Psychology of Chronic Depression

The Psychology of Chronic Depression

Many people who have been depressed for a long time, develop a pattern of interacting with others that is designed to protect them from disappointment, this pattern, the psychology of chronic depression, needs to be understood in order to help people successfully emerge from this devastating condition.
Avoiding disappointment and rejection is obviously a good thing, but it can lead to relationships that are not satisfying.
If I can never risk changing my relationship because of the risk that the change could lead to turmoil, that relationship inevitably becomes more distant, and less satisfying.

James P. McCullough, in his book Treatment for Chronic Depression, has helped us to understand what happens for many people with depression.

Over time, in people with chronic depression, there is a shift in how they think about the world and their relationship to it. They no longer see the connection between their own behavior and the responses that they get from others.

This makes sense as a way of avoiding being disappointed over and over again. Don’t expect that you can do anything positive and you won’t be disappointed when things don’t work out. But it becomes a self-fulfilling prophecy.

The psychology of chronic depression involves seeing the world of relationships as:

  • A world in which the emotional reactions (sadness, hopelessness) that they experience when they encounter disappointment are inevitable and often overwhelming.
  • A world in which there are few differences in how others interact with them, in which other people are more alike than they are different.
  • A world that tends to be experienced “in the moment.” So that disappointment in the moment makes past experiences that were satisfying “disappear.”

These changes are natural, but they are not inevitable, and a systematic approach to addressing them is at the heart of one of the most effective psychotherapies for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP).

For More Information

Chronic Depression: What You See Depends on Where You Look

Relationships and Chronic Depression


McCullough JP Jr. Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). J Clin Psychol. 2003 Aug;59(8):833-46. PubMed PMID: 12858425.