The central feature of a depression disorder is the tendency to think about the self, the future, and the world in a dysfunctional, negative way.

Depressed people regard themselves as unworthy, incapable, and undesirable. They expect failure, rejection, and dissatisfaction, and see most experiences as confirming these negative expectations.

This happens because depressed people have "negative automatic thoughts" which are believed as being true and valid. Consequently, all depressions can be viewed as a direct consequence of chronic negative thinking patterns.

A central feature to understanding depression is that the depressed individual's thinking is biased in a negative direction because of underlying maladaptive core beliefs called schemas for which the individual is unaware.

Some examples are:

"I must never fail."

"I must have everybody's approval."

"I must be a success in order to be a worthwhile person."

Reference: Dr. David Burns, Ten Days to Self-esteem.

Basic Treatment Strategies

There are three basic assumptions for overcoming depression are:

1. Depression is a function of a person's negative thinking of the world, self, and the future.

2. These thoughts, beliefs, and feelings can be monitored and reported by the individual.

3. It is assumed that modification of these negative thoughts will lead to a change in the individual’s depression.

The individual is helped to understand that depression results from chronic automatic negative thinking. The thoughts are shaped by an underlying, negative core, belief system.

Thus, the combination of negative automatic thoughts plus the negative belief system leads to symptoms of depression.

Intervention Steps

There are four guidelines to follow:

1. Recognize the connection among thoughts, emotions, and behaviors.

2. Identify and modify dysfunctional automatic thoughts.

3. Learn to substitute more realistic thoughts for the automatic ones.

4. Identify and alter dysfunctional core beliefs (schemas).

Reference: Cognitive Theory and Therapy by William Sacco and Aaron Beck; from Handbook of Depression Second Edition by E. Edward Beckham and William Leber.