The following is a more specific list of behavioral factors involved in depression.
- Loss of rewards. Have you experienced significant losses in your life recently-for example, loss of work, friendships, or intimacy? There is considerable research evidence that people who suffer significant life stresses are more likely to become depressed-especially if they lack or do not use appropriate coping skills.
- Decrease of rewarding behavior. Are you engaged in fewer activities that were rewarding for you in the past? Depression is characterized by inactivity and withdrawal. For example, depressed people report spending a lot of time in passive and unrewarding behaviors, such as watching television, lying in bed, brooding over problems, and complaining to friends. They spend less time engaged in challenging and rewarding behaviors, such as positive social interactions, exercise, recreation, learning, and productive work.
- Lack of self-reward. Many depressed people fail to reward themselves for positive behavior. For example, they seldom praise themselves, or they are hesitant to spend money on themselves. Many times depressed people think that they are so unworthy that they should never praise themselves. Some depressed people think that if they praise themselves, they will become lazy and settle for less.
- Skill deficits. Are there any social skills or problem-solving skills that you lack?
Depressed people may have difficulty asserting themselves, maintaining friendships, or solving problems with their spouses, friends, or work colleagues. Because they either lack these skills or do not use the skills they have, they have greater interpersonal conflict and fewer opportunities to make rewarding things happen for them.
- New demands. Are there new demands for which you feel ill prepared?
Moving to anew city, starting anew job, becoming a parent, or ending a relationship and trying to find new friends can cause significant stress for many people.
- Being in a situation where you feel helpless. Depression may result from continuing to stay in a situation in which you cannot control rewards and punishments. You feel sad or tired, lose interest, and feel hopeless because you believe that no matter what you do, you cannot make things better. Unrewarding jobs or dead-end relationships can lead to these feelings.
- Being in a situation of continual punishment. This is a special kind of helplessness: Not only are you unable to get rewards, but you find yourself criticized by others and rejected. For example, many depressed people may spend time with people who criticize them or hurt them in various ways.
Although each of the factors of stress and loss described above may make you prone to depression, they do not necessarily have to result in depression. Certain ways of thinking can increase your chances of becoming depressed, however. You are more likely to become depressed if you think that you are entirely to blame, that nothing can change, and that you should be perfect at everything. These interpretations of stress and loss are the “cognitions” or thoughts that you have about yourself and your environment. Cognitive therapy is specifically focused at identifying, testing, challenging, and changing these excessively negative views of life.