Cognitive Behavioral Therapy for Depression? Yes and No

DepressionPortrait of a sad woman can make people feel like a dark cloud hovers over them, while the sun shines brightly on the rest of the world. According to the U.S. Department of Health and Human Services, major depression affects approximately 14.8 million American adults each year, and as many as 1 in 33 children and 1 in 8 adolescents experiences clinical depression.

When people feel like they don’t have the strength to pull themselves out from under the shadow of depression, there are many therapeutic options to choose from. Depression is a highly treatable mental health condition with 80% to 90% of those who seek treatment reporting relief.

One of the most popular forms of behavioral therapy used to treat depression is cognitive behavioral therapy (CBT). Cognitive behavioral therapy techniques are routinely used to treat depression by focusing on a person’s internal dialogue and how it affects his or her behavior.

What Is Cognitive Behavioral Therapy (CBT)?

CBT is a blend of two types of therapies: cognitive therapy and behavioral therapy. Cognitive behavioral therapy has proven to be effective for a wide range of mental health conditions including anxiety, eating disorders, and depression. Cognitive therapy focuses on how our thought patterns and belief systems affect our mood and actions, while behavioral therapy aims to transform unhealthy habits and behavior patterns.

How Do CBT Techniques Help with Depression?

Cognitive behavioral therapy focuses on the present moment, concerned more with the thoughts and behaviors themselves rather than their origins. A therapist using CBT techniques might assist a person in therapy for depression by first educating him or her about automatic thoughts, known as cognitive distortions, and then by teaching the person to monitor themselves for such thoughts.

Cognitive distortions are irrational or inflated thoughts and beliefs that cause a person to have a distorted and often negative view of reality. These distortions often reinforce negative thought patterns and perpetuate mental states like anxiety and depression. Some common dysfunctional thinking patterns include all-or-nothing thinking, over-generalization, “should” statements (ruminating about the way things should be or how you expect them to be, not as they are), and personalization.

Negative thinking and behaviors often precipitate depression. CBT techniques can help people in therapy restructure their thought patterns and alter their behavior to alleviate depressive symptoms.

For example, a person experiencing depression may have an automatic thought such as “I am worthless and things are hopeless.” A cognitive behavioral therapist would help this person reframe the thought to something more realistic like, “I may have made some mistakes, but I am learning. I do have value as a person regardless of my imperfections.”

Another CBT technique for depression is pleasant activity scheduling. This involves scheduling healthy activities into your life that you enjoy—perhaps for 30 minutes a day, 3 hours a week, or whatever your schedule allows. You might read a book, ride a bike, or go for coffee with your friends. Whatever yours may be, pleasant activities create more positive feelings of joy and well-being in your life.

Is CBT Effective for Treating Depression?

Studies have shown that psychotherapy is at least as effective as antidepressants for individuals experiencing mild to moderate depression. In fact, varying degrees of depression can often be treated with psychotherapy alone, without the use of psychotropic medication. However, individuals experiencing severe depression may have a more difficult time utilizing cognitive behavioral therapy techniques alone and may require medication in addition to therapy to transform debilitating symptoms.

Therapeutic outcomes are improved by people’s capacity for self-motivation, introspection, and recognition that they have the power to change their lives—conditions which may not be met depending on the severity and root cause of a person’s depression.

Limitations of Cognitive Behavioral Therapy for Treating Depression

Some therapists don’t see CBT as the most effective method for treating depression because they believe deep-seated trauma and other circumstances may require a more long-term approach to treat effectively. California-based psychotherapist Cynthia W. Lubow, MS, MFT, for example, is one of many who share this opinion. “While there are cognitive elements of the work that I or any therapist does, I find that they are mostly helpful at the end of therapy when people are mostly resolved and doing well, or when people really are very psychologically healthy and just need a little guidance,” she said.

Lubow believes that CBT techniques are difficult to administer in those dealing with severe depression and that other therapies should be utilized first until the person is stabilized. “Trying to do [CBT] with people who are depressed or severely depressed because of trauma, abuse, or chemical issues is pointless. … They need intervention with their emotional state, including reprocessing trauma and resource building and strengthening before they can get to the cognitive and behavioral changes,” she said.

Therapy Is a Great First Step in Treating Depression

Just as depression is multifaceted, so is its treatment. If you are experiencing symptoms of depression, a great first step to take is to find a therapist you’re comfortable with who can help you understand your depression.

Cognitive behavioral therapy is just one of many options for helping an individual experiencing depression, and it may or may not be the best one for you. Regardless of modality, therapy can help you reduce stress, gain perspective, learn to talk about your feelings, and change your thought and behavior patterns. Regardless of what type of therapy you and your therapist choose, there is much to be gained from seeking help and learning more about the mental health issues affecting your quality of life.

References:

  1. Depression Statistics. Retrieved from Depression and Bipolar Support Alliance. http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_depression
  2. Duckworth, Ken M.D. & Freeman, Jacob M.D. (2012).Cognitive Behavioral Therapy. National Alliance on Mental Illness. Retrieved from http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Treatments_and_Supports/Cognitive_Behavioral_Therapy1.htm
  3. Facts on access to medications for people with depressive, bipolar and anxiety illnesses: The policymaker’s resource. (n.d.). National Alliance on Mental Illness. Retrieved December 8, 2014, from http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/Policy_Research_Institute/Policymakers_Toolkit/Facts_on_Access_to_Medications_Policymakers_Res
  4. Goldberg, Joseph. (2012). Cognitive Behavioral Therapy for Depression. WebMD. Retrieved from http://www.webmd.com/depression/guide/cognitive-behavioral-therapy-for-depression

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Laura

    December 15th, 2014 at 3:25 AM

    This is very interesting. CBT is a the first chapter in the Destroy Depression system, and it really helped me become depression-free. I think the reason it worked is the system was not JUST CBT – there were 6 other steps which I implemented that help each other. I guess what I am saying is, CBT on its own will be a decent way to treat depression, but in conjunction with other things like a healthy diet and exercise, it can work wonders.

  • Ludwig

    December 15th, 2014 at 3:50 AM

    So it may not be the end all and be all for people experiencing depression, but it can be a great first step for many who struggle with this in their lives and who want to add something more to their daily lives instead of just more medication.
    Certain medications have their place and I am sure that with CBT or other forms of therapy they can be highly useful.
    I also know how easy it can be to become addicted to something without ever having it really help, only mask the real things going on inside and this is why I would advocate for therapy along with medication.

  • sheila g.

    December 15th, 2014 at 10:49 AM

    what works for me might not work for you, and there is nothing wrong with that. what is wrong is not trying to find something that will work for you, even if it could be seen as more unconventional.

  • Janna

    December 16th, 2014 at 3:47 AM

    I understand how behavioral therapy could work for those who are depressed, but how does the cognitive aspect come into play? I mean, surely it is not what you think about depression that would cause you to be depressed?

  • Melissa

    December 16th, 2014 at 9:17 AM

    Please know that there is also a significant different in the training of Masters level clinicians and Doctoral level clinicians. This translates into a different experience for the client.

  • Samuel

    December 16th, 2014 at 10:52 AM

    I would love to go to a therapist who could walk me through this process of letting me know what they believe and how they think that me working with them could have value to me. I think that if they could sit down and explain a lot of this to me, and to other clients too, I think that a lot more people could be comfortable with the whole therapy process and would make some better and more informed decisions about their care. Most of us don’t know the difference between what would be the best approach or not, so I think that one of the first things that I would like to do would be to talk to someone about how their approach may differ from others and why that would potentially be of greater benefit to me.

  • maryjo

    December 16th, 2014 at 10:54 AM

    I need at the age 68 almost 69 big time help!!!…to long to discuss, but I lost 5 members in the last 5 yrs of my extended family 2 just July 23 and Sept. 23 2014, Help I am looking at high risk surgery, had a triple bye pass not yet 2 yrs. My adult children are 34 &35 and for 16 yrs just do things that cruel and not wanted. I don’t give advice, they keep in the dark about anything (especially health issues for me and events that envove a exhusband that drank but succeeded to divorce and take all the assets of a business in our home for 18 yrs. he had a plan over 5 years and had move us from South Carolina to Atlanta Ga. for this from one state SC that is more conservative to Atlanta Ga. 5 yrs after we moved he had complete control of of the money signed IRS (liabilities and assets every years with out him allowing me to read this) where he took our house, I never saw proof of the retirement I signed every year. Now my Adult children see me as a responsibility (as we can go for many months not having any kind of communications and I am in a position were I will not bother them or changing their lives. Any thing the say I apopgize or just do to be part of their life….But after finding out bad new about my future health and not yet sharing with them so I don’t sound like I am worried. The first time xmas plans in 16 yrs with a new grandson was a plan I didn’t expect as the plan was said in advance and I confirmed christmas with them. The rug was pulled from again under my feet. I am desperate as my future health and going to NYC from Charleston SC for this surgery came up Last Friday Dec 12, not good news….I my inncome is $800.00 a month, NO Retirement this was hidden at the divorce, also assets that never was shown at divorce, this was a high income independent contractor (xhusband and myself) we owned a software company I being 7 yrs older had more connections and traveled with my career before marring him so I was grooming him as we had 2 babies and I worked from home and made sure I was always involved with my children and as a older mom for 1979, and had a very successful career, I was very on top of anything to do with family, business education(private schools) things I worked hard to get growing up in a family of 7 siblings and my father died at 40 yrs in front of me at the age of 4. I am worried about these feelings and very hurt, angry because I stayed with this man because of my children. My out come is they talked to me as abusive as what they heard in lies action and horrible name callng his same behavior how he talked to me. The was business succees within 2 yrs to over 6 figures….he drank but could do his best work that way, and was gone out of town for last 10 yrs of our marrage 85% of the time and started to NEVER give me his travel plans after and became physically and emotionally abusive to me and my son. I need a good professional to help me while I go through this surgery as I live a lone and through the time lost marriage children, family old friends and live in HUD as of 62 yrs home and got here on my 62 birthday as he stopped my last year of alimony and didn’t have money to go back To Atlanta to do contempt order and he new this. I became disabled in my feet, ankles and lower legs . I feel so trapped and I can usually find hope and faith but I am overwhelmed with no one to organize all of this disappointment and sadness. Please get back to me as all of this is front of me

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    December 16th, 2014 at 3:32 PM

    Hi, maryjo. If you would like to consult with a mental health professional, please feel free to return to our homepage, http://www.goodtherapy.org/, and enter your zip code into the search field to find therapists in your area. If you’re looking for a counselor that practices a specific type of therapy, or who deals with specific concerns, you can make an advanced search by clicking here: http://www.goodtherapy.org/advanced-search.html

    Once you enter your information, you’ll be directed to a list of therapists and counselors who meet your criteria. From this list you can click to view our members’ full profiles and contact the therapists themselves for more information. You are also welcome to call us for assistance finding a therapist. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Pacific Time; our phone number is 888-563-2112 ext. 1. We hope this helps!

    Warm regards,
    The GoodTherapy.org Team

  • Vee

    December 16th, 2014 at 9:26 PM

    look I know many readers here are thinking one type of therapy may not be the best fit for everybody…and I agree with that.but because CBT is used for just so many things,Im forced to think a lot more professionals would have experience using it.and having your therapist experienced in a therapy you are undergoing would definitely be a huge advantage.

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