It’s long been known that depression colors people’s view of the world, the self and the future. But new experimental research suggests that it also skews how your process your past, too.
A team led by Julia Gross at Heinrich Heine University in Düsseldorf, Germany, found that the higher study participants (all college students) scored on a common test for depression, the more they interpreted negative events described in vignettes as foreseeable and inevitable.
“Viewing a past, negative event as foreseeable suggests the possibility of personal influence or control—thereby inviting regret or self-blame, but also the possibility of improvement and actions and decisions in the future,” the authors write in the journal Clinical Psychological Science. “Viewing the event outcome as inevitable at the same time, however, precludes personal influence and thus future improvement, and therefore most probably invites feelings of helplessness.” That’s why depressive symptoms come with the expectation that things are going to go badly, and if they do go awry, there’s the assumption that it was going to be that awful all along—thus “the depressive hindsight bias.”
This is the emotional, clinical extension of a cognitive bias well-documented by social research psychologists. Whether it’s which team won a college football game, which candidate won a political election, the performance of a stock, the troubled fate of a nuclear power plant, or whether a romantic date would lead to a marriage proposal, we humans have a way of thinking after the fact that we “knew it all along.”
In two clever experiments, Gross and her team illustrated the emotional load of hindsight bias. In the first, 60 participants with a wide range of scores on depression tests—from extremely low to very high—listened to 16 everyday scenarios, some with positive outcomes and some with negative ones. For example, in one vignette, participants were asked to imagine that after several stressful weeks they finally arrived at their vacation destination in Southern France, where they booked a hotel through the Internet. In the “positive” version, the room was even better than it looked online, with an ocean view and a basket of fresh fruit waiting, while in the “negative” one, the small, shabby room didn’t look anything like how it looked like on the website, and there was no promised ocean view. As predicted, people with greater depression symptoms rated the negative outcome as more inevitable and more predictable. In line with earlier research, more depressed people also had a bigger sense of responsibility for negative outcomes and less for positive ones.
For the second experiment, a fresh batch of 75 participants listened to all 16 scenarios without immediately learning the outcome. First they had to rate how positively or negatively they thought the scenario would turn out and how imaginable, foreseeable and inevitable it seemed. After hearing the outcome they again rated the foreseeability and inevitability, as well as what they recalled their outcome prediction to be and the way it made them feel.
This design allowed the researched to pick out “depressive hindsight bias”: the higher someone’s depression scores, the more foreseeable and inevitable negative outcomes seemed in reflection compared to their initial prediction. Quite intriguingly, people without depressive symptoms thought negative outcomes were less foreseeable and inevitable in hindsight. (This is called “defensive processing,” and our Commander-in-Chief modeled it when he said “’Nobody knew health care could be so complicated” in regard to Affordable Care Act reform efforts.)
It’s a dark topic to get into, but this research is actually hopeful in that it gives another target for therapists, their patients and anyone else who wants to improve their mental health. Cognitive behavioral therapy works on depression because it helps people challenge negative thoughts and beliefs they have about themselves, but first those mental patterns have to be identified. In naming “depressive hindsight bias,” more light is thrown on the dark ways depression distorts our experience of the world, and thus better equips us to treat it.
Given how many people struggle with depression, the more help we have to treat it effectively, the better. An estimated 6.7 percent of Americans had a major depressive episode in 2015. Depression takes more years off of American lives than any other mental disorder, and it’s expected to take the second-most years off of human lives worldwide by 2030, behind only HIV/AIDS. The National Center for Health Statistics just published data finding that 12.7 percent of Americans age 12 or older are on antidepressant drugs, the global market for which is expected to swell to $16 billion by 2020.
The capturing of “depressive hindsight bias” that Gross and her team have done here shows the power of research and clinical psych teaming up. While this might be surprising to people outside of the psychology field(s), clinical psychology (what psychotherapists do) and research psychology (what academics do) are somewhat estranged siblings, with their own conferences, vocabulary and ways of viewing the mind and its contents. (And that’s without getting into the tribal conflicts between CBT, psychoanalysis and other branches of psychotherapy, or on the other side of the aisle, the various beefs between social, personality, relationship, positive and evolutionary research psychology, without even getting into neuroscience. Turns out psychology isn’t as well-mannered as might seem.)
Pairing hindsight bias with depression also represents a fascinating intersection of timelines: Melancholia, as depression was formerly known, dates back to Hippocrates himself, and translates directly as “black bile,” which the Ancient Greek physician thought the source of the disorder—representative of some of the earliest diagnoses of mental health, some 2400 years ago. Hindsight bias has been a part of social psychology since at least the 1970s, but, reflecting the Cognitive Revolution in the sciences of the mind that was going on at the time, it was thought to be merely the work of thought, rather than feeling. (But, as other research is bearing out, that old thought-versus-feeling dichotomy is falling by the wayside, too.)
People who struggle with depression have what psychologists call “negative schemata,” or ways of filtering or interpreting the events of life and mind in an uncharitable light. What might be happening with the depressive hindsight bias, the authors suggest, is a sort of ratcheting effect that happens due the readiness of depression to find new things to think poorly of. “If memory hindsight bias is a byproduct of knowledge updating, our results would suggest that knowledge is updated more easily with negative information, (i.e., information that is consistent with the existing negative schema),” Gross and her colleagues write. If you already think everything is terrible, then you’re going to be more receptive to terrible events than benign or pleasant ones—in the same way that a Chicago Cubs fan, before last season, would find it more believable that their team would miss the playoffs than win the World Series.
While these cognitive patterns are dangerous for everybody—and, the authors say, may not only be a component of depression, but a driver of it—the issue is especially acute for people reaching the end of their lives. “A negatively biased view of one’s biography puts particular strain on the person,” the authors observe. A therapeutic technique called “life review” targets this specifically and helps get people to see their life stories with greater balance. This is a large-scale version of what therapists call “reappraisal,” where you find ways tell your narratives about yourself with new, possibly more compassionate angles—a process that also helps release people from perfectionism. If you’re looking for more hope about all this, consider another all-too-human bias—”the end of history illusion.” In experiments, people acknowledge that their musical tastes have changed since they were kids, but don’t think their current preferences will continue evolving into the future. Same with emotional life: the present might seem like it will stay the same as it tumbles into the future, but the truth is that people can and do change. Like the philosopher said, you can’t step into the same stream twice.