PSYCHOLOGICAL RISK FACTORS FOR ANXIETY AND DEPRESSION

by Joyce Chong 

In Part 3 of our series Develop a Healthy Mindset we’re looking at some psychological risk factors for anxiety and depression.

WHY FOCUS ON ANXIETY + DEPRESSION?

A while ago we did a post on mental health statistics (you can find that post here), which showed that the top two mental health issues facing us are anxiety and depression. Even if we don't have a diagnosis of anxiety or depression it's still helpful to learn ways to become more resilient. Below, we cover four risk factors - negative thinking styles, desire for control, low self-esteem, and low distress tolerance - that we commonly see in our work as clinical psychologists.

NEGATIVE THINKING STYLES IN ANXIETY + DEPRESSION

We covered Thinking Styles in our last post , and when it comes to anxiety and depression these negative thinking styles are often at play.

Anxiety: When we look closely at some of the self-talk that increases our anxiety, thinking styles that we often see include:

• Catastrophising: “Oh my god did you feel that bump? This plane is going to crash!”

• Mind reading: “She must think I’m incompetent!”

• Emotional reasoning: “I feel so anxious...something awful is about to happen, I just know it.”

• Black and white thinking: “If I don’t get at least 80% on this assignment then it’s as good as a fail!”

Depression: Negative thinking styles often involved in depressive thinking include:

• Labelling: “Yet another mistake I’ve made on this project. I’m such a loser.”

• Negative filter: “I can’t believe that I fumbled that last question in my presentation.”

• Minimising the positives: “I’ll bet they only said I did well on the project because they took pity on me.”

• Personalisation: “It’s all my fault that the party was a fizzer and that people had a bad time.”

• Mind reading: “I’ll bet she thinks I’m a failure.”

TRY   Call out your thinking styles as soon as you recognise them, and start to see things in the proper context. For example:

• Negative filter: “I may have fumbled the last question on my presentation, but the remainder of the feedback was positive.”

• Emotional reasoning: “Yes I feel nervous about flying, but I have felt nervous flying on all of the holidays I have taken thus far and nothing bad has happened.”

• Personalisation: “What other reasons can there be for the party not going well? I did the invitations, decorations and food, but ultimately I can’t force people to talk to each other nor hover over every single conversation to facilitate interactions.”

THE DESIRE FOR CONTROL IN ANXIETY + DEPRESSION

A strong desire for control is something that we see in both anxiety and depression. In anxiety, the fear of losing control in a situation, or of not being in a highly predictable situation, can intensify feelings of anxiety and even trigger panic attacks. In depression, it is typically a loss of control over our circumstances that triggers feelings of helplessness (being unable to do anything that changes the situation) or hopelessness (e.g. having "what's the point?" thoughts).

TRY   In situations where the thought of losing control increases your anxiety, ask yourself what is the worst case scenario. Is it something that you can cope with, even if it feels unpleasant? Have there been times in the past when you've felt the same but ended up being able to manage the situation (again, even if the situation has felt unpleasant)? 

Quite often, we want control over a situation because we dislike the feeling of anxiety that comes with it when, in reality, the outcome is beyond our control. If this is the case, perhaps the best approach is to expect the unexpected and accept that feeling anxious will be part of the process.

To take steps towards easing the hold that control has over you, take stock of the tasks or events that you like to have control over. Separate these into ‘essential’ and ‘desirable’ tasks or events. Gradually, attempt to delegate some of the ‘desirable’ tasks. Yes, you will feel discomfort initially, but that is the point entirely when we start to do a bit of exposure therapy.

LOW SELF-ESTEEM IN ANXIETY + DEPRESSION

Self-esteem difficulties often lie at the core of social anxiety where there is an underlying fear of negative evaluation. The thought of being judged negatively and of seeming inadequate can lead to intense anxiety. Low self-esteem can also present in depression, wherein feelings of worthlessness or failure lead to low mood.

TRY   Look at what maintains your low self-esteem, and start to make changes by looking at the evidence that backs your assumptions. For example:

• If it started with negative messages that you received when you were younger, look at how valid these messages are today. Perhaps you were told that you wouldn’t amount to much – has that really rung true or have you had successes along the way?

• If it started from thinking that you’re not good enough, take a step back and look objectively at the evidence. For example, you may think that you’re unlovable, but consider those friends who do reach out to you, or attempt to socialise with you - would they seek you out if you weren't good enough?

• If it’s how you view your body compared to the images that you see in the media that gets you down, spare some thought to how these images appear to be perfect – is it reality that you actually see, or just a well-orchestrated image? (see our post on How social media hurts our self esteem for more details).

LOW DISTRESS TOLERANCE IN ANXIETY + DEPRESSION

Difficulties tolerating uncomfortable feelings can, in itself, reinforce our anxiety and depression. It's true that no one wants to feel awful, but what is the cost when you’re constantly trying to escape those feelings?

• Does it lead to a rapidly shrinking set of activities/situations/people that you consider ‘safe’?

• Do you spend much of your time in an intoxicated haze because you want to avoid thinking or feeling awful?

• Are you facing setbacks or missing obligations because of how awful you feel?

TRY   Recognise the impact of having difficulties tolerating distress. Yes, ideally you wouldn’t have to do things that cause you distress, but if it’s stopping you in your daily life, then let’s look at taking small steps to turning things around. For example:

• If driving causes you anxiety, start by driving around the block. If that causes too much anxiety, break it down further by driving on your street only or practising driving in the carpark.

• If you’ve been using alcohol to dull your thoughts, look at techniques like Cognitive Behaviour Therapy, Mindfulness and grounding techniques, or Acceptance and Commitment therapy to help you better manage those thoughts rather than just escaping from them.

Hopefully the tips that we've covered in this post give you a boost in the right direction to bounce back from anxiety or depression, or help build your resilience.