Understanding Avoidance as a Coping Strategy in Depression

December 21, 2023

Understanding Avoidance as a Coping Strategy in Depression

Numerous studies suggest that physical activity can prevent and even treat depression. Distancing has covered similar research; one found that running twice a week for 16 weeks had antidepressant-like effects. Such a simple and clear study! Now, let's encourage all those feeling down to start running. Let's nationally operate running groups, support them, and reward active participation.

Reality, however, paints a different picture. Depressed individuals, even when aware that movement could benefit them, won't step outside. Why is this? Lack of motivation? Perhaps. But there are more complex reasons why people in a slump don't go out.

From a cognitive-behavioral therapy (CBT) perspective, individuals often harbor biased views on their condition and future. "I'm lethargic all day and can't do anything," they say. Therapists start by prompting action to address such thoughts. "You feel lethargic all day? Shall we observe if that's truly the case?" Through this, those who are depressed begin to realize that they aren't completely immobilized by their depression nor utterly incapable of doing anything. Therapists illuminate such insights to induce behavioral change.

Yet often, underneath these skewed perceptions lie more complex issues. Many with depression have had adverse past experiences—cold treatment from parents, deep relational wounds, significant failures. Such experiences naturally lead to negative self-perceptions: "I'm inadequate," "I'm worthless," "I won't make it." When such thoughts take hold, people limit their activities for fear of confronting these perceived inadequacies, no matter the challenge or outing—even exercising. CBT refers to this pattern as 'avoidance.'

Although avoidance might seem to offer security by reducing the risk of negative experiences, it gradually constricts life's scope and traps individuals in self-criticism over the long term. This provides context for why simply saying "Just move," or "Start exercising," to someone with depression, and funneling them into exercise programs, can be misguided. Real change in behavior is difficult to achieve without understanding why they are inactive and what thoughts dominate their minds.

In this vein, Aaron T. Beck, the founder of CBT, explained that "behavior activation ultimately involves identifying the underlying thoughts and working with these thoughts." Hence, he originally termed this approach 'cognitive therapy.' Modern psychiatry has evolved; there are effective drugs and behavioral techniques. However, a mechanical approach—simply taking medication well or moving one's body without deep understanding—won't resolve core issues.

Distancing focuses on helping those who are depressed and anxious understand themselves and learn directly how to cope with their cognitive structures. It's not an easy process, but there are people who are gradually creating change. Hopefully, many will distance themselves from limiting thoughts and create shifts that steer back to the values they wish for in life.

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