If patients are starting to feel depressed it can be very easy to get into a cycle of automatic negative thoughts that then become difficult for patients to challenge: patients get depressed and then patients get more depressed about being depressed. Being in a state of depression can then become a bigger problem than the actual difficulties that caused it in the first place. Patients need to make a conscious effort to break the hold that the depression has on patients. Deciding to do something to help patients is the most important step patients can take.