The What Keeps Depression Going? handout presents key factors that maintain depression.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted.
What Keeps Depression Going? is designed to help clients experiencing depression understand more about their condition.
Understanding what keeps depression going is crucial for effective intervention. By identifying these factors, therapists can develop idiosyncratic models of clients' experiences and focus their interventions.
Designed to help clients affected by depression.
Explain to the client that certain difficulties persist due to cycles that maintain them.
Use the handout to discuss what might be keeping the client's difficulties going.
Pinpoint and personalize maintaining factors that are relevant to the client.
Explore how these maintaining cycles can be interrupted.
Everyone feels 'down' from time to time, but when individuals are depressed, low mood can last for weeks or months at a time. Common symptoms of depression include feeling dejected or down for most of the time; taking less interest in things; fatigue or tiredness; feeling worthless, guilty, or very self-critical.
Research studies have shown that cognitive behavioral therapy (CBT) is one of the most effective treatments for depression (Cuikpers et al, 2020). CBT therapists work a bit like firefighters: while the fire is burning they aren’t very interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. This is because if they can work out what keeps a problem going, they can treat the problem by ‘removing the fuel’ and interrupting this maintaining cycle.
Modern approaches to treating depression stem from earlier advancements. In the 1970’s, psychologist Charles Ferster published an influential behavioral account of depression. At the same time, psychiatrist Aaron Beck was beginning to describe cognitive aspects of depression. The What Keeps Depression Going? information handout describes some of the key factors identified by these two approaches which act to maintain depression. It illustrates the maintaining factors in a vicious cycle or 'flower' format, in which each ‘petal’ represents a separate maintenance cycle. Helping clients to formulate a model of their experiences is an essential part of cognitive behavioral therapy for depression. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.
