depression first and encourage getting treatment.
What's included in the cycle of depression handout?
In the handout, you’ll find the cycle of depression explained and tips your client can follow to boost their mood and break free of the depressive cycle.
Therapists can use the cycle of depression handout during an in-person or telehealth session with clients, as a psychoeducational tool, or as a handout for clients to take home and read through on their own.
Sources
- Centre for Clinical Interventions. (n.d). Depression – reversing the vicious cycle.
- National Institute of Mental Health. (2024). Depression.
- University of Michigan Department of Medicine. (n.d.). Behavioral Activation for Depression.
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