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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by glenn on April 17, 2003, at 16:46:40
I have managed a bit of thinking about your post regarding cortisol and the two interesting theories you mentioned and I have a problem with them both. I could accept both as being possible for many people but as you bring up the evolutionary aspect it seems a bit unlikely that everyone would work in the same way.
An idea is that it pays to have certain members of a population who are either supersensitive or perhaps wired differently in order to give such a population early warnings of possible danger.
Such an idea is expressed slightly differently but similarly in the book- " living with our genes" by Dean Hamer and Peter Copeland in the concept of harm avoidance and in - " The highly sensitive person " by Elaine N Aron.
I cannot work out if this is simply a matter of extra sensitivity or a different structure to those mentioned in the theories but my experience of cognitive therapy may illustrate it.
I had 30 sessions and in spite of being called a compliant patient I could never convince my therapist that for me feelings came first , then bad or negative thoughts.
She always used to say to me that cognitive therapy worked better if you knew waht you were afraid/ worried/ depressed about and I could never give her a better answer than " how I feel, after I have begun to feel it!)
Sounds strange and maybe it is, but I guess ther is some evolutionary advantage to having some who feel and act before they can cognitively respond.
Also my reaction is not adrenaline like at all, no sweating, thumping heart etc.
I guess no one can say if this is cortisol or not or whether that is just somewhere downstream, but for me I know my levels are massively high and the symptoms are rather wierd.
Interestingly enough Xanax is the only benzo that helps, valium for example makes me much more anxious ?!
Food for thought!All the best
Glenn
Posted by mattdds on April 18, 2003, at 15:31:03
In reply to To Mattdds, posted by glenn on April 17, 2003, at 16:46:40
Glenn,
For me it is the same way. Feelings *seem* to come first, preceeding my *awareness* of what I am thinking. It takes a while to learn to get that awareness. The interaction between cognitions and emotions is definitely not a one way street. Feelings can sometimes preceed the *awareness* of cognitions, especially after depression has become chronic. Then depressive feelings can certainly come spontaneously. Have you ever been doing something, and realize you are well along a train of thought that you didn't even realize you were on? Most of the time, we aren't even aware of what we are thinking. And one should not conclude that since feelings seem to come first, that therefore cognitive therapy will not work for them. I don't think people are wired as differently as you might think. One of the core aspects of depression is that we believe we are somehow defective (e.g., my brain works SO much differently than "normal" people). Don't fall for that trap, as it serves you no advantage to believe that.
Take me for example. I used to never know what I was depressed / anxious / worried / panicky about. There were never any major problems that I would get worried about. Just a sort of nebulous cloud of worry.
So, again, it is not only:
Cognition ------> emotion
But much more like:Cognition <-----> emotion
It works both ways; it's a reciprocating relationship. CBT makes the big deal about the cognitions because we can to some degree control that variable. We can influence our beliefs and thoughts throught conscious effort, but we cannot directly change our feelings, or none of us would be sick. That is the whole point!
Did you do the exercises in CBT? Or did you just show up to the therapy sessions? There have been good studies done that show that mood improvement is directly correlated with the amount of homework done in CBT(causally related, as in it was shown that homework was *causing* the improvement, not just an association between the two).
In CBT, you describe the event that is upsetting you, when it happened, who you were with, etc. Describe the emotions that you were having. This applies even to you when you said that the only thing upsetting you was your mood! So use your *MOOD* as the upsetting event. So, a brief example:
Upsetting event: my mood is low, I feel depressed for no apparent reason.
Emotions: depression (90%)
Automatic Thoughts:
1. I will never get better
2. This CBT will never work on my, I'm different
3. I am biologically programmed to be depressed
4. There is nothing I can do to make myself feel better.
5. I have always felt depressed, I never feel right.Do you see how these thoughts could perpetuate the cycle, or become self-fulfilling prophecies? So sometimes your automatic thoughts that need to be straightened out are *concerning* your mood! Does that make sense? I had the same stumbling block as you, but realized I could apply this method to any upsetting experience in life, including apparently random mood dips.
I reached a point where I carried distorted beliefs about depression and anxiety, e.g.:
1. I will not be able to finish dental school because I am depressed
2. I will probably commit suicide
3. My wife is going to leave me (because I'm depressed)
4. I will never be able to work (again, because of the depression)These were just a few of the core beliefs that I had to work on.
In short, cognitions about moods themselves can feed the cycle of depression.
Does any of this make sense?
Thanks,
Matt
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