When we think of depression, we typically think of prolonged sadness, lethargy, disturbed sleep, and suicidal thoughts. However, depression has effects beyond your energy level and mood. One of these effects is that depressed people have a harder time making good decisions. Interestingly, antidepressants don’t appear to improve decision making even when they improve mood. Depression affects your decision making in several ways. When we say depression leads to poorer decision, it means that the decisions lead to outcomes that have less positive impact on your life over the long run. The first way depression leads to poor decisions is that depressed people tend to be more indecisive. They have more trouble making any decision at all. One reason for this indecisiveness may be an attempt to minimize regret later on. If someone makes an active decision that leads to a bad outcome, she tends to feel worse than if the decision had been out of her hands. Not only has something bad happened, but she is responsible for it happening. Delaying or refusing to make a decision is a way of accepting the default option, so even if turns out badly, at least you’re not responsible for it. This is connected to another feature of depressive thinking, pessimism. Depressed people are more likely to believe that a situation will turn out badly. If they think an active decision will have a negative result, they are less likely to make it. This is compounded by the fact that depressed people, as part of their pessimistic thinking style, believe they have fewer resources to deal with problems and are also likely to have fewer resources to deal with problems in the future. So, for example, if someone is depressed and is offered a promotion, she may be more likely to decline because she believes she will fail in the new position. This is often a distorted assessment, and taking the promotion will often be the better decision in the long run. A common feature of depressive decision making is risk aversion. Studies have found that people with depression often make decisions specifically to avoid anxiety. People with depression often feel hopeless and as a result, don’t want to waste energy on plans they believe won’t work. This leads to less information gathering, less idea generation, and less thinking through options. These tend to be labor intensive activities requiring mental energy and focus, which depressed people have in short supply. Because of this impaired decision making ability, therapists often recommend that patients not make major decisions during a depressive episode. Fortunately, studies have shown that using specific techniques from cognitive behavioral therapy can help even depressed people make better decisions, leading to better long-term outcomes.
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