This third element of the Diamond comes from the observation that thoughts always set the foundation for behavior. How I think and what I believe, always precedes how I respond and what I do. This is as true in depression as it is in life. A powerful variation on cognitive therapy, mentioned in the last section, is "cognitive-behavioral-therapy," which addresses this connection between thought and action.
To continue the example of the girl in the last section – if she adopts the pessimistic mindset described (pervasive, permanent, and personal) she will be likely to display depressive behaviors, such as withdrawing from others, crying, and staring off into space blankly. She'll have a hard time eating, sleeping, exercising, studying, socializing. She'll slump over dejectedly, speak in a quiet and troubled tone, and avoid eye contact with others.
Such behavior, if continued, can significantly interfere with her social life (even, for example, if she encounters the same young man she was interested in the day before – creating a self-fulfilling prophecy – "No one will ever call me or engage in a relationship with me.") Such self-fulfilling prophecies – depressive behavior acting out negative depressive thinking – are extremely common, interfering with successful social, educational, and professional goals. Perfectionism; avoidance of needed tasks; social withdrawal; neglect of physical health; and hours of time drained in depressing rumination or in "escapist" entertainment (such as TV, internet, novels, or negative music) are very common manifestations of depressive behavior.
Depressive behavior usually begins with these garden-variety, milder versions. If unchecked, it can grow into much more dangerous forms. Depressive behavior – fueled by depressive thinking – can even grow to the level of serious addictive or self-harm behavior, even suicide. Individuals contemplating suicidal behavior are almost always thinking something like, "This pain is unbearable, and it will never stop – there's no other way out;" "Everyone will be better off without me;" "There is no hope – I've always been miserable, and I'll always be miserable, so I will end this pain." The thinking sets the foundation for the behavior.
Whether mild or serious, depressive behavior complicates the original problem immeasurably, and gets in the way of resolving it. It is one of the ways in which depression tends to become more serious over time, and to have a "contagious" effect on others.
Cognitive-behavioral therapy and effective skills training can help depressed individuals to learn a healthier set of behaviors that can stop this destructive tide. Both the depressive thinking and the resulting depressive behavior can be turned around, and replaced with better, more functional alternatives.
1-Triggers > 2-Thoughts > 3-Behavior > 4-Impact
