How acceptance and commitment therapy can help with depression

Many of us will experience depression at some point during our lives. It can vary significantly from mild symptoms that have a minimal impact on our day-to-day functioning to severe symptoms which can be incredibly debilitating. 

Signs of depression

Depression can creep up on us gradually. It may start with a slightly lower mood; sadness, a sense of emptiness or irritability. Sometimes this might lift in a few days, but at other times it may deepen and become more persistent.

You might find that you lose interest in and no longer enjoy activities that you used to gain pleasure from. You may lack energy or feel more tired than you usually do. It might be harder to concentrate and remember things. Your thoughts may become more negative, and you might feel bad about yourself, as well as excessively guilty. This can lead to feeling hopeless and helpless. Sleeping too much or too little might become an issue, as well as a lack of appetite or overeating. 

Causes of depression

Research suggests that certain people might be genetically predisposed to experiencing depression. Usually, there will also be a triggering life event at the start of an episode. This could be some form of loss, such as being bereaved of a close family member or friend, a relationship breakdown or redundancy.

Injuries or changes in health which prevent us from doing as much as we used to, or periods of intense stress, can also bring on depression. Past trauma or low self-esteem can be underlying factors in some cases.

What is acceptance and commitment therapy?

Acceptance and commitment therapy (ACT) is an approach that helps people to live a rich and meaningful life, whilst accepting the inevitable pain that happens along the way. It enables clients to clarify what is most important to them, then set goals and take actions in alignment with their values.

ACT also teaches us how to handle unhelpful thoughts and feelings more effectively so that they impact us far less. It similarly helps us learn how to be more present in our lives, so that we’re not losing as much time to dwelling on the past or worrying about the future.

How acceptance and commitment therapy can help with depression

When we are depressed, we often lose our sense of purpose, and life can seem meaningless. We don’t have a clear direction. We become disconnected from our values. Reconnecting with what is most important to us and setting ourselves goals helps us find a sense of purpose again and shift out of the lack of motivation that accompanies depression. 

Being depressed usually means our minds generate many more negative thoughts than they normally would, and that we are more likely to believe these thoughts. Thoughts might be about ourselves, such as “I’m useless”; about other people, such as “They don’t really like me”; or broader, such as “The world is doomed”. We can get stuck in rumination, with these thoughts going round and round in our minds, keeping our mood low.

If we try to push these thoughts out of our minds, research shows that they just come back stronger. The most helpful way to approach them is to find a different way to relate to them. In ACT, we step back from these negative thoughts so that we can see them for what they really are, as mental events in the mind that may or may not be true. We are getting some distance from them so that they don’t have so much power over us.

Being caught up in negative thoughts and rumination also blocks us from being fully engaged in life and what we are doing. We might spend significant periods of time replaying situations from the past in which we wish we had acted differently, or dwelling on how unfairly we feel we have been treated by others.

ACT brings our focus into the present moment by paying attention to sensory experiences. This might be in the form of specific mindfulness practices or by bringing greater awareness to the everyday activities of life. Being more engaged with the present brings us out of our minds and enables us to feel more connected to other people and the world around us, which can really help with alleviating low mood.

Emotions can often get stuck in depression, whilst we are lost within the stream of thoughts in our minds. We might become unable to really feel our emotions; a numbness and inner emptiness may set in. ACT helps us to approach our feelings with acceptance and self-compassion rather than blocking them or being overwhelmed by them. Really feeling our feelings in this way can allow them to become unstuck and move through more easily. 

Depression can significantly impact our lives, but therapy can effectively bring us out of it. ACT is an evidence-based approach which can help you to let go of negative thoughts and start engaging fully with life again. If you are experiencing low mood or depression, please do seek support; there are ways to feel better.