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Depression is a common mental disorder and a severe medical illness that negatively affects how you feel, think and act.

Depression can also be defined as a negative state of mind ranging from unhappiness and discontent to extreme sadness, pessimism, and dependency that interferes with one’s daily life.

Various factors contribute to the onset of depression. However, a downward spiral often begins with distorted perceptions, judgemental beliefs, and automatic thoughts that usually accompany an individual’s experience of depression. 

Depression spiral is commonly used to describe a person’s depressive state, which becomes difficult to control, leading to symptoms worsening quickly.

What Are The Theories Behind This Worksheet?

  1. Cognitive Behavioral Therapy (CBT) 

CBT is a type of psychotherapy used to help an individual identify and change negative thoughts and associated behaviors. People who suffer from depression struggle with negative thought patterns.

  1. Dialectical Behavior Therapy (DBT)

DBT is a talking therapy treatment adapted to treat individuals who suffer from extremely intense emotions. DBT teaches individuals to identify, accept, and regulate their emotions.

  1. Behavioral Activation (BA)

BA works in conjunction with CBT and DBT to treat depression. In addition, BA helps patients adopt a long-term coping strategy by identifying specific goals and working towards meeting them.

  1. Electroconvulsive Therapy (ECT)

This medical treatment is reserved for patients with severe major depression who have not responded to other treatments. ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia.

How Will This Worksheet Help You?

This worksheet will help you recognize the different stages that can help stop or reverse the downward spiral of depression.

How Should You Use This Worksheet?

This worksheet should be used when experiencing negative or suppressing emotions, repetitive negative thinking, and avoidance behaviors.

This worksheet should be used as a self-evaluation tool to help individuals recognize the downward spiral of depression. 

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American Psychiatric Association. (© 2022). What Is Depression? Available at:  [Accessed December 16, 2022]


American Psychological Association. (© 2023). Depression. Available at: [Accessed February 07, 2023]


Clarity Counseling. (© 2020). Reversing the Downward Spiral of Depression. Available at: [Accessed February 08, 2023]


Mind My Peelings. (© 2019-2023). Reversing the Downward Spiral of Depression. Available at: [Accessed February 08, 2023]