Common Cold of Mental Health

Social Anxiety Help

Larry Cohen, LICSW

Common Cold
of Mental Health


by Larry Cohen
Washington Blade

‘Tis the season to be … depressed?

Coming out of the holidays – replete with family tensions and myriad expectations to be joyous (but not gay!) – many Lesbians and Gay men live through the winter with moods reflecting the season: gloomy, cold, and harsh. Unfortunately, many people feel as powerless over their moods as they are over the weather. But most people can learn to greatly improve how they feel.

Due to its prevalence, depression is sometimes considered the common cold of mental health. But the effects of depression are frequently far more painful and serious than that of a cold. Deadly serious, sometimes, given that depression frequently leads to suicide attempts and substance abuse.

The good news is that depression – unlike the common cold – is usually curable. Certain medications help some depressed persons greatly. And a relatively new approach called cognitive therapy has demonstrated that most people can quickly alleviate their depression by learning to pay attention to their negative thoughts and beliefs and testing these against reality.

Growing up Gay in a society that would rather they not exist, many Lesbians and Gay men develop highly negative beliefs, such as, “There’s something terribly wrong with me,” or “If people got to know the real me, they would reject me.” The process of coming out involves changing at least some beliefs from “I’m Gay and that’s sick/ sinful/ disgusting,” to “I’m Gay and I can’t do anything about it,” to, finally, “I’m Gay and that’s good.” Many never get that far.

Growing up isolated and feeling ashamed, without role models or mentors to provide a different perspective, many Lesbians and Gay men succumb to the hopelessness that springs from their negative beliefs. Witness the extremely high rates of attempted suicide among Gays.

“Core beliefs” — deep-seated assumptions individuals maintain about themselves, the world, and the future — are like eyeglasses that are worn all the time. They profoundly affect how the world is seen. Put on a different pair of glasses and things look quite different, for better or worse, depending on the prescription.

Take the example of Sam, recently dumped by his lover. Sam’s feeling hurt, angry, rejected, and very sad. although he doesn’t talk to anyone, he unwittingly shows his feelings through subtle behaviors: a gloomy facial expression, teary eyes, monotone voice, slumping posture. Sam’s only Gay friend, Sue, notices these behaviors and gently asks Sam, “What’s the matter?” This is the situation. Sam’s automatic thoughts are, “Sue’s upset with me; I don’t need this.” Sam’s feelings immediately follow: increased anger and hurt. Behaviors, in turn, follow Sam’s feelings and thoughts: Sam glares at Sue, tells her to leave him alone, and then storms away.

But the cycle — situation, automatic thoughts, feelings, and behaviors — repeats itself, over and over. Sam’s response to Sue is the new situation, to which Sue’s automatic thoughts are, “Some nerve, who needs him!” Sue feels angry and hurt. Her behavior is to shout at the exiting Sam, “Well, screw you!”

Sam hears this – the new situation – and thinks, “I was right; she’s no friend of mine.” He feels utterly depressed and intent on ending the friendship with Sue, right when he needs her most.

But it didn’t have to be this way. Imagine that instead of Sam, there is Steve, who thinks quite differently. In response to the original situation (Sue’s “What’s the matter?”), Steve’s automatic thoughts were, “Finally, someone I can talk to. Someone who cares!” An entirely different scenario would follow. Steve would feel relieved, and he’d talk with Sue about the breakup. Sue would think, “Oh, how sad,” and she would feel compassionate as she comforted Steve. The two would grow closer in friendship. Vastly different feelings, vastly different outcomes. All because Sam and Steve had different automatic thoughts.

But why would two people think so differently about the same situation? They wear different “glasses.” What they see through their different core beliefs appear like entirely different situations. A person who lives with negative core beliefs responds to situations like Sam: in highly negative, self-defeating manners that lead to depression. Those who live with more realistic core beliefs are like Steve: they see their experiences more accurately, and feel a lot better as a result.

Most people use the word “depressed” to simply mean “sad.” But in the field of mental health, depression and sadness are not the same thing at all. Although it doesn’t feel good, sadness is a healthy human emotion in response to a loss. If the loss is big enough, sadness may be very painful and intense, also called grief. But even that’s not depression.

Sadness is one ingredient in the sickening stew of depression. Other common ingredients include pessimism (things won’t turn out right); hopelessness (things won’t ever get better); apathy (I just don’t care anymore); decreased motivation (I don’t feel like doing anything); general dissatisfaction (I just don’t enjoy things like I used to); guilt (it’s all my fault, I get what I deserve) and self- deprecation (I’m disappointed in myself).

Gay men and Lesbians don’t have to be stuck with the same negative core beliefs learned as children from unhealthy families and an oppressive society. Cognitive therapy teaches people to change their automatic thoughts and core beliefs to more accurately reflect reality. They learn to put on a better pair of glasses: not rose-colored, just a more accurate prescription.

The author, a psychotherapist in private practice in D.C., coordinates volunteers who lead Whitman-Walker support groups for Lesbians and Gay men. For further reading, the author recommends “Feeling Good” (depression) by David Burns and “Love is Never Enough” (relationship problems) by Aaron Beck. Some people may benefit more with the help of professional cognitive therapy in individual or group sessions. Referrals may be obtained through the Mental Health Services Program of Whitman-Walker Clinic, (202)797-3500

Reproduced with permission from The Washington Blade, January 17, 1992.

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If you have any questions or comments, please email Larry Cohen, LICSW, with offices in Washington, DC.

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