The Slow Poison of Negative Thoughts

Coping with the inner voice of depression

Apr 11, 2021

Would you willingly drink a slow acting poison? Would it surprise you if I told you that you probably do — daily? I did, for years. The poison I ingested was made up of all the negative thoughts about myself my mind threw at me. I took the thoughts, as horrible as they were, as fact, rather than the product of a depressed mind stuck in negative thought loops.

I started my professional life as a general practitioner. I ran a busy medical practice, unaware that my own swinging moods were caused by Bipolar II, a condition I had inherited from my father’s side of the family.

A lot of negative thoughts about myself accompanied the mood swings. At one level I understood they didn’t make sense, but that didn’t stop them. My mind continued to churn out thoughts about how I wasn’t good enough or smart enough or dedicated enough.

If I gave my mind free reign, there was nowhere it wouldn’t attack me. Between a busy office and a husband and two young children at home I didn’t have time for these negative thoughts, so I continually pushed them below the surface where they festered and poisoned my well-being.

What you resist persists

The more I tried to shove those thoughts down, the more they plagued me. It seemed there was no escape. My mood swings became worse, and the periods of depression became longer and deeper. I didn’t acknowledge any of this. I put my head down and kept working.

I don’t know how long this would have gone on. Six years into my practice a driver with a record of numerous car accidents drove into my car while I was stopped, waiting to turn left.

I struggled to continue working for a while, but I developed fibromyalgia and debilitating headaches after that accident and for a number of years spent most of my time in bed. My children would play on the bed beside me.

I was restless at home, so ten months after the accident I started working one morning a week at Western University as a physician psychotherapist. I had done a lot of counseling in my family practice. I had been good at it.

I only worked a few hours one day a week for the first few years. It was all I could handle. But my new, exclusive focus on psychotherapy led me to read extensively in the field. That’s where I discovered mindfulness.

Mindfulness opened up a new world to me

As I learned to help my patients, I started to help myself. Among the many things I learned was how to see my thoughts differently.

During this time period I was finally diagnosed with Bipolar II. In retrospect it had onset at age fourteen and for various reasons my symptoms were ignored by those around me.

I was tried on many medications and it turns out I don’t tolerate medication well. From allergic reactions to severe side effects, it eventually became clear that medication was not going to be my answer. I will also note that in addition to all of the difficulties I experienced taking medication, none of them helped me.

I’m going to stop for a moment to emphatically state that I am not suggesting anyone go off their medication. I prescribed psychotropic medication to patients throughout my career when it was appropriate to do so. Many benefited from medication, though some did not. Had my personal experience with medication been different, it would have become part of my arsenal in dealing with Bipolar II.

Mindfulness based cognitive therapy

Cognitive therapy holds as a tenet that thoughts cause mood changes. The thoughts may pass through your mind so quickly that you don’t remember having them. Their effects, nonetheless, can impact mood and even trigger depression. Treatment is aimed at challenging negative thoughts and is helpful in decreasing relapse into depression.

Therapists Zendel Segel, Mark Williams, and John Teasdale incorporated Jon Kabat Zinn’s mindfulness based stress reduction (MBSR) course with cognitive therapy to create mindfulness based cognitive therapy (MBCT).

Cognitive therapy is about challenging negative thoughts about oneself and the world. Mindfulness based cognitive therapy is a modified form of this that employs meditation and breathing techniques as well.

MBCT also takes a somewhat different approach to negative thoughts. It acknowledges that the mind is built to think and that it does so constantly. If you sit quietly for a while and just watch your mind, you’ll quickly realize that it spews out thoughts, jumping from topic to topic at times, ruminating on negative thoughts at other times. It doesn’t want to sit still.

Mindfulness teaches us to watch our thoughts without judgment

Thoughts don’t make us feel bad. Our judgments about them do. A thought may run through your head. I’m so stupid. If you judge the thought to be true, you believe it and it triggers a cascade of negative feelings and further negative thoughts. You descend into something called automatic thinking, so mired in the constant flow of negative thoughts you don’t consider any other point of view.

Classical cognitive therapy would have you challenge this thought with the evidence that shows it’s not true. This is helpful for some, but in my experience as a therapist, for many patients it created an internal battlefield.

An alternate approach is to view a thought as just a thought. The mind is a thinking machine, constantly pouring out thoughts, many of which are pointless, or worse, harmful. It also gets stuck in ruts formed as we think and rethink the same thoughts. The brain makes connections and reinforces them based on repetition.

We learn through repetition. Hence children drill their times tables, and we make notes and reread them before exams. The more often a thought runs through our brain, the more likely we are to think it again. If we think it enough times, it becomes automatic, surfacing whether we want it to or not.

In MBCT we watch our thoughts. When a negative thought comes up, instead of engaging it, we note it. We think, “That’s a thought.” Then we let it go. This is obviously not as easily done as that. It takes practice and repetition, just as any new learning does.

Over time we stop clinging to negative thoughts as though they’re true just because we think them. We begin to realize that truly, a thought is just a thought. They begin to lose their stranglehold grip on our emotions.

Negative thoughts are especially prominent during a depressive episode

It’s very difficult to counter your inner negative voice when you’re experiencing depression. Depression feeds the negative voice. It tells you that any voice that counters it is lying.

It’s vital to establish a pattern of watching thoughts and acknowledging them as nothing but thoughts during a period of wellness. You can work on it when depressed (I did), but it’s much harder and less effective.

Jon Kabat-Zinn wrote in one of his many books on mindfulness, “Make sure you weave your parachute every day, rather than leave it to the time you have to jump out of the plane.”

This is sound advice. Practice watching your thoughts when you’re not mired in depression. If you don’t, you’re not likely to be able to begin when you need it most.

A thought is just a thought

Watching our thoughts without judgment, neither arguing with them nor believing them, can help us suffer fewer relapses into depression. It can also help us ride depression a little better when it does recur. It has changed my life.

I still live with Bipolar II. I experience periods of depression. I deal with this by employing an arsenal of lifestyle choices, supplements, and mindfulness. MBCT is part of living mindfully for me, and watching my thoughts has become second nature. Depressive episodes are generally less deep and prolonged than they used to be, and I ride them better than I used to. You can too.