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Cognitive Behavioral Therapy

How Hopelessness Grabs Hold, and How to Stop It

New research finds associations between hopelessness and interpretation bias.

Key points

  • Hopelessness is on the rise and linked to poor mental health outcomes.
  • New research suggests that how we interpret ambiguous situations is related to feelings of hopelessness.
  • Treatments exist that improve both interpretation bias and hopelessness.
Source: Pixel-Shot/Shutterstock

Hopelessness refers to a state of complete lack of optimism or belief in our ability to respond to a situation. Researchers theorize that when we frequently expect to encounter bad outcomes, and we don’t feel capable of changing them, we will experience hopelessness (Abramson et al., 1989).

This past year-and-a-half has brought more than its fair share of negative outcomes. Perhaps you’ve lost a loved one, lost a job, struggled financially, had to adapt to working remotely or home-schooling children, struggled with depression and anxiety, or felt lonely or burned out. And maybe it seems that each time we take a step forward (vaccine rollout, re-openings, etc.), we immediately are met with new challenges (spikes, new emerging strains) that make it seem as though we may never put the pandemic behind us. Or even as the world is loosening restrictions, perhaps you are struggling with anxiety or apprehension about returning to “normal." The pandemic has been a perfect driver for hopelessness.

Researchers have been tracking rates of hopelessness throughout the pandemic. A recent study in Turkey found significantly higher levels of hopelessness among healthcare workers, individuals whose income level decreased during the pandemic, and individuals living with a high-risk individual for COVID-19 (Hacimusalar et al., 2020). A separate study from Saricali and colleagues (2020) found that fear of COVID-19 predicted hopelessness.

And hopelessness should be taken seriously. It is associated with increased suicide risk (Beck, 2006), lower quality of life (Scogin et al., 2016), and increased anxiety symptoms (Kocalevent et al., 2017). It is also a key symptom of depression.

Unsurprisingly, rates of depression and anxiety have also risen significantly over the course of the pandemic. In the early spring of 2020, U.S. adults were three times as likely to screen positive for depression and/or anxiety as they were in 2019, with more than one in three U.S. adults screening positive for one or both in a national study conducted by the U.S. Census Bureau (Twenge & Joiner, 2020). But while rates of mental illness have risen significantly over the pandemic, not every individual faced with adversity will exhibit hopelessness or subsequent mental illness. In fact, a recent study found that 39.3% of nurses sampled exhibited posttraumatic growth following the pandemic (Chen et al., 2020). This points to the importance of examining what mechanisms contribute to our perceptions of hopelessness during difficult times.

Factors that Contribute to Hopelessness

Many factors contribute to someone’s level of hopelessness. One potential mechanism that my lab has studied extensively is interpretation bias, or the tendency to jump to negative conclusions when faced with an uncertain or ambiguous situation.

Suppose a coworker doesn’t respond to an email. There are lots of reasons this could happen: They may have unexpectedly taken some time off, they may be swamped with other tasks, or they may simply have forgotten to reply. However, someone with a negative interpretive style might jump to the conclusion that this non-responsive coworker is upset or angry with them—or being a lazy, incompetent jerk.

The cognitive theory of depression developed by Beck and colleagues (1963; 1979) posits that experiencing repeated stressful life events can trigger negative attitudes, which in turn can lead to information being processed in a disproportionately negative way (i.e., interpretation bias). And when someone consistently interprets things in a negative manner, they may develop the expectation that future events, relationships, and endeavors will also have negative consequences. It makes sense that repeatedly interpreting uncertainty in a negative way throughout your day might ultimately lead to hopelessness.

The Link Between Interpretation Bias and Hopelessness

Despite the intuitive link between interpretation bias and hopelessness, few studies have examined their relationship. We recently tested whether hopelessness is related to interpretation bias in people attending McLean Hospital’s Behavioral Health Partial Hospital Program (Beckham et al., 2021). This program provides intensive treatment for mental health problems such as depression, anxiety, bipolar disorder, and borderline personality disorder.

In 56 patients, we found that:

  • A negative interpretation bias for routine daily life situations was significantly correlated with greater levels of hopelessness.
  • This association remained significant even after controlling for depression symptom severity, suggesting that interpretation bias plays a unique role in hopelessness.

Treating Hopelessness

Try to think back to a moment you felt hopeless. What was that experience like? Were you able to look at the situation objectively and identify how your interpretations were influencing the experience? Most likely you weren’t. When we experience hopelessness, it often just feels like part of our reality—as though everything is going wrong and there’s nothing we can do to fix it.

However, when armed with the knowledge of the cognitive processes behind these feelings, individuals may have the power to parcel apart their thought processes. Instead of feeling as though their lives are fundamentally doomed, they may be able to take a step back and catch themselves in the act of jumping to negative conclusions. Indeed, creating a pause between a situation and interpretation and a distance from one’s thoughts is the goal of several psychotherapies.

There are established interventions for interpretation bias, such as Cognitive Behavioral Therapy (CBT) and newer technology-assisted interventions such as Cognitive Bias Modification. In fact, some research has shown CBT to be effective in reducing hopelessness (Rush et al., 1982; Raj et al., 2001), although it’s unknown whether this change is due to improvement in interpretation bias. It is possible that interventions for interpretation bias may also indirectly increase hope, but this requires further study.

Although experiencing hopelessness from time to time is pretty common, feeling continuously hopeless can have a negative impact on mental health. By understanding the mechanisms that contribute to hopelessness, we may be able to develop better treatments.

Erin Beckham, BA, contributed to this post. Erin is a Research Assistant in the Cognitive and Affect Research and Education (CARE) Lab at McLean Hospital.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or the Crisis Text Line by texting TALK to 741741. To find a therapist near you, see the Psychology Today Therapy Directory.

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Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological review, 96(2), 358.

Beck, A. T., Brown, G., Berchick, R. J., Stewart, B. L., & Steer, R. A. (2006). Relationship between hopelessness and ultimate suicide: A replication with psychiatric outpatients. Focus, 147(2), 190-296.

Beck, A. T. (Ed.). (1979). Cognitive therapy of depression. Guilford press.

Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of general psychiatry, 9(4), 324-333

Beckham, E., Salon, Y., Daskalakis, L., Björgvinsson, T., & Beard, C. (2021, May). Interpretation Bias is Associated with Hopelessness and Perfectionism in a Psychiatric Sample. Poster presented virtually at the 79th annual meeting of the Association for Psychological Science (APS).

Chen, R., Sun, C., Chen, J. J., Jen, H. J., Kang, X. L., Kao, C. C., & Chou, K. R. (2021). A large‐scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID‐19 pandemic. International journal of mental health nursing, 30(1), 102-116

Rush, A. J., Beck, A. T. B., Kovacs, M., Weissenburger, J., & Hollon, S. D. (1982). Comparison of the effects of cognitive therapy and pharmacotherapy on hopelessness and self-concept. The American Journal of Psychiatry.

Scogin, F., Morthland, M., DiNapoli, E. A., LaRocca, M., & Chaplin, W. (2016). Pleasant events, hopelessness, and quality of life in rural older adults. Journal of Rural Health, 32(1), 102–109.

Twenge, J. M., & Joiner, T. E. (2020). US Census Bureau‐assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID‐19 pandemic. Depression and anxiety, 37(10), 954-956.

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