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... it is a learned pattern of thinking that becomes embedded in your neurochemistry and neural structure. You have an experience that makes you very sad or creates self-loathing, and that lays down the initial pattern for later responses.
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Lurkette, that's about the best and most concise explanation I've ever seen for this phenomenon. That said, I agree completely. Wow, well said.
And SF, if I may extend Lurkette's metaphor a bit further:
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Think about it like water cutting a pathway in dirt or rock. The first time it happens, it causes a little rut, which makes it easier for water to follow that pathway next time, which makes it easier for water to follow the pathway next time, and pretty soon you've got a river and the water is pretty much guaranteed to follow that path. The same thing happens to you cognitively (and even neurochemically). You have a thought in response to a situation (e.g., I'm worthless) and the next time a similar situation happens, the automatic response is "I'm worthless." Etc.
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You can either work on those thoughts individually-- realize that you're not worthless, etc.. and find someone who will reinforce your belief (a girlfriend, a therapist).. or take an antidepressant to carve a more convenient "river" for your responses to setbacks to go down. That said, make a lot of goals that you CAN achieve. Start out with something like .. I'll go outside 1 hour per day. Simply achieving these little goals makes you realize that you CAN achieve what you want if you put your desire behind it. Likewise, it starts to make those "I'm going to fail" reactions go down the right river.