What is Depression?

The truth about depression is that you can't just snap out of it.
What is Depression Unit Guide

Depression is not just feeling blue. It’s a problem that can make it impossible to get through your day. Depression can take a toll on your relationships and leave you feeling disconnected from everything you used to love. The truth about depression is that you can’t just snap out of it. We all need help to turn things around when we’re feeling overwhelmed.

  • The Facts
  • The Symptoms
  • Psychotherapy
  • Medications


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Audio Tip
the various factors that can contribute to depression

The Facts

It Can Happen to Anyone

Although some factors like struggling with poverty can increase risk, depression can affect anyone. A depressed person can come in all forms: young or old, rich or poor, man or woman.

It’s More Common Than You Think

Most people don’t realize that depression is remarkably common. Studies report that close to 1 in 5 people will experience depression at some point in their lives.

Even if you don’t realize it, you’ve most likely met someone who suffers from depression. You’re certainly not alone. The big problem is that many people suffering from depression don’t reach out for help. Instead, they are left to struggle on their own.

Symptoms of Depression

There are four types of symptoms used to identify depression. Doctors and therapists look for these signs to decide if someone is depressed.


Thinking patterns are often negative or pessimistic during an episode of depression. You might be pretty hard on yourself and down about the future.

Dr. Theo DeGagne

Most people know that depression can make you feel sad, but it can also cause anger or irritability. Many people notice that they now have a short fuse and are quick to snap at others. Feelings of guilt and worthlessness are also common.

Dr. Colleen Cannon

Depression doesn’t just change your mood, it can also affect your body. You may experience low energy or a restlessness that makes it difficult to sit still. Changes in sleep, appetite and loss of sex drive are common as well.

Dr. Christine Korol

People with depression often choose to be alone and withdraw from family and friends. Losing interest in the activities you used to enjoy is common too. Some people find it hard to get out of bed, take care of themselves or get things done at work or school.

Dr. Colleen Cannon


The good news is that depression can be treated! Different kinds of therapy and medications can get you feeling better:


There are many types of psychotherapy or talk therapy. Kelty's Key is based on cognitive behavioral therapy. This method teaches you to challenge unhelpful thoughts and learn new coping skills.

Dr. Suja Srikameswaran

Different medications can be used to treat depression. You should discuss the options with your doctor. It can take time to find the best medication for you. Medication and psychotherapy are often used together to get people feeling better.

Dr. Jesse Sidhu

Well Done. You’re on Your Way.

You’ve taken the first step and learned about depression. Knowledge is important. Understanding what depression is and how it works will help you moving forward.

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Get Active

Did you know that getting active is one of the most effective treatments for depression?
Get Active Unit Guide

It may sound too simple to work, but adding a few small activities to your day can help you feel better. This is especially important if you are experiencing severe depression. When everything feels like a challenge, getting active is a great place to start. Focus on getting active until you feel ready to tackle other units.

  • Creating a Plan
  • Making Small Changes
  • Tackling Obstacles
  • Staying on Track


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Audio Tip
how your activity level can help improve your mood

Making a Plan

The more active you are, the better you’ll feel. That means getting active is a good first step in treating depression. To get active you need to plan activities, stick to your plan and then record your mood.

There are three different types of activities that give you the biggest bang for your buck. Achievement, closeness and enjoyment activities are the best at boosting your mood.

Audio Tip
setting up achievable goals


Achievement is the first type of activity to do at least once a day. These activities make you feel accomplished when you finish. It could be something you avoid starting, like a chore, but feels good to cross off your "to do" list. Some examples of achievement activities are exercising, cleaning, or paying a bill.

What’s an achievement activity that you could try this week? Is there something you’ve been avoiding?

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Feeling Stuck?
Under $10CleanVolunteeringTake out the garbage
AloneGrocery shoppingHome repairsExercise
Low ImpactPay a billHomeworkCook a meal
Please only select one

What’s an achievement activity that you could try this week?

Audio Tip
tips on building rewarding relationships


Closeness is the second type of activity to do at least once a day. A closeness activity is something social. Reach out to people in your life, or reconnect with someone you've lost touch with. If it feels overwhelming, you can start small. Send someone an email or text and build up towards doing something together. Over time the relationships you develop will increase your happiness and wellbeing.

What’s a closeness activity that you could try this week? Is there someone you’d like to connect with?

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Feeling Stuck?
Under $10Make a phone callGo for coffee with someoneGo for a walk with a friend
AloneLike a post on social mediaEmail a friendSend a text message
Low ImpactGo to a movie with someoneHave dinner with a friendGo on a date
Please only select one

What’s a closeness activity that you could try this week?

Audio Tip
how enjoyment can come from setting realistic goals


We’ve saved the best for last with enjoyment activities! One of the first things most people drop when their mood is low is a guilty pleasure that makes life joyful. It’s so important to do the things that feed your soul and renew your energy. An enjoyment activity could be listening to music, getting a massage, or reading a book. As long as it's fun, it counts.

What’s an enjoyment activity that you could try this week? What do you like to do?
If that’s hard to answer, think about what you used to enjoy doing.

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Feeling Stuck?
Under $10Watch a movieGo to the beachPlay a sport
AloneListen to musicGardeningArts and Crafts
Low ImpactTake a bathYogaPlay a video game
Please only select one

What’s an enjoyment activity that you could try this week?


Overcoming Obstacles

Now that you’ve planned some activities, let’s discuss some of the obstacles that can get in your way. Almost everyone finds getting active challenging. Your therapist can help.

Obstacles vary from person to person. But some are almost universal. Low motivation and negative thinking are two of the most common obstacles people face. We’ve got a few tips to help you:

Talk Back

Thoughts like, “This will never work” can drain all your energy before you even start an activity. Talk back to these thoughts and give the activity a try.

Dr. Suja Srikameswaran
The 5-Minute Rule

The 5-minute rule is a great way to get motivated. It’s simple: try your planned activity for just 5 minutes and then stop if that’s all you can do. You may find that once you get going you can continue beyond 5 minutes. If not, that’s okay too.

Dr. Christine Korol
Start Small

Another strategy to increase your motivation is to start small and see where it takes you. Your therapist can help you plan easy activities at the start of your program and build from there.

Dr. Theo DeGagne
Follow Your Plan, Not Your Mood

If you wait until you feel like doing an activity, you may never do it. Follow your plan, not your mood. Focus on why you want to do your activity, not how you feel about it. Don’t focus on why you hate exercising; think about how good you’ll feel once you get moving.

Dr. Jesse Sidhu
Audio Tip
how small activities can lead to positive shifts over time

Don't Underestimate Small Changes

It may seem hard to believe, but small changes can yield big results. It’s common to question whether something like a short walk is really something to be proud of. It really is!

We all get stuck. Every single one of us. The only way to get moving again is by taking small steps in the right direction. Your simple 5-minute activities add up and will get you feeling better. Getting active is simple but powerful. Don’t underestimate how much it can help.

Anna's Story


Anna’s depression had sucked away all her energy. She could barely get out of bed, let alone help with the household chores and keep up at work. While she still loved her partner, she found her sex drive had all but disappeared. She felt like a lousy partner, a terrible companion and an overall bad person. The guilt was overwhelming.

Anna slouching

Anna’s therapist recommended that she do one small thing every day to help improve her mood. This gave her an idea. Her partner loved having a coffee every morning, but often didn’t have time to make it. Although she doubted it would help, Anna decided to try making coffee each morning.


The next morning, Anna ground the beans, and placed them in the coffee filter. The coffee began to drip into the pot, and the sweet smell of fresh coffee filled their small kitchen. It took a lot of effort, but her partner’s look of surprise and thanks made it worth it. It was a little thing, but Anna felt like she had “done something”. It made her feel a little less guilty; her partner knew she was thinking of them.

One year later Anna's depression has subsided. Even though her mood is good, Anna still makes her partner a coffee each morning. The morning coffee has become a part of the daily routine and it gives Anna pleasure. Anna is now a firm believer in the power of small changes.

Good job! You've Got 3 Activities to Try Out This Week

Download Your Worksheet

Plan what days and time you’d like to do these activities and stick to the plan. After each activity, keep track of how good you felt. Rate your mood in terms of your achievement, closeness and enjoyment where 0 = none and 10 = very high. Download this worksheet to keep planning new activities. Discuss your progress with your therapist.

Date & Time
Monday, May 1
7:00 am
Rate Mood
Achievement: 5
Closeness: 4
Enjoyment: 6

Congratulations! You've Created a Plan and Are Ready to Get Active

Start small, have fun, and reach out to others. See how your activity level is closely connected to your mood. If you feel stuck, review this unit or talk to your therapist or healthcare provider.

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Problem Solving

When you've got a problem, you need to do more than challenge negative thoughts
Problem Solving Unit Guide

It’s easy to feel overwhelmed when facing a problem like losing your job or a close friend. When you have a problem, changing your thoughts is not the goal; you need to change your situation. In this unit, you will learn how to work through your problems and generate solutions. Take control and create a plan. Even at the worst of times, a good plan will help you get through it.

  • Naming the Problem
  • Brainstorming Solutions
  • Making a Choice
  • Taking Action


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Audio Tip
how a plan can help you overcome life’s tough situations

Plan to Action

Problem-solving plans are the key to helping you face life’s challenges, big or small. Ignoring your problems doesn’t make them go away — it gives them time to get bigger. Instead, take action and make a plan to help you break down your problem and solve it once and for all. Your plan will also help boost your confidence. When you trust that you can handle whatever life throws at you, you’ll worry less and feel better.

Audio Tip
the difference between a 'worry' and a 'problem'

Name the Problem

So how do you make a problem-solving plan? The first step is naming the problem. It’s important to make sure you are dealing with a problem and not a worry. Worries focus on something that might happen. They usually start with the words "what if." Problems are happening right now or about to happen very soon. If you aren’t sure if you have a worry or a problem, ask yourself if it’s already happened. If the answer is yes, you’ve got a problem.

Name the problem. What's going on?

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how brainstorming can lead to unexpected solutions


Once you’ve named your problem, it’s time to brainstorm possible solutions. Try to think up a few ways that you could solve your problem. It’s important not to censor yourself. Write down all your options, even if some seem silly. Sometimes the most ridiculous thought can lead you to the best solution.

If you're feeling stuck, try brainstorming with someone else. Your therapist, a good friend, or a family member can help you come up with ideas.

Try brainstorming three solutions to your problem:

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Pros and Cons

Take a look at the different options you came up with to solve your problem. What are the upsides and downsides for each possible solution? For example, if you lost your job you might consider going back to school. An upside could be that it would lead to better job opportunities. The downside could be that tuition is expensive.

What are the benefits of each of your solutions? What are the drawbacks?

Possible Solution
Possible Solution: 1.
Possible Solution: 2.
Possible Solution: 3.
Audio Tip
the benefits of having more than one solution to a problem

Make a Choice

The upsides and downsides of each solution can help you decide what to try first. Take a look at each of your possible solutions and rank them in terms of which you should try first, second and third. There’s no perfect way to rank your solutions. A solution could be ranked first because it’s easy to do, has the fewest downsides or seems the least risky.

Take a minute to order your possible solutions 1, 2, or 3. Which would you like to try first?

Possible Solution Order
Possible Solution: 1.
Possible Solution: 2.
Possible Solution: 3.

Give it a Try

Now it’s time to give your solution a try! If it doesn’t solve your problem, try another solution on your list or brainstorm some new ones. Depending on the nature of your problem, you might be able to try a few ideas at the same time. For example, if you were looking for a new job you might try a few things right away. You could let your friends know you’re looking, send your resume to a few companies and register with a headhunting agency.

Vijay's Story

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Vijay was having a terrible day. Work was busy and he was running late. Everything came to a head when he got into his car and it wouldn’t start. Great. Money was already tight this month. Vijay didn’t know how he’d afford to get the car fixed, and still be able to pay his mortgage and buy groceries. With help from his therapist, Vijay needed to come up with a plan to save money for this month’s expenses.

Vijay started to brainstorm some ideas. He could ask creditors to skip a payment or borrow money from family or friends. Packing a lunch for work instead of eating-out could save some cash. He could rent out the basement or sell some things online. He was sure he could find a cheaper cell phone plan and ride his bike to work. He even considered delivering flyers in the evenings, like he did when he was a teenager.

Vijay considered his options. He didn’t want to ask anyone for money. But then he remembered that his brother owed him $200 for a present they bought for their parents. He didn’t mind asking for that back, and his brother apologized for forgetting. Finding a cheaper cell phone plan was easy, but Vijay didn't want to rent out the basement. He saved more money than he expected by bringing lunch to work.

When it all added up, Vijay was able to buy groceries and make his mortgage payment! He was thrilled with what he’d managed to save over the month. He decided to keep up some of the changes to build up a cushion for the next emergency.

Your Game Plan

Download Your Worksheet

Good job! You’ve got a solution to your problem that you’re ready to try out. If it’s not effective, you’ve got a few backups ready to go. It’s helpful to fine tune your plan with your therapist and keep track of how well your solutions work out. Remember that having a solid plan can help you solve your problems. When you have fewer problems you'll have less stress and more confidence. This will make you feel better and boost your mood. Download this worksheet to save a copy of your plan and keep track of your progress.


Great Work! You’ve created a plan to solve your problem.

Remember that making a problem-solving plan will help you cope with life’s ups and downs. The steps are simple:

  1. Name the problem
  2. Brainstorm possible solutions
  3. List the upsides and downsides of each solution and rank them
  4. Test a solution
  5. Evaluate the outcome
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Thought Challenging

Your thoughts and feelings are connected.
Thought Challenging Unit Guide

Few things in life are as important as talking to yourself kindly. If you want to achieve a goal or live a happy life, you need to talk to yourself like you are your own best friend. It’s hard to stay motivated or positive if we are too critical or feeling hopeless about a situation. When everything feels like too much, negative thinking can become routine and get in your way. In this unit, you’ll learn how to break the cycle and challenge the thoughts that keep you down.

  • Keep a Thought Diary
  • Track Unhelpful Thoughts
  • Find Evidence
  • Balance Your Thoughts


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Audio Tip
how our thoughts affect our mood, not our situation

Different Perspectives

Most people believe their feelings are the result of what happens to them. If you failed a test, had a fight with your best friend, or you lost your wallet — you’re going to feel bad, right? But not everyone will react the same way, even in a tough situation. Thoughts like “I’m such an idiot” will make you feel worse, while thoughts like “I’ll do better next time” will make you feel a bit better. In the end, it’s our thoughts about things or events, not our situation, that determine how we feel.

Audio Tip
practicing self-compassion when depressed

Why Challenge Thoughts?

When you’re worrying or feeling down, most people will tell you to “let it go.” The problem is that’s easier said than done! The only way to let go of an unhelpful thought is to challenge it enough that you no longer believe it. If you try to force yourself to think, “It’s all going to be okay,” when you don’t believe it, you’ll feel worse.

Audio Tip
about keeping a thought diary

Keep a Thought Diary

Sometimes, thoughts can come so quickly that you don’t notice them. The best way to track these sneaky thoughts is to keep a thought diary. Act like a detective. Keep track of the feelings and thoughts you experience in specific situations. It is important to track the strength of your feelings too. Your therapist can help you identify some of your unhelpful thoughts if you are feeling stuck.

A thought diary looks something like this:

What was happening? Feeling and Strength Thoughts
I was sitting on the couch watching TV. Sad → 60%
Anxious → 40%
Disappointed → 80%
“Will I ever get better?”
“What’s wrong with me?”

Start a Diary

Pick a situation that is troubling you right now. It may be something that just happened a moment ago. It could be something that happened in the past but still continues to bother or worry you.

What was happening?

Remember that the situation doesn't have to be the cause of your feelings. Sometimes an event causes a big reaction, like getting fired. Other times your feelings and thoughts aren't related to what you're doing. Like if you started to cry while taking a shower. You can use a thought diary for any type of situation.

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Your Feelings

How do you feel right now when you think about that situation?

If it is a past event, don’t try to remember how you felt then. How do you feel at this moment when you reflect on the situation?

Select up to 5 feelings:

Rate Your Feelings

Now rate how strong your feelings are from 0-10. Remember to focus on the feelings you have right now, not during the event.

We’ll keep track of how strong your feelings are after challenging your thoughts too. This will help us see if the exercise is helpful.

Your Thoughts

What is going through your mind right now when you think about this situation?
If you’re feeling stuck, ask yourself these questions:

What does this say about me? My future? Why does this situation feel difficult? What does this say about others?

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Keep Using your Diary

Good job! You’ve started to use a thought diary.

Just recording your situations, feelings and thoughts can take practice. It’s okay if you don’t feel ready to start challenging your thoughts. Keep practicing with your therapist and come back when you’re ready.

If you’ve got the hang of keeping a thought diary then it’s time to start challenging your thoughts. Keep going!

Pick the Most Unhelpful Thought

It’s common to have many thoughts about a situation. Pick the thought that causes the most trouble, anxiety or sadness. You’ll work on challenging this one thought for the rest of the exercise.

Sometimes thoughts don’t work well in thought challenging. Use these tips to pick a suitable thought:

Match Up

Make sure your thought is connected to one of your feelings about the situation. If the thought makes you feel sad, angry or some other emotion, it's a good thought to choose.

Audio Tip

Choose a thought that is testable. If your thought starts with “What if” then you can't prove it true or false. These thoughts are not good for thought challenging.

Audio Tip

Here are your thoughts. Which would you like to challenge?

Rewrite the thought you’d like to challenge and “let go” of.

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Evidence for the Unhelpful Thought

Do you have any evidence that your thought is true? For example, if your thought is “Jim is mad at me,” your evidence might be that he didn’t return your call. Maybe the email he wrote you seemed cold.

People sometimes realize that they can’t find any proof to support their unhelpful thought. You might think it, but there are no facts that make it true! That makes it easier to let it go.

What evidence do you have that your unhelpful thought is true?

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Audio Tip
how thought challenging can improve self-compassion

Challenge the Thought

It is almost impossible to let go of a thought if you still believe it! The best way to get rid of a thought is to challenge it until you don’t believe it anymore. To challenge a thought, you must find evidence that disagrees with it. Play devil’s advocate. Look for proof that your unhelpful thought is false or just not completely true.

For example, let’s go back to the thought “Jim is mad at me.” Evidence against this thought could be that Jim smiled at me while saying hello this morning. Sometimes his emails come off as cold when he’s busy.

Challenge your Unhelpful Thought

Here's your unhelpful thought:

What evidence do you have that this thought is not completely true? Include everything you can think of even if it seems too small to mention.

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Audio Tip
how to talk to yourself in a supportive way

Balanced or Helpful Thoughts

Forcing yourself to think happy thoughts won’t make you feel better. If you don’t believe a positive thought is true, it could make you feel worse. The trick to feeling better is to find a balanced or helpful thought. These thoughts take both the positive and negative evidence into account. Balanced thoughts are more encouraging and supportive than positive thoughts.

Here are some examples comparing positive versus helpful thoughts:

Positive Thoughts Balanced or Helpful Thoughts
I’m a great friend. I’m not perfect but I am a good friend. I may not always be there for my friends, but I know that this will get better as my mood improves.
I can do anything if I put my mind to it – including getting over my problems! It might take some practice, but I feel a little more hopeful that I can feel better by changing how I talk to myself.
Everybody in my life is supportive and helpful. I’m getting better at knowing who to count on in my life. I’m not 100% confident, but I’m willing to practice trusting a few people who I think are nice.

Your Balanced Thought

Take a look at your positive and negative evidence:

Use this evidence to help you make a new balanced thought. If you’re feeling stuck, don’t worry. Balanced thinking can be tricky and your therapist can help you get the hang of it.

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Re-rate Your Feelings

Now that you have worked on your balanced thought, take a moment to re-rate your mood. We can compare the strength of your feelings before and after thought challenging. A drop of at least 2 or 3 points in at least one of your emotions tells us that the exercise was helpful.

Audio Tip
the importance of practicing thought challenging

Practice Makes Perfect

Thought challenging is one of the harder things to learn in cognitive therapy. Remember that it does get easier with practice and help from your therapist. Most people find after practicing 50 or more times that they have fewer unhelpful thoughts. Also, balanced thinking becomes more automatic. Challenging your thoughts 50 times might seem like a lot, but you’ll get faster at it the more you practice.

Sean's Story

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Sean was finishing up his day at work when he realized that he made a typo in a company-wide memo. He always proof-reads his emails before sending and couldn’t believe he’d missed such an obvious error.

Sean’s emotions started spiralling. He felt embarrassed, angry, irritated and ashamed. “I can’t cope with normal life,” Sean thought. “I’m such an idiot. I can’t concentrate!”

But hold on! Sean began to challenge his unhelpful thoughts. He reminded himself “Everybody makes mistakes; even my boss makes typos sometimes.” He noted that “If co-workers tease me, I can handle it.” And finally, “I’m not an idiot because I just finished a big project that was very successful.”

After challenging his unhelpful thoughts, Sean was able to rework his thinking and create a balanced thought: “I’m not at my best right now, and I make mistakes, but all things considered I do more things right than wrong.” Sean noticed that self-encouragement worked better than self-criticism. He felt better, could focus on his work, and move on with his day more quickly when he shifted how he talked to himself. Sean now tries his best to be kind to himself, especially when he makes mistakes.

Good job! You’ve Created a Thought Record

Download Your Worksheet

Good job! You’ve learned how to make a thought record and challenge unhelpful thoughts. If you’ve been hard on yourself or thinking unhelpful thoughts for awhile, it can take some work to break that habit. The more you practice thinking balanced or helpful thoughts, the more natural it begins to feel. Try challenging a few thoughts a day and share them with your therapist who can help you tweak them until you don’t believe them anymore. If you have a few unhelpful thoughts that keep creeping back, it’s a good idea to write down a few balanced thoughts or responses on a card to keep as a handy reminder.


Congratulations! You’ve Started to Practice Challenging Your Thoughts

Continue making thought records and creating balanced or helpful thoughts. If you’re feeling stuck you can review this unit or talk to your therapist or healthcare provider.

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Core Beliefs

Beliefs can distort experiences and thoughts.
Core Beliefs Unit Guide

We all have beliefs about ourselves, others and the world that we have held for a long time. These underlying beliefs can affect how we interpret our lives. If you hold a negative core belief you may have a habit of only noticing what fits in with it. This bias can get in the way of thought challenging. No matter how hard you work at it, your mood might crash whenever specific thoughts appear. To continue working through your depression or anxiety, you need to tackle your core beliefs. In this unit, you’ll learn how to break apart your core beliefs and start seeing the world from a different angle.

  • Identify a Core Belief
  • Find Evidence
  • Balance Your Belief
  • Daily Reinforcement


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Audio Tip
What core beliefs are.

Trapped by Core Beliefs

If you’ve been challenging your negative thoughts for a while, you’ve probably become quite good at it. It should be easier to review your thoughts and come up with something more balanced.

However, you may notice that some thoughts are still getting you down, despite your hard work. It may seem like you can’t shake them, no matter how much challenging you do.

Your problematic thoughts probably fall under a general theme. Are they all about being unlikeable? Maybe they revolve around being unsafe. If this is the case, a core belief is likely keeping you stuck.

Core beliefs are more than just a group of thoughts. They are deep-rooted ideas or assumptions about yourself, others and the world. Core beliefs tend to be rigid and not easily broken down. To overcome your anxiety or depression, you need to rework your core beliefs.

Audio Tip
How core beliefs form and their usual content.

Fundamental and Powerful

You may wonder how your core beliefs formed in the first place. Where did they come from? Core beliefs are created through your life experience. When you are young, what you see, hear, and do, gets interpreted into rigid laws and rules about the world. For example, say school was hard as a child, and you got a lot of criticism or negative feedback. This experience could lead to a global belief like “I’m stupid.”

Core beliefs, as the name suggests, tend to be central and fundamental. In fact, at their root, core beliefs focus on our ability to survive. They often fall into these categories: safety, likability, and capability. Being safe and a valued member of your community can mean life or death. From an evolutionary perspective, it’s no wonder that core beliefs are so emotionally powerful!

Let’s explore the categories of core beliefs a bit further. Core beliefs about safety may be something like “I’m helpless,” or “The world is a dangerous place.” For likability, you may hold beliefs like “I’m unlovable,” “I’m a bad person,” or “People are judgmental.” Finally, in the capability category, you may find the beliefs “I’m incompetent,” or “It’s a dog-eat-dog world.” A core belief may fit into more than one category at a time. What they all have in common is the suggestion that you won’t prevail. There is something that may prevent you from surviving in our world.

To protect against this threat, many people cope by creating conditions or rules. You may tell yourself “I’ll be safe as long as I’m in control,” or “I’m lovable if I can make everyone happy all the time.” You might try to live by the rule that “I’m competent as long as I don’t make any mistakes.” As you can see, these conditions tend to be nearly impossible to uphold. No one is immune from making mistakes! How can you keep everyone happy all the time? It’s only natural that you’ll eventually “fail” at maintaining these impossible standards. When this happens, your core belief is exposed, and your anxiety or depression can get even worse.

Audio Tip
Why core beliefs are hard to change.

The Selective Brain

Think back to a time when you had an argument or debate with someone, say about politics. Did it seem like facts didn’t matter? Like nothing was going to change your friend’s mind? You were probably left wondering how your friend could completely ignore the side of the story that doesn’t fit with their political view. The same thing happens with core beliefs. It’s not just your friend, we all have selective brains!

Imagine your mind as a house. Your core beliefs come first. They are the foundation or bedrock of the whole building. When you experience something, your brain takes in all the pieces that fit with your core belief. These experiences add bricks and walls to the house. What doesn’t match the foundation is ignored and left out. In a sense, the human brain takes shortcuts. It’s easier to cast aside experiences that don’t fit into our core beliefs than it is to tear down the house and rebuild from scratch.

The selective power of the human mind ensures that core beliefs are always reaffirmed. The connections in your brain relating to your core beliefs are very strong. Reworking a core belief means you’ll need to look out for the experiences your mind tends to ignore. You need to offset the selective nature of your brain. It’s not easy, but you can do it.

Audio Tip
How to identify a core belief.

Find a Core Belief

The first step to challenging a core belief is to identify one. This task may not be so easy. You may find you see the rooms and windows of the house but not the foundation. If that's the case, it may help to work in reverse. Start by writing down a common negative thought. Then ask yourself, "What does this say about me? Or others? Or the world?" Keep doing this exercise until you reach the central idea, your core belief.

Keep in mind that core beliefs tend to fall into the categories of safety, likability, and capability. It may also help to think of a core belief as a statement starting with "I am...," "People are...," or "The world is...." Other core beliefs may start with "God is…," "My life is…," or "The universe is…"

Start with a problematic negative thought and work down to your core belief.

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What does this say about you, others, or the world?

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What does this say about you, others, or the world?

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What does this say about you, others, or the world?

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Feeling Stuck?
Safety:I am powerlessThe world is dangerousI am out of control
Likability:I am unattractivePeople will reject meI am toxic
Capability:I am ineffectiveEveryone is better than meI am defective
Please only select one


Audio Tip
How to identify evidence that a core belief is not entirely true.

Challenge your Belief

Once you've identified a core belief, you can start to challenge it. Remember that your brain is selective. It has a habit of only letting in the experiences that fit with your core belief. For this reason, it may be hard to find evidence that shows that your core belief is not true. You may need to work at it. If you are feeling stuck, there are a few things you can try. You can ask friends or family members for help or think about recent activities you've done. It may also help to look at examples in your thought diary.

Here's your core belief:


What evidence do you have that your core belief is not completely true? Include everything you can think of even if it seems too small to mention.

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Balanced Beliefs

Similar to thought challenging, the key to reworking a core belief isn’t to make it 100% positive. You need to create a balanced belief. Pretending that life is all sunshine and rainbows won’t help. You need a belief that is realistic. It should capture both the negatives and the positives about yourself, others or the world.

Here are some examples comparing negative, positive, and balanced core beliefs:

Negative Belief Positive Belief Balanced Belief
I am useless. I am competent at everything. I can do certain things well, but not everything. I make mistakes sometimes, but I am also able to learn from them.
Nobody loves me. Everybody loves me. I have a few good people in my life that love me.
The world is better off without me. I am a really important part of this world! While my existence might not be important to the world at large, I do my best to help out my community. The people I connect with are happy I am in their lives.
Audio Tip
The important characteristics of a good balanced core belief.

Your Balanced Core Belief

Take a look at your evidence that does not support your core belief:


Use this evidence to help you make a new balanced core belief. If you’re feeling stuck, don’t worry. Reworking core beliefs can be tricky and your therapist can help you get the hang of it.

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Audio Tip
Techniques that help reinforce a balanced core belief.

Boost Your Belief

Creating a balanced core belief is a good step forward, but you won’t feel real change until you reinforce it. Remember that your brain is selective and ignores information. Just writing down a new balanced belief won’t be enough to change your thinking. You need to start doing little things every day to strengthen it.

Start by writing down experiences each day that support your new belief. Keep a diary or notebook. This exercise will help you notice what your brain tends to dismiss. You don’t need big events! Small things count. A conversation or minor situation can be good evidence for your new belief.

Audio Tip
How to address setbacks.

Don't Sweat It

Some people worry when new evidence for their old belief comes up. You might panic and think that your old belief was right after all. The truth is, life happens, and sometimes things won’t go your way. Your new core belief is balanced and includes the positive and negative. Evidence that supports your old belief doesn’t automatically oppose your new one. In fact, finding the negative has never been the problem! Nobody is perfect, and that’s not the goal. Try not to sweat it and keep working on finding evidence that supports your new balanced belief.

Adeline's Story

Adeline always believed that if she had a good job, she was a success. At her work, she was able to climb the ranks until finally reaching her dream job as a sous chef. Unfortunately, after a few months, Adeline's boss told her it wasn't working out. Out of work, Adeline felt her world crashing down and became depressed.

Adeline began to work through her depression with the help of a therapist. She started to reconnect with friends and challenge her negative thoughts. She also got a position volunteering at a soup kitchen. On the outside, everything seemed to be going well. But despite her hard work, Adeline's mood still plummeted every time she made a mistake. It was as though some thoughts were too strong to challenge away.

Today, Adeline and her therapist work through her thoughts and identify a core belief. "I am incompetent and defective." They begin to look for evidence that this belief is not true. Adeline points out that she is valued and trusted by her friends. She also notes that she gets good feedback when volunteering. Adeline's therapist agrees with this evidence and suggests there is more. He reminds Adeline that she doesn't usually give herself credit for what she does well.

Adeline and her therapist develop a new balanced belief. To help reinforce it, Adeline keeps a diary. She writes down little things that happened each day that support her new belief. This exercise helps her notice the daily achievements she was ignoring. It also stops Adeline from discrediting her abilities. A few months later, Adeline is still hard on herself when she makes a mistake. But her mood doesn't crash. She's able to see that one mistake doesn't define her.

Good Job! You've Started Working on a Core Belief

Download Your Worksheet

Good job! You’ve learned about core beliefs and how to reframe them. Remember that core beliefs are deeply ingrained and will take time to break down. Keep working on your new balanced belief with your therapist. Record evidence that supports your new belief every day to help strengthen it. A diary of positive experiences can be handy to look on back on if your original core belief creeps up.


Congratulations! You’ve Begun to Rework a Core Belief

Continue identifying core beliefs and reworking them. Create new balanced beliefs and reinforce them with daily evidence. If you’re feeling stuck, you can review this unit or talk to your therapist or healthcare provider.

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Understanding Medication

Like other medical concerns, medications can help treat severe anxiety or depression.
Understanding Medication Unit Guide

The use of medication in the treatment of anxiety and depression can be very important. When other types of treatment have not made you feel better, it might be time to try medication. Medication can be used on it’s own or with other treatments, like therapy.

  • Why Medication?
  • Types of Medication
  • Side Effects
  • Expectations


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Why Medication?

Doctors use medication to treat anxiety and depression for the same reason they use it to treat many other health concerns. Sometimes, it’s the best way to get the results you need.

Take someone with high blood sugar. They might start by exercising more and changing their diet to try and fix the problem. If this doesn’t lower their sugar levels, their doctor might start them on medication.

The same is true for anxiety and depression. Some people suffer so much that therapy isn’t enough. Perhaps your anxiety or depression is so strong that starting therapy feels too hard to do right now. Medication can help boost your energy and ease your symptoms. Once you are feeling a bit of relief, you’ll be able to focus on therapy and other treatments.

Audio Tip
the most common types of medications for anxiety and depression

Types of Medication

The same medications are often used to treat anxiety and depression. We can divide these medications into 2 groups: slow and fast-acting.

Slow-acting medications are a bit like vitamins. They take a while to build up in your body, but have a long lasting effect. These medications help restore the balance of the chemical messengers in your brain. Different types work on different messengers. Slow-acting medications are the most common treatment for depression and anxiety.

Fast-acting drugs are like rescue agents. They work right away to help get you through an intense episode like panic. Some people also use them to get to sleep. Fast-acting medications only treat the “here and now.” It is important to note that you can develop a tolerance to some of these medications. This means that over time you might need more of the drug to get the same relief. For this reason, rescue agents aren’t a good long-term solution. But they can help you get through the days or weeks it takes for your slow-acting medication to kick in.

Audio Tip
the common side effects that you may experience

Finding the Right Medication

Our brains are all unique. There is no one medication that works for everyone. One drug might do wonders for you and have no effect on someone else. It’s common to try 2 or 3 different medications before finding the right one for you.

Your medication should improve your quality of life. The benefits should outweigh the negatives. One possible negative is side effects. Antidepressants and anti-anxiety medications can cause dry mouth, stomach aches, dizziness, and headaches. Some might make you feel a bit “off.” Most of the time these side effects disappear after a few weeks. But if they continue, or are too painful to push through, then this medication is not right for you. Some side effects, like increased thoughts of suicide, are very serious, but uncommon.

Talk to your doctor as you begin trying medication. It’s important to find the right drug and the right dose for you. Remember that medication should make you feel better overall, not worse.

Audio Tip
the common concern that these medications are addictive


People often worry that if they start medication they’ll always need it and won’t be able to stop.

Here’s what you need to know:

The slow-acting group of medications do not cause cravings. They are not addictive. But you might feel a bit sick when you stop. For example, you may have bad headaches or dizziness. Going off your medication slowly, in steps, can help avoid these symptoms. Make sure you talk to your doctor.

People can build a tolerance to fast-acting medications. This means you might want more and more of the drug to get relief. Luckily, these medications are not the main treatment for depression and anxiety. It’s important to use these drugs carefully. Take them only when it’s urgent, not all the time.

Audio Tip
long-term treatment with medication

Length of Treatment

Another concern many people have is how long they’ll need to take medication.

Even if you no longer feel depressed or anxious, you should not stop treatment too soon. It’s recommended that you stay on your medication for 6 months to a year. This will help relieve you of symptoms and stop them from coming back.

If your anxiety or depression keeps coming back, you can stay on medication long term. This is no different from other chronic health issues. Diabetics take insulin daily for life.

Audio Tip
medication as a treatment for depression and anxiety


The main drugs used to treat anxiety and depression are slow-acting. This means you won’t get results overnight! It will take a few days or weeks for you to gradually feel better. Sometimes your friends or family might notice changes before you do.

Medication won’t cure all of your problems. Instead, it will help boost your energy and mood enough to get started. It might make you feel more social or get your appetite back to normal. When you can concentrate and sleep better you’ll be more able to work on your other problems. Medication is a stepping-stone that can give you the push you need to take on other treatments like therapy.

Good Job. You're Exploring Your Options.

When you know what medication can and can't do, it can make a world of difference. Think about whether this is an option you're interested in, and talk to your doctor.

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