The most common cognitive distortions in depression

Have you ever wondered what the mindset of a person with depression is like? Or perhaps you want to learn more about this disorder and its specific characteristics. One of the most studied and addressed aspects of cognitive behavioral therapy for depression is cognitive distortions. The goal of this article is to help you understand how cognitive distortions play a fundamental role in depressive disorders, including examples of how to identify and change them.

First, let’s better understand what cognitive distortions and depression are. The American Psychological Association (APA) defines cognitive distortions as «an erroneous or inaccurate pattern of thinking that contributes to the maintenance of negative emotions and dysfunctional behaviors. They are often automatic, rigid, and unconscious, and tend to reinforce dysfunctional beliefs about oneself, the world, and the future.» Some cognitive distortions include polarized (all-or-nothing) thinking, overgeneralization, emotional reasoning, or personalization, among others.

We can define depression as “A mood disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in almost all activities. It may be accompanied by cognitive, physical, and behavioral symptoms, such as fatigue, difficulty concentrating, changes in appetite and sleep, and thoughts of worthlessness or excessive guilt.» Also, according to the APA.

Although depression is a specific disorder in the DSM-5, it is important to note that cognitive distortions can also occur in other types of disorders, such as anxiety or addictions. They can also be present even if the person does not meet the clinical criteria for any disorder. In other words, cognitive distortions can be observed in most psychological disorders and problems.

In individuals with depressive symptoms, these errors in thinking commonly occur systematically, affecting the perception and interpretation of situations about oneself, others, or the world. Cognitive distortions are learned, reinforced and, in some cases, can become part of the person’s personality structures and schemas. Cognitive distortions, as well as many other symptoms such as anxiety, are especially activated during times of stress or emotional vulnerability.

Detecting and changing our cognitive distortions is one of the best ways to contribute to our mental health. Which is why we will now explore options of practical ways and examples of how to do this.

In clinical practice, it is essential to identify and understand these thought patterns and the functions they serve in terms of thought, emotion, and behavior. In many cases, cognitive distortions do not occur solely as a result of a depressive episode, but act as predisposing and maintaining factors, causing the onset of these states. Ultimately, people with depressive symptoms have attentional distortions toward negative stimuli, as well as a negative interpretation of situations and themselves, which leads to the maintenance and reinforcement of symptoms. Therefore, during clinical intervention, it is necessary to confront and challenge these ways of acting and proceeding in patients and provide them with tools to deal with situations in a more adaptive manner. Let’s look at some examples.

Therapist’s goals: to foster in the individual the attitude of a detective of their own thoughts. First, to detect thoughts, without the desire to eliminate or fight them, but to accept them as the brain’s propositions. Second, to rethink the situation from a more rational and objective perspective.

Case: Maria, 33, presents a project in her department. The project was delivered without incident and normally, and Maria says, «It was a complete disaster. If everything doesn’t go well, it’s useless.»

Possible questions:
a) Is there a more intermediate way of thinking?

Objective: To develop cognitive flexibility and realize that her performance is not as «black and white» as she initially thinks.

Case: Tom, 29, reports: “I feel like I can’t do anything right, so it must be true.”

Possible questions:
a) Do you think feeling this way means that you are that way?
b) What would someone who loves you say?

Objective: The validity of taking emotions as objective evidence of reality is questioned.

Case: Jaime, 27, reports that his partner is distant and concludes: «It’s clear she doesn’t love me anymore; I’ve lost her.»

Possible questions:
a) Could there be another possible explanation?
b) What is my basis for thinking this way?
c) What would another person in my situation tell me?
d) Would everyone think the same?

Objective: Begin to explore alternative hypotheses and loosen your initial certainty.

Case: Toni, 28, always responds to praise for his work with something like, «It’s not that big a deal, this is normal.»

Possible questions:
a) Why is my work less valuable?

Objective: To challenge his tendency to minimize his achievements.

Case: Ana, 30, after a job interview that didn’t go well, comments: «I’m never going to get a good job.»

Possible questions:
a) I’ve made this mistake. Does that mean I’m a failure and worthless?
b) Does this apply to everything or to this specific event?
c) Watch your language and be wary of anything that makes general judgments about reality.

Objective: By limiting the scope of your thoughts, you reduce the associated emotional charge and minimize generalization.

Case: David, 50, reports: “My daughter is very depressed, I’m sure it’s because I asked her to do her homework.”

Possible questions:
a) What other variables beyond my control can explain this situation?
b) Why am I relating this to myself?
c) Could it be due to other reasons?

Objective: To promote a more global perspective and better understand the emotional context in her environment.

Case: Bob, 40, is frustrated because his friend canceled a plan at the last minute and explains, “He should have come on time; he always does the same thing.”

Possible Questions:
a) Is it realistic to ask others to always behave according to my wishes?
b) Was this done with malicious intent?
c) Is your friend capable of handling this differently?

Objective: To empathize, be flexible, and question rigid internal rules.

Case: Bill, 26, received a critique amidst much praise while presenting his master’s thesis. Looking back, he says, «It was a horrible day.»

Possible questions:
a) Am I missing out on some of the information about the situation?
b) Am I only focusing on the negative?

Identifying our cognitive distortions doesn’t mean thinking “I’m wrong,” but rather starting to observe our thoughts with more curiosity and less harshness. Change doesn’t happen instantly, but recognizing these patterns is already an important step. Learning to question them, to see them in a more nuanced way, or simply not letting them take control of our actions is part of the path toward living more freely and with greater self-kindness. That’s why understanding how cognitive distortions shape depression allows us to intervene more effectively. Therapeutic progress often happens when people begin to rebuild a more realistic, compassionate, and flexible relationship with their thoughts.

Héctor Pastor Pardo is a general health psychologist specializing in addictions and individual and couples therapy. Trained in third-generation therapies and in psychopharmacology and drugs of abuse, he applies a cognitive-behavioral and integrative approach. His primary practice is the treatment of adults and couples.