Which came first, the chicken or the egg? Which came first, the depression or the pessimistic thoughts? I can't answer the first question, but the answer to the latter may surprise you.

In many cases, depression actually is the result of habitual negative thoughts. When bad things happen, we begin chastising ourselves with thoughts such as: I'm no good, I'm a total failure or Nothing ever goes my way. Our feelings follow what we are thinking, and negative thoughts like these can send us spiraling down into depression.

This concept is the guiding principle behind cognitive therapy, a type of psychotherapy developed by psychiatrist Aaron T. Beck in the 1960s. If we think something often enough, we begin to believe it's true and our feelings match what we are thinking about ourselves. To conquer depression, we must stop those automatic negative thoughts and replace them with more positive, truthful ones. By nipping these thoughts in the bud, we can halt depression before it even starts.

Cognitive therapy is directed at 10 common cognitive distortions, or faulty thought patterns, that send us into depression. See if you recognize yourself in any of these.

• All-or-Nothing Thinking: John recently applied for a promotion in his firm. The job went to another employee with more experience. John wanted this job badly and now feels that he will never be promoted. He feels that he is a total failure in his career.
• Overgeneralization: Linda is lonely and often spends most of her time at home. Her friends sometimes ask her to come out for dinner and meet new people. Linda feels that that is it useless to try to meet people. No one really could like her. People are all mean and superficial anyway.
• Mental Filter: Mary is having a bad day. As she drives home, a kind gentleman waves her to go ahead of him as she merges into traffic. Later in her trip, another driver cuts her off. She grumbles to herself that there are nothing but rude and insensitive people in her city.
• Disqualifying the Positive: Rhonda just had her portrait made. Her friend tells her how beautiful she looks. Rhonda brushes aside the compliment by saying that the photographer must have touched up the picture. She never looks that good in real life, she thinks.
• Jumping to Conclusions: Chuck is waiting for his date at a restaurant. She's now 20 minutes late. Chuck laments to himself that he must have done something wrong and now she has stood him up. Meanwhile, across town, his date is stuck in traffic.
• Magnification and Minimization: Scott is playing football. He bungles a play that he's been practicing for weeks. He later scores the winning touchdown. His teammates compliment him. He tells them he should have played better; the touchdown was just dumb luck.
• Emotional Reasoning: Laura looks around her untidy house and feels overwhelmed by the prospect of cleaning. She feels that it's hopeless to even try to clean.
• Should Statements: David is sitting in his doctor's waiting room. His doctor is running late. David sits stewing, thinking, "With how much I'm paying him, he should be on time. He ought to have more consideration." He ends up feeling bitter and resentful.
• Labeling and Mislabeling: Donna just cheated on her diet. I'm a fat, lazy pig, she thinks.
• Personalization: Jean's son is doing poorly in school. She feels that she must be a bad mother. She feels that it's all her fault that he isn't studying.

If you recognize any of these behaviors in yourself, then you're halfway there. Here's a homework assignment for you: Over the next few weeks, monitor the self-defeating ways in which you respond to situations. Practice recognizing your automatic responses. Now, we will take each of the above cognitive distortions and discuss some powerful coping strategies that will help you dispel the blues before they even start.

Psychotherapy can be a time-consuming, expensive process. You don't want to waste money and effort on a therapist who won't help you achieve results. The following tips will help you select a therapist who best meets your needs.

Find Someone You Are Comfortable With

Although the therapy relationship is not a friendship, you will still get the best results if you trust your therapist and feel comfortable with him or her. You should feel able to open up and be honest with your therapist. If you withhold information, you cheat yourself out of making real progress. Just like with any relationship, you and your therapist may not "click". If not, you owe it to yourself to seek another therapist.

Psychiatrist, Therapist, Counselor or Social Worker?

Three important factors that will influence your choice are:

• Is your depression situational, a result of biochemical imbalance or a side-effect of another illness?
• How severe is your depression?
• How are your finances?

The interplay of these three factors makes it difficult to offer hard and fast rules for selecting a treatment provider, but you may use the following as a guideline:

• Short-term counseling is generally cheaper and may be the best choice for situational depression. Counselors help you work to resolve the specific situation which is troubling you.
• It is wise to see your family doctor for a medical checkup to rule out illnesses which may create the symptoms of depression as well as any medications you may be taking that have depression as a side-effect.
• If your depression is severe, consider seeing a psychiatrist first for medication. You will make more progress with your therapy if your moods are stabilized. In addition, psychiatrists do possess the training to administer therapy. While many psychiatrists prefer to handle only medication matters and refer their patients to another professional for therapy, it is possible you can get one-stop-stopping. It's worth checking into.
• A combination of psychotherapy and medication is generally the most effective treatment if you can afford it.
• Choose professionals with the highest level of training that you can afford. Psychiatrists and psychologists being preferred. Clinical social workers would be your next best alternative, especially if they have several years experience.
• Avoid obtaining treatment from your family doctor (other than the initial physical) unless there is no other alternative available. They cannot offer you therapy nor do they have adequate knowledge about how to prescribe and fine-tune psychiatric medications. You may get lucky and do well on the first medication they prescribe, but you may also waste valuable time if you do not respond.
• Take whatever help you can afford. Although it may not be the best fit, some help is better than none at all.

What Are the Minimum Qualifications to Look For?

Look for at least a Masters degree. A therapist should be licensed in the state in which he or she practices. Avoid counselors who have little or no formal training. If in doubt, ask about the therapist's credentials. An ethical therapist should have no problem providing you with the requested information.

Where Can I Find a Recommendation for a Therapist?

The best source for recommendations are trusted friends. Alternatively, ask your family doctor or psychiatrist--if you have one--for recommendations of colleagues. There are also several databases on the Internet which provide listings. Many patients have reported good success by simply choosing a name from the phone directory. Be aware that your insurance provider may limit who you may see.