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According to the idea of the growth mindset a person is more likely to successfully change, when they believe that change is possible.

To what extend does that apply to depression? Is a person who believes that it's possible to overcome their depression more likely to overcome it then a person who believes that there's no hope overcoming their depression?

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Is a person who believes that it's possible to overcome their depression more likely to overcome it then a person who believes that there's no hope overcoming their depression?

The answer depends on many factors; and if therapy is received, as with all mental health conditions, it also depends on the form of therapy the depressed client receives and the rapport between client and the therapist.

CBT is often the go to form of therapy within IAPT services advocating for therapies which they can easily measure outcomes. However, as pointed out in my answer on the limitations of CBT,

There are a fair few factors which can prevent CBT from becoming effective, and a trained and certified CBT practitioner will be able to assess the suitability of CBT. If they operate ethically, they will not go ahead with providing CBT to someone who it would not benefit.

One of the biggest factors which doesn't allow CBT to work is that if the client is not willing or able to challenge their thoughts and behaviours, then CBT will not be effective.

There are articles covering the effect of positive expectations creating positive outcomes. Scheier & Carver (1993) pointed out that

People who see desired outcomes as attainable continue to strive for those outcomes, even when progress is slow or difficult. When outcomes seem significantly unattainable, people withdraw their effort and disengage themselves from their goals. Thus, people's expectations provide a basis for engaging in one or two very different classes of behavior; continued striving versus giving up.

Belief that your depression can be cured will help by a considerable margin.

There is evidence consistent with the suggestion of the cognitive model of depression that certain negative cognitions can produce and maintain the state of depression. There is also good evidence that depressed mood affects the relative accessibility of positive and negative cognitions. Thus, negative cognitions appear to produce depression, and, conversely, depression increases the probability of just those cognitions which will cause further depression. This reciprocal relationship between depression and cognition may form the basis of a vicious cycle which will perpetuate and intensify depression. (Teasdale, 1983).

Owen Lightsey (1994) also looked at positive automatic thoughts (PATs) as a "stress buffer".

Is it possible that positive automatic thoughts (PATs) may similarly protect against depression? Such a finding could have considerable clinical significance. Cognitive therapies tend to focus on elimination of negative cognitions and on replacing maladaptive beliefs with adaptive beliefs (e.g., Beck et al., 1979); there is little focus on PATs per se. If PATs are found to uniquely buffer the effects of stress, straightforward training in generation of PATs could help to confer resilience

Later in the article he pointed out that things can be a little complicated:

Results for the overall sample confirmed the hypothesis that PATs predict future happiness: Higher frequency of pre-existing PATs was associated with greater future happiness. This finding suggests that PATs have an impact not only on immediate well-being, as suggested by Goodhart (1985), but also on future well-being. Contrary to hypotheses, however, the overall PATs x Stressful Event interaction did not predict either depression or happiness. Unexpectedly, a subtype of PATs — PATs about social self-worth — behaved in a manner consistent with a stress buffer role: The interaction of PATs about social self-worth with stressful events predicted unique variance in depression, above the variance accounted for by other Factor x Stress interactions.

It won't necessarily mean you are doomed if you feel there is no end to your mental health problems; it just means it will take longer to help you. All depression can be dealt with effectively and successfully given enough time and proper support.

References

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

Goodhart, D. E. (1985). Some psychological effects associated with positive and negative thinking about stressful event outcomes: Was Pollyanna right?. Journal of personality and social psychology, 48(1), 216. DOI: 10.1037/0022-3514.48.1.216

Lightsey, O. R. (1994). " Thinking positive" as a stress buffer: The role of positive automatic cognitions in depression and happiness. Journal of Counseling Psychology, 41(3), 325. DOI: 10.1037/0022-0167.41.3.325

Scheier, M. F., & Carver, C. S. (1993). On the power of positive thinking: The benefits of being optimistic. Current directions in psychological science, 2(1), 26-30. DOI: 10.1111/1467-8721.ep10770572

Teasdale, J. D. (1983). Negative thinking in depression: Cause, effect, or reciprocal relationship?. Advances in Behaviour Research and Therapy, 5(1), 3-25. DOI: 10.1016/0146-6402(83)90013-9

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Let us look at the neurological aspect of depression:

There appears to be a complex series of areas of the brain implicated in the pathophysiology of depression although limited overlap was found across imaging paradigms. This included a network of regions including frontal and temporal cortex as well as the insula and cerebellum that are hypoactive in depressed subjects and in which there is increase in activity with treatment. (Source: Fitzgerald, 2007)

Now, what does this mean? All we can safely draw from this is that when looking at depression neurologically we are looking at traces of hypoactive activity in the brain. In psychological terms, that can be traceable as delayed answers to reaction-type tasks (Source: Azorin, 1995), lack of interest, negative outlook on life and reality. To come back to your question and reformulate it: is having a positive outlook on your own illness a sign that you are more likely to get out of depression?

The answer is yes. Looking at the data, having a positive outlook on anything means that your brain is starting to activate more (aka be hypoactive in fewer areas or less hypoactive overall), so your chances to overcome the illness are stronger.

Now, the catch 22 is, if you have a positive outlook on your depression, is that really depression? What if you are suffering from, say, Schizoaffective Disorder Bipolar type and you expect to have depression after a manic state, you feel bad, but instead of depression you have only negative symptoms of your illness? (avolition etc) You are not technically depressed, as your reactions to stimuli and your outlook on life and your own illness might be unaffected, but that's not to say you feel better, so you will be a counter-example for the above theory. Likewise, you can feel suicidal for a number of reasons except depression, but report yourself as being depressed and be a counter-example for the theory that expectations of a good outcome are most likely a predictor of depression being on its way to remission.

What I am trying to say is, the answer to your question is yes, definitely, if the illness is typical depression, the ability to expect positive outcomes should be a predictor of remission. However, the neuroimaging tests that would confirm the theory are usually administered to test effects of medication, rarely for effects of therapy alone, so it would be hard to prove this regarding therapy alone.

Depression is hard-coded in our system just like fear, and it would be hard to identify, measure or even generate the effects of therapy without medication to first stabilise the brain activity. After the patient is medicated and somewhat stabilised, you can give them positive insights on anything, including their own ilness, and you will be right to think that those insights are useful to get them out of depression, as well.

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  • $\begingroup$ The paper you cited doesn't say that it's defining depression and the standard clinical way to define it is via DSM or ICD definitions that are agnostic over the specific neurology. The same goes for common ways to measure it like the Hamilton Depression Rating Scale. $\endgroup$ – Christian Jun 1 '18 at 10:35
  • $\begingroup$ @Christian Thank you, edited. As forthe DSM and ICD definitions, sure, they re agnostic of the neurolgic imaging of the depression, but really, and it's a debate that I believe has already started (will look that up, though) , they shouldn't be. The two are just what they are, manuals for reference, and not supreme authorities on what depression actually is. The science, in this case, backs them up (and by that I mean neurology and genetics) - but DSM and ICD are not thoroughly scientific, to put it nicely. $\endgroup$ – OMan Jun 1 '18 at 10:39
  • $\begingroup$ @Christian the way DSM is compiled is, indeed, relying on a lot of data, but it is unstructured data, based on observations that most likely are influenced culturally and by the mere tool they are aiming to correct (the DSM) so it is far from the most reliable scientific tool to judge by. Surely, a good one to reference when dealing with patients , but far from infailible. $\endgroup$ – OMan Jun 1 '18 at 10:44
  • $\begingroup$ Just for the love of it, here's an example of the debate regarding DSM V I was talking about: ncbi.nlm.nih.gov/pmc/articles/PMC3846446 $\endgroup$ – OMan Jun 1 '18 at 10:58
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    $\begingroup$ Your sources don't support your conclusions, and you seem to be advocating for a far simpler neurological model of depression than anything I am familiar with from a neuroscience perspective. To make this a reasonable answer, you need to find much more concrete support. $\endgroup$ – Bryan Krause Jun 1 '18 at 19:33

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