In this series, I dig a little deeper into the meaning of psychological terms. This week’s term: Hope/hopelessness
Wikipedia defines hope as “an optimistic state of mind that is based on an expectation of positive outcomes with respect to events and circumstances in one’s life or the world at large.” Psychologist Charles Snyder identified three main elements related to hope: goals, finding pathways to achieve those goals, and having the agency to take action toward achieving those goals. He described hope as a cognitive skill and also as a potential mechanism in therapy to help people overcome barriers to achieving their goals.
Wikipedia explains that hope plays an important role in health. Hope can motivate people to pursue healthy behaviours. It can also alter the experience of pain by triggering the release of endorphins, and it can improve the prognosis for chronic and life-threatening illness, and enhance quality of life. Hope appears to play a role in the placebo effect.
The opposite of hope is, obviously, hopelessness, something that many of us living with mental illness struggle with at some point. It can be a symptom of depression, and it’s a major risk factor for suicide. An article on PsychCentral identifies 9 different types of hopelessness, taken from the book Hope In The Age of Anxiety (by Anthony Scioli and Henry Biller): alienation, forsakenness, uninspired, powerlessness, oppression, limitedness, doom, captivity, and helplessness. These are based on disruption in the ability to meet the fundamental needs of mastery, attachment, and survival. At first glance, these types strike as being related to but not necessarily the same as hopelessness.
A paper by Liu et al. describes the hopelessness theory of depression developed by Abramson et al. According to this theory, causal attributions of negative life events fall along three dimensions: internal to external, stable to unstable, and global to specific. Individuals who attribute negative reasons to internal (i.e. they have caused it), stable (i.e. it will be enduring), and global (i.e. it’s not limited to the specific situation) are more likely to become hopeless, making them more vulnerable to becoming depressed and suicidal under conditions of stress. This is a diathesis-stress model, so these cognitive styles don’t increase the risk of depression without the presence of stressful events.
Abramson et al. also proposed a hopeless subtype of depression, in which a high degree of hopelessness is enough to trigger the onset of depression. Hopeless depression is characterized by 5 or more of the following symptoms: sadness, slowed voluntary responses, suicidal thinking, difficulty falling asleep, fatigue, self-blame, concentration difficulties, slowed movement (psychomotor retardation), brooding or worrying, reduced self-esteem, and dependency.
This was the first I had heard of the hopelessness theory of depression, and my initial impression was that it makes a lot of sense. I don’t know if this has always been the case, but when depressed I definitely tend to have stable and global attributions for negative events. I sometimes think difficult situations arise from internal causes, but even when I attribute things externally I feel very powerless in response, which probably isn’t good either. There are certainly times when my depressive symptoms would meet the proposed criteria for hopeless depression, but when my depression is at its worst I fit much more into the melancholic subtype.
How do you balance hope and hopelessness in your life or your illness?
- Liu, R.T. et al. (2015). The hopelessness theory of depression: A quarter century in review. Clinical Psychology: Science and Practice, 22(4), 345-365.
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