Introduction
Methods
Recruitment and participants
The semi-structured topic guide
Concepts | Description of the concepts | Example questions |
---|---|---|
Capability | Whether young people can think about the future | ‘Are you able to think of images of a future self? Can you describe what it’s like?’ ‘Has there been a time when you don’t feel like you have a future or don’t want to think about the future?’ |
Content | What the future thinking involves, if they can think about the future | ‘When I say ‘the future’, what does it mean to you? What thoughts does it raise in your mind?’ ‘How do you think things are going to be in the future?’ |
Frequency | How often do they think about the future | ‘How often do you imagine your future self?’ ‘Has there been a time when you think more or less about your future?’ |
Structure | Whether the thinking is focused/fixated on a single event or a series of events | ‘Do you see a series of negative events?’ ‘Do you dwell on the same thing over and over again?’ |
Valence | Whether the content of their thinking is negative, positive, or neutral | ‘How do you feel about the future?’ ‘Do you look forward to your future? What are you hoping for? Are you worried about your future?’ ‘Has the way you feel towards the past/future changed? Have you become more optimistic/pessimistic about the future?’ |
Salience/vividness | How clear the details and images of that thinking are | ‘When you think about your future, do you think about concrete plans and specific situations?’ ‘When you think about your future, is it clear or quite blurry?’ |
Procedure
Coding and analysis
Results
Participant characteristics
Participant number | Age | Gender | Ethnicity | Diagnosis |
---|---|---|---|---|
1 | 18 | Male | Asian/Asian British—Indian | Clinical depression and anxiety |
2 | 19 | Female | Black/Black British—African | Depression and anxiety (self-report) |
3 | 19 | Female | Black/Black British—African | Clinical post-traumatic stress disorder |
4 | 16 | Female | Asian/Asian British—Indian | Clinical depression and anxiety |
5 | 19 | Female | White British | Clinical depression and anxiety |
6 | 19 | Female | White—Other | Depression and anxiety (self-report) |
7 | 19 | Female | White British | Clinical anxiety |
8 | 19 | Female | Asian/Asian British—Indian | Clinical depression |
9 | 16 | Male | Asian/Asian British—Vietnamese | Depression and anxiety (self-report) |
10 | 19 | Female | Black/Black British—African | Clinical post-traumatic stress disorder |
11 | 18 | Male | Black/Black British—African | Clinical depression and post-traumatic stress disorder |
12 | 19 | Female | Asian/Asian British—Indian | Depression and anxiety (self-report) |
13 | 19 | Female | White British | Clinical depression and anxiety |
14 | 19 | Female | White British | Depression and anxiety (self-report) |
15 | 17 | Female | White British | Depression and anxiety (self-report) |
16 | 19 | Female | Mixed—White British and Indian | Clinical depression |
17 | 17 | Female | White British | Clinical depression and anxiety |
18 | 16 | Female | Mixed—White British and Asian | Clinical mixed anxiety and depressive episodes |
19 | 19 | Female | White British | Clinical depression and anxiety |
Domains | Themes |
---|---|
The impact of mood on the future thinking capability | Varied ability and motivation |
Stuck in the past | |
The impact of mood on images, thoughts, and feelings about the future | Valence |
Vividness | |
Agency | |
Structure | |
Social influences | Social pressure and support from friends and peers |
Pressure from parents and financial hardship | |
Reflections on personal worries and expectations about the future | The impact of future thinking on mood |
Optimism, pessimism, and future expectations | |
Personal coping | Engaging in future thinking as a strategy to combat depression |
Scientific thinking, to challenge perception with evidence |
Domain 1: The impact of mood on the future thinking capability
Themes | Poor mental health state | Wellness state |
---|---|---|
Varied ability and motivation | “I think it was more of a lack of capability in the sense of not want, being so scared of it, that you don’t even want to acknowledge it. So I would avoid thinking about it because it would, one, make me more stressed, and two, make me more sad.” [061; female, 192, subclinical depression and anxiety] “I hated thinking about the future. I didn’t want to think. People at the time tried to help me a lot by saying, ‘but it won’t. You won’t always feel anxious. It’ll be OK in the future’, but I don’t want to think about that, because I didn’t think that the future would ever change. I thought it would always be like that.” [17; female, 17, clinical depression and anxiety] | “I can think a lot more further into the future without getting upset, and I guess I let myself have fun imagining things.” [18; female, 16, clinical mixed depression and anxiety episodes] “But now, I look forward to the future, I forget about the negativity, I don’t dwell on each day thinking about what’s happened. I’m just thinking about tomorrow. Tomorrow is going to be a good day.” [01; male, 18, clinical depression and anxiety] |
Stuck in the past | “When I’m highly anxious and in that sort of state, I don’t really think of anything else apart from what’s happening right now. … I don’t know if it’s you don’t want to look at it [the future] or you just give up thinking about it cause you’re so highly stressed about the current state, you would inward looking rather than thinking about the future.” [07; female, 19, clinical anxiety] | “I’m still quite past orientated, but at the same time I’m a lot more future orientated. … I do look more into the future now, and that’s me actively trying to do that, cause I think sometimes when I get stressed out, I’m trying to think, well there are better things to come and they’ll be there soon.” [07; female, 19, clinical anxiety] |
Varied ability and motivation
“I was feeling like I couldn't go on any longer, cause it's feeling too low, too down. I was struggling so much that I couldn't think about the future. I knew the future was there, but I couldn't get out of the bubble.” [01; male, 18, clinical depression and anxiety]
“I would avoid thinking about it, because it would, one, make me more stressed, and two, make me more sad.” [06; female, 19, subclinical depression and anxiety]
“I physically and emotionally couldn't imagine anything beyond. … It was more of a day-by-day thing, so it wasn't like five years into the future, not even a year, just literally taking each day at a time and trying to hold onto something each day.” [16; female, 19, clinical depression]
Stuck in the past
“Whenever I thought about the future back then, it was never good. … What I thought would be only getting worse, never getting better. I would dwell upon the past; as for the future back then, I didn't even have an image.” [04; female, 16, clinical depression and anxiety]
“I’ve learned that, forget about the past and move forward. I don't pay attention to what has happened because that's gone. You need to be thinking about tomorrow.” [01; male, 18, clinical depression and anxiety]“I try to focus more on the future, but I also remember the past. The past has made me the person that I am.” [10; female, 19, clinical PTSD]
Domain 2: The impact of mood on images, thoughts, and feelings about the future
Themes | Poor mental health state | Wellness state |
---|---|---|
Valence | “It really affected me, because I felt like I just didn’t have any sense of purpose. I was so nervous about everything. I was even afraid everything will probably went wrong around me.” [10; female, 19, clinical PTSD] | “But now when you’re better after going through that [depression] and coming out, you plan about something. So you are really looking forward to achieving that goal that you have set in an exam for example.” [03; female, 19, clinical PTSD] |
Vividness | “Blurry, definitely blurry. I didn’t know anything. I didn’t know what I wanted to do.” [04; female, 16, clinical depression and anxiety] | “Now I can think straight, I’m optimistic and I can think about the future. I’m more realistic in thinking about something than before, at least I can think about the steps towards achieving that thing, and I now know that there are a lot of challenges before achieving.” [11; male, 18, clinical PTSD] |
Agency | “I had no control over what I was thinking about at that time. It just came. And slowly by slowly, I was losing control of everything.” [11; male, 18, clinical PTSD] | “It [the future] is all in my hand, so it depends how much work I put in, how much I actually really want it. Cause if I really want it, then I’ll make sure it comes true.” [04; female, 16, clinical depression and anxiety] |
Structure | “I usually think of everything that could possibly go wrong and then just play it in my head. … It’s overwhelming because you just end up spiralling. There’s no positive way out, as soon as you start overthinking, you’ve almost set yourself up to spiral.” [14; female, 19, subclinical depression and anxiety] | “When I was in a really anxious day, I looked at very small things as being super long period of my life and being a massive event that was going to affect everything else. I’ve come to realise a little bit better that actually those small events are just really small in the whole span of my timeline of life. So I look to the future with more possibilities, and there’s greater time.” [07; female, 19, clinical anxiety] |
Valence
“Mainly negative, I don't remember thinking anything positive.” [05; female, 19, clinical depression and anxiety]
“I used to think that the future will also be bad. So like goals, targets, I never used to have those, just living for the moment. But right now, I've set up goals and targets, and I'm actually hopeful for the future and how it will be.” [02; female, 19, subclinical depression and anxiety]
Vividness
“Cause I was so negative being in depression, it just became like there was no light at the end of the tunnel. It was so blurred in the whole process that I couldn't think what am I moving towards?” [01; male, 18, clinical depression and anxiety]“I could see myself just not having done well, coming back home and having to answer questions, just staying in my room and crying, because I couldn’t do it. It was more vivid than other images of the future.” [08; female, 19, clinical depression]
“I've got a lot of things that I look forward to. I'm always thinking one step ahead, about third year, and what speciality, what skills.” [05; female, 19, clinical depression and anxiety]
Agency
“Interviewer: Do you think you have control over the future?Participant: No, not at all. … I felt like there was a huge lack of control, and I felt that in terms of every aspect. … That lack of control was the most frustrating part because it's dehumanising in a way. Every aspect of life, like appetite, sleeping, friends, walking, was affected.” [19; female, 19, clinical depression and anxiety]
“I can't think of anything else that would play a bigger part than my own choices and my own vision.” [08; female, 19, clinical depression]
Structure
“I felt so out of control with my emotions that I felt like it was going to be like that forever. I would think, I've been like this for a month and a half, it's never gonna end, I'm gonna continue like this for the rest of my life.” [06; female, 19, subclinical depression and anxiety]
“I used to be so focused on overthinking the thing that was gonna come up. Now I can look at more things, at the bigger picture, so my whole life perspective, sequencing and timeline.” [05; female, 19, clinical depression and anxiety]
Domain 3: Social influences
Themes | Quotes |
---|---|
Social pressure and support from friends and peers | “I definitely think my friends were the most positive thing about that time, and because they made me feel so valued, I thought I have hope with my friends, like we’re gonna stay together even throughout this, even after everything. And my sister, she definitely kept hope in me about college, just holding on even after GCSEs.” [04; female, 16, clinical depression and anxiety] |
Pressure from parents and financial hardship | “I think the fact that you’ve grown up now, and also my parents don’t provide everything for me. You have to look for a job, and you have to plan for yourself and your lifestyle. So through that, it just comes automatically, you just have to plan for the next day.” [03; female, 19, clinical PTSD] |
Social pressure and support from friends and peers
“There are those people who believe in you, and they believe you can really do it, but as always, we have people who’re so negative and they discourage you in everything. … Why do you think you are special? People failed before, why would you succeed?” [11; male, 18, clinical depression and PTSD]
“It’s a good inspiration, when I saw that person got out of depression, worked hard and succeeded, it motivated me to concentrate in my dreams and goals, and just stop getting sad most of the time. So I thought even my life can be that way. I had a more optimistic way of thinking.” [02; female, 19, subclinical depression and anxiety]
Pressure from parents and financial hardship
“My education wise, at that time, they [my parents] were making all my decisions for me. That’s why I felt like I had zero control of my future, and that whole thought process would spiral in my head all the time. I wouldn’t have considered [the future], because everything was done, all the decisions were made.” [04; female, 16, clinical depression and anxiety]
“I think what worries me is money, if I’m not able to get a good job, to pay off my bills, to live the expectations of life I’m looking forward to, because I haven’t had that in life, I come from a deprived neighbourhood. I don’t wanna be on benefits. I wanna do something in life, I hope that it is a positive future ahead for myself.” [01; male, 18, clinical depression and anxiety]
Domain 4: Reflections on personal worries and expectations about the future
Themes | Quotes |
---|---|
The impact of Future thinking on mood | “Thinking about the future would only make my anxiety high, and make me want to just not go on anymore, so thinking about the future was just not a good idea. It didn’t even feel like I had, in my present moment, thought it out, so I don’t even think about the future.” [04; female, 16, clinical depression and anxiety] “I think now my relationship with the future is, I wouldn’t say it’s very good, I think it’s fine. I’m coping with it well and it doesn’t scare me to think about what I might be doing in two years or three years from now. I have an idea of what I want to do, I don’t know how to get there yet, but I know that eventually I will find the way.” [06; female, 19, subclinical depression and anxiety] |
Optimism, pessimism, and future expectations | “I wanted to go to the College of my choice, not the College of my parents’ choice, and the subjects of my choice, so non-medicine subjects and subjects I was actually interested in, considering I have to spend two years studying them. These are all expectations that seemed unrealistic at the time, but now I’m actually doing it all.” [04; female, 16, clinical depression and anxiety] “Basically everything that I ever worried about happening didn’t happen. I can’t think of one thing that did happen.” [17; female, 17, clinical depression and anxiety] |
The impact of future thinking on mood
“I can think a lot further into the future without getting upset, and I guess I let myself have fun imagining things.” [18; female, 16, clinical mixed depression and anxiety episodes].
Optimism, pessimism, and future expectations
“Initially I thought I’d do really bad in my GCSEs, and that didn’t really come true. I thought I’d probably do quite bad in my A-levels, and I did better than I thought I would. And I thought I’d get to university, but I’ve done better than I thought I would.” [05; female, 19, clinical depression and anxiety].
“I’d tell myself that, looking back, I had nothing to worry about, it was all self-inflicted.” [04; female, 16, clinical depression and anxiety]“I think that right now, I’m doing a lot better, and I’m seeing it like a learning experience because now I look back at it, I can analyse myself the way I felt, in order for me to avoid going back to that hole in the future.” [06; female, 19, subclinical depression and anxiety]
Domain 5: Personal coping
Themes | Quotes |
---|---|
Engaging in future thinking as a strategy to combat depression | “Imagine I meant to get from point A to B, I would stress a lot about GETTING to point B and not about the process of getting there, but now I’m just trying to enjoy the process of getting to point B. … I think it has allowed me to take things slow, and not want to rush to get to a specific place. Before, I would get more stressed if I didn’t get specific things done on time. Now, I’m a lot calmer about it.” [06; female, 19, subclinical depression and anxiety] |
Scientific thinking, to challenge perception with evidence | “I’m a lot more scientific in my thinking in terms of basing it on evidence. I try to combat any worries and fears I have with what I have in front of me, so exams, for example, I’m starting to worry about my exam and I’m like, ‘what if I fail?’ But then I look at all the work I’ve done, and all the revisions and all the plans I’ve made for it, and I’m like, ‘well, there’s still a possibility it’s more unlikely’, to use that as a reassurance.” [05; female, 19, clinical depression and anxiety] |
Engaging in future thinking as a strategy to combat depression
“I realise how things can change in an instant, and it does impact how I think about the future in that, I try not to be as rigid with ‘this must happen, if I don’t get this job, I’m not going to be happy’. It also makes me realise that things happen and we don’t have that much control over them.” [07; female, 19, clinical anxiety]
“It has allowed me to take things slow and not want to rush to get to a specific place. … Before, I would get more stressed if I didn’t get specific things done on time. Now I’m a lot calmer about it.” [06; female, 19, subclinical depression and anxiety]
“There's a song, by BTS called Pied Piper. … So during my really depressing period, I would just listen to that song, and it kept me going. Even if I felt bad now, I knew it would end so that I could get into that future state. … So me thinking about bad stuff from the past or from now, I thought about the future to counteract it, to give me hope in that times.”
“The detail of me being a mathematician in the future is extremely detailed. It’s me in front of a blackboard, with my hot chocolate and marshmallows, drinking, doing the problem on the board, just thinking really hard.”
Scientific thinking to challenge perception with evidence
“I’m much better at analysing these thoughts and thinking, do they make sense? Are they logical or are they just something I don’t really need to worry about and I need to distract myself from?” [18; female, 16, clinical mixed depression and anxiety episodes]
“So for depression, it’s avoidance, denial to see the future; and anxiety, it’s overanalysing, overthinking and also irrational thoughts. Depression is very different in the way that the future is not even a consideration; anxiety is the polar opposite, it’s on your mind, it’s intrusive, it’s over control, like overpowering.”