Countering negative thoughts worksheet
Summary
Identify client-specific risk factors like medical conditions, major life transitions, and trauma by using a free, downloadable depression triggers worksheet that easily integrates into electronic health records.
Track common depressive symptoms, including low energy, concentration difficulties, and loss of interest, to help individuals recognize early signs of distress.
Implement evidence-based behavioral activation, cognitive restructuring, and mindfulness tactics using the comprehensive triggers and coping strategies for depression worksheet.
About one in six people will experience depression in their lifetime, according to the Centers for Disease Control and Prevention.
Depression can happen to anyone, but certain factors can increase the risk of developing this condition.
This article provides an overview of triggers and coping strategies for depression to use with clients, and we’ve included a free downloadable depression triggers worksheet that you can save to your electronic health record (EHR).
What are the symptoms of depression?
Everyone may experience depression differently depending on the person and their circumstances. However, the main symptoms of depression include:
Feeling sad or having a low mood
Low energy
Lack of motivation
Tiredness after minimal effort
Loss of interest in once pleasurable things
Feelings of worthlessness or like you’re letting others down
Difficulty concentrating
Suicidal thoughts
Difficulty sleeping or sleeping too much
Changes in appetite
Moving more slowly than usual or having difficulty staying still
For a list of diagnostic criteria, see understanding the major depression ICD-10 code.
For clients who are experiencing thoughts of suicide or self-harm, please call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7 in the US and Canada.
Can certain things trigger depression?
While there is no exact cause of depression, research suggests that genetic, biological, and environmental factors may play a role in the development of depression. However, certain risk factors increase the risk of developing depression.
Triggers for depression
Risk factors and triggers for depression include:
Medical conditions: Having or developing a medical condition, like cancer, cardiovascular disease, diabetes, respiratory diseases, experiencing chronic pain, or having a stroke, can increase the risk of depression.
Major life changes: Significant events or transitions, such as separation, retirement, other job changes, or relocation, can cause depression.
Trauma: Experiencing traumatic events such as a natural disaster, abuse, or assault is a risk factor for depression.
Stressful events: The ending of a relationship, betrayal, unemployment, economic hardship, or experiencing bereavement may lead to depression.
Pregnancy: Some women develop depression during pregnancy, and others can develop postnatal depression due to the responsibility of parenting and hormonal changes.
Genetic factors: A family history of depression may increase the chances of developing depression.
Medication: Certain medications can cause depressive symptoms as a side effect.
Lifestyle: Using substances like alcohol or cannabis, insomnia, and inactivity can cause depression.
Seasonal changes: Some people develop a type of depression called seasonal affective disorder in colder and darker months.
Co-occurring disorders: People with depression may also have other mental health conditions, like anxiety, which commonly co-occur.
Personality traits: People with low self-esteem, individuals who ruminate, and those who are self-critical may be more vulnerable to depression.
Social isolation: Loneliness can increase the risk of developing depression.
Coping strategies for depression
A big step in managing depression is identifying individual triggers and coping strategies for depression. Once a client is aware of their triggers, you can work together to implement helpful coping strategies, such as:
Behavioral activation: Guide clients to rebuild structure, boost mood, and alleviate symptoms of depression by scheduling small, achievable tasks.
Cognitive restructuring: Help clients identify, reality-check, and reframe unhelpful thought patterns that fuel depression.
Mood tracking: Encourage the use of mood charts or depression logs between sessions to help clients identify patterns and triggers.
Mindfulness tools: Activities such as mindful meditation, progressive muscle relaxation, and diaphragmatic breathing exercises can help alleviate symptoms of depression.
Promote connections: Encourage clients to reach out to friends and family to stay connected and receive emotional support, which in turn can lighten the burden of clinical challenges and boost mood. Support groups or local communities may also serve as a source of support.
Seek professional support: Seeking help from a mental health therapist and a medical provider is an essential step in getting support for depression.
How to use the depression triggers worksheet
You can download and use the triggers and coping strategies for depression worksheet in several ways:
Use the worksheet in session to provide psychoeducation about depression triggered by an event.
Ask the client to reflect on the depression triggers worksheet between sessions and report their findings at their next therapy appointment.
Combine this worksheet with other worksheets for co-occurring disorders, like our triggers for anxiety worksheet.
Use this worksheet with other depression-related worksheets, including the cycle of depression handout, depression activity scheduling, and coping skills for depression worksheet.
Share the worksheet with coworkers.
Print the depression triggers worksheet to provide as a take-home resource at the end of a session.
Use the worksheet to facilitate discussion with interns or supervisees.
Sources
Centers for Disease Control and Prevention. (2023). Mental Health Conditions: Depression and Anxiety.
Cui, L., Li, S., Wang, S., & et al. (2024). Major depressive disorder: Hypothesis, mechanism, prevention, and treatment. SIG Transduct Target Ther.
Harvard Health Publishing. (2022). What causes depression? Harvard Health.
NHS. (2023). Causes - Depression in adults.
Remes, O., Mendes, J. F., & Templeton, P. (2021). Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain sciences.
World Health Organization. (2023). Depressive disorder (depression).
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