Depression

Definition

In REBT, depression is an unhealthy emotional problem (unhealthy negative emotion / UNE) that arises in response to inferences about loss, failure, deprivation, or inability to achieve valued goals. It is characterized by low mood, hopelessness, withdrawal, loss of interest, and negative self-view.

Depression is distinguished from the healthy alternative, sadness, by the presence of:

• Rigid/extreme attitudes (particularly about self-worth and the permanence of loss)
• Rumination and hopelessness-maintaining thinking
• Withdrawal and inactivity
• Global self-devaluation

Core Inference Theme

When depressed, people typically perceive inferences related to:

• Loss: loss of a relationship, opportunity, status, or health
• Failure: inability to achieve something important
• Deprivation: feeling deprived, disadvantaged, or unfairly treated
• Hopelessness: belief that the situation is permanent and unchangeable

Rigid/Extreme Attitudes Underlying Depression

Depression is underpinned by a rigid attitude combined with extreme attitudes:

Rigid attitude:

• “I must achieve [valued goal]” OR “I must not lose [valued thing]”
• “I must be competent, successful, or loved”

Extreme attitudes (derived from the rigid attitude):

1. Awfulising: “It’s terrible and unbearable that I’ve lost/failed; the future is hopeless”
2. Devaluation: “Because I failed/lost, I am worthless; I am a failure”
3. Unbearability (less common but present in some cases): “I can’t bear this loss; I couldn’t survive the permanent disappointment”

Behaviours Associated with Depression

When depressed, people typically:

• Withdraw socially and physically (isolation)
• Reduce activity (fatigue, lack of motivation, avoidance of normal tasks)
• Ruminate about the loss or failure
• Neglect self-care (sleep, nutrition, hygiene)
• Express hopelessness (verbal expressions of futility)
• Avoid future-oriented planning or goal-setting
• Seek reassurance (temporarily reduces mood but doesn’t address underlying attitudes)

Note: This behavioural withdrawal can become a maintenance cycle; reduced activity prevents the person from discovering that engagement and accomplishment are still possible.

Thinking Associated with Depression

Rumination and hopelessness:

• Repetitive, unproductive focus on the loss or failure
• “Nothing will get better”
• “I’ll never be happy again”
• “I’m incapable”

Selective negative attention:

• Focusing on evidence of one’s worthlessness or the permanence of loss
• Ignoring counter-evidence or alternative interpretations
• “Always/never” thinking about one’s competence or the situation

Global negative self-evaluation:

• “I’m a failure” (rather than “I failed at X”)
• “I’m unlovable” (rather than “This relationship ended”)
• “I’m hopeless” (rather than “This situation is difficult”)

Healthy Alternative: Sadness

When the same inference theme (loss/failure) is processed with flexible/non-extreme attitudes, the person experiences sadness instead:

Flexible attitudes:

• “I would have preferred not to lose/fail, but that doesn’t mean I shouldn’t have”
• “Losses and failures are part of life, even though I don’t like them”

Non-extreme attitudes:

1. Non-awfulising: “It’s bad that I lost/failed, but not catastrophic; I can recover”
2. Unconditional self-acceptance: “I failed at X, but that doesn’t make me a failure as a person; I’m still worthwhile”
3. Bearability: “I can bear this loss; sadness is painful but manageable; I will experience happiness again”

Behaviours associated with sadness:

• Grieve or process the loss appropriately
• Maintain basic self-care and activities
• Gradually re-engage with life and new possibilities
• Seek support from others (not for reassurance, but for connection)
• Problem-solve: “What can I do about this?”

Thinking associated with sadness:

• Realistic acknowledgment of the loss
• Balanced perspective: “This is bad, but other things are still good”
• Future-oriented: “I feel sad now, but things will change”
• Non-ruminative; focused on adaptation

Difference Between Clinical Depression and Healthy Sadness

Clinical Depression (UNE):

• Persistent hopelessness
• Global self-devaluation
• Complete withdrawal of pleasure and engagement
• Duration interferes with functioning
• Pervasive negative thinking

Sadness (HNE):

• Sadness about a specific loss or failure, but hope about other domains
• Maintained self-worth (despite the setback)
• Maintained engagement with valued activities (even if less pleasurable temporarily)
• Proportional to the adversity and gradually resolves
• Realistic thinking about the situation and one’s capacity

REBT Approach to Depression

The therapeutic process involves:

1. Identifying the loss or failure that triggered depression
2. Identifying the rigid/extreme attitudes about that loss
3. Setting sadness (the HNE) as the emotional goal
4. Developing behavioral goals: re-engagement, activity scheduling, self-care
5. Examining the rigid attitudes and building conviction in flexible/non-extreme alternatives
6. Crucially: Addressing the global self-devaluation; building unconditional self-acceptance
7. Behavioral activation: gradually increasing engagement despite emotional resistance

The behavioral component is particularly important because withdrawal maintains depression.

Subtypes of Depression in REBT

Windy Dryden’s framework identifies depression rooted in:

• Ego-based depression: Low self-worth, self-blame, global negative self-evaluation
• Discomfort-based depression (less common): Demoralization about life’s difficulties or inability to achieve comfort

Common Clinical Challenges

• “I’ll never feel better”: Hopelessness about change; depression itself creates the rigid belief that things won’t improve
• Isolation: Withdrawal prevents social connection, which could disconfirm hopelessness
• Behavioral inertia: “I’m too depressed to do anything” becomes self-fulfilling
• Secondary guilt or shame: The person may feel ashamed of their depression or guilty about withdrawal from others
• Medication vs. attitudes: While medication may help, addressing rigid attitudes is necessary for lasting change

How Different Frameworks Treat Depression

• REBT: Focuses on rigid/extreme attitudes about failure and self-worth; emphasizes behavioral activation and unconditional self-acceptance
• CBT: Focuses on negative automatic thoughts and behavioral activation; similar in many ways to REBT but less emphasis on philosophical attitudes
• ACT: Emphasizes values-directed action and acceptance of difficult emotions; behavioral activation is primary
• CFT: Addresses shame, self-compassion, and emotional regulation alongside behavioral approaches
• MBCT: Uses mindfulness to observe depressive thoughts/rumination without engaging; emphasizes present-moment awareness

Related Concepts

See also: Sadness (the healthy alternative), Unhealthy Regret vs. Healthy Regret (related but distinct), Global Evaluation of Self, Unconditional Self-Acceptance, REBT, ABC model, Healthy Negative Emotions.

Sources

• Windy Dryden: Dealing with Emotional Problems Using REBT: A Practitioner’s Guide (2nd ed., 2024) — Chapter 3: “Dealing with Depression”
• David Burns: Feeling Good: The New Mood Therapy (1980) — Classic cognitive approach to depression (complements REBT)