Cognitive Behavioral Therapy for Depression? Yes and No
Depression
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:
- Depression Statistics. Retrieved from Depression and Bipolar Support Alliance. http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_depression
- 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
- 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
- Goldberg, Joseph. (2012). Cognitive Behavioral Therapy for Depression. WebMD. Retrieved from http://www.webmd.com/depression/guide/cognitive-behavioral-therapy-for-depression