Every person is different. Because every person is different, the way they experience depression is different. And because the way they experience depression is different, the way they respond to treatment is different as well.

An analysis of 35 studies has revealed that the success of a psychological treatment depends greatly on the preference of the patient. When a treatment syncs up well with a patient, they are more likely to see the therapy all the way through and to demonstrate greater improvement. Thus, over time, there has been a stronger push in psychology to embrace flexibility in treatment methods so that conditions, such as depression, can be treated most effectively.

However, what exactly does this “preference” entail? A patient’s preference is the result of a multitude of factors, both innate and environmental. Factors that influence preference include culture, values, language, economic resources, social support, and more. Understanding how all these factors interact is key to developing the best treatment for depression.

In this article, we will explore four ways to break the cruel hold of depression. All of the methods are equally effective, but they each focus on a different assumed cause and resolution for the problem. Read on to learn which method is most effective for which preference.

• Thoughts
• Relationships
• Behavior
• Emotions

Thoughts

People with depression tend to have a negative impression of themselves. They zero in on their flaws and weaknesses, losing sight of their gifts and feeling as though they are unlikeable and worthless. This mindset exacerbates the downward spiral of depression, as low self-esteem causes negative events to be perceived as a confirmation of the sorrows of life–sorrows that seem to be never ending.

Cognitive behavioral therapy (CBT) assumes that our thoughts are the main propellant behind depression. Using this treatment, practitioners work with patients to locate and weed out inaccurate negative beliefs about the self and the future.

In order to complete this, several of the “thinking errors” that often plague those with depression must be challenged:

• Arbitrary inference: drawing a conclusion despite a lack of evidence or in the face of evidence of the contrary
• Selective abstraction: taking a detail out of context and applying it to the whole experience, ignoring other important parts of the situation
• Overgeneralization: using isolated incidents to form a general rule or conclusion and applying it to unrelated or barely-related situations
• Magnification and minimization: inflating negative perceptions of events or qualities and depreciating positive perceptions of those same things
• Personalization: relating external events to the self when there is no substantial connection
• Absolutistic, dichotomous thinking: casting all experiences into one of two opposing categories, with no gray areas of in between

Therefore, in order to defeat depression with your thoughts, you must learn to change your mindset to become a more positive thinker.

Relationships

But depression doesn’t always concern just one person; sometimes, the root of the problem can be in the relationships of the patient. Oftentimes, someone struggling with this type of depression has failed to consider all the options they have to resolve interpersonal distress. Rather than solve disputes, they either avoid or endlessly worry about the problem.

Thus, interpersonal therapy (IPT) seeks to locate centers of depression in the context of relationships and to devise plans to resolve these conflicts. However, relationships are very complex, and even relationships we had in the past, from childhood to adolescence to adulthood, can have a big impact years later, influencing our relationships in the present.

Therefore, there are different types of relationship distress we must consider:

• Grief: the reaction to the real death of a person, whether in the past or present
• Role disputes: interpersonal conflicts with friends, family, romantic partners, or co-workers
• Transitions: the response to role-changing life events, such as marriage, a new job, becoming a parent, etc.
• Interpersonal deficits: Interpersonal isolation and/or the poor quality and/or quantity of relationships

While there is always an internal component to depression, sometimes, outside factors can be a major cause as well. It’s important to examine the people in your life to find areas of improvement.

Behavior

A common symptom of depression is a withdrawal from hobbies and social activities that the patient once enjoyed. This, unfortunately, only serves to deepen the downward spiral, as the more they avoid the things that bring them joy, the less reward they receive from them, isolating them from what they truly desire and/or value. Furthermore, getting trapped in the negative thoughts that come from this destructive behavior often makes the depression even worse.

Behavioral activations (BA) assumes that this withdrawal from pleasurable activities is the main exacerbation behind depression. With a practitioner, patients can devise sets of rewarding activities that change behavior to boost their mood and add more positivity to their lives.

Emotions

Emotional experiences can be damaging, and some of them even cause us to withdraw into ourselves and avoid similar experiences in the future. Patients with depression have often internalized problematic emotional responses to repeated and/or intense emotional occurrences, such as trauma, shame, rejection, humiliation, etc.

Emotion focused therapy (EFT) aims to help patients recognize and express their emotions in a healthy manner. This often involves pushing the patient to experience the emotions they previously avoided and learning how to cope with them. Patients may be asked to put themselves in simulated situations to confront their fears, such as by engaging with dialogue with an imaginary person in an empty chair.

As depression often involves divergence from a normal emotional state, this treatment may seem counterintuitive at first, but it’s actually more helpful than suppressing emotions the patient doesn’t know how to handle.

In his book, Emotion-Focused Therapy: Coaching Clients to Work Through Their Feelings, Second Edition, award-winning Distinguished Research Professor Emeritus of Psychology at York University Leslie S. Greenberg says, “Paradoxically, one of the most effective ways of helping clients contain emotion may actually be helping them to become aware of it, express it, and decide what to do about it as soon as it arises. This is because suppressing an emotion and doing nothing about it tends to generate more unwanted emotional intrusions, making it more overwhelming or frightening.”

Thus, though it may seem terrifying at first, overcoming emotional baggage is vital to developing healthier coping habits.

Though depression is caused by a variety of factors, and nobody should ever be led to believe it’s their fault that they’re depressed, it’s important for patients to put in the effort to overcome barriers and break free from the cursed downward spiral.

As we’ve seen in all four methods, the best way to combat depression is through self-improvement–learning to think positive thoughts, learning to solve problems in relationships, learning to engage in empowering behavior, and learning to cope with troublesome emotions healthily.

While it’s important to seek help when you have depression, only you are capable of seeing yourself through it. So stay strong and persevere through all the challenges life throws at you.