Cognitive behaviour therapy (CBT) is a goal-based and brief therapy that’s been proven effective for treating depression. CBT aims to primarily reduce unhelpful thoughts and negative behaviours that are common for those experiencing depression. It works through homework assignments and problem-solving options.
Generally, those seeking cognitive behavioural therapy for depression typically see a CBT therapist for 12 to 20 weekly sessions. However, you may see improvements after only a few treatments. It can be done online or in person.
What’s Cognitive Behavioural Therapy (CBT)?
Cognitive behavioural therapy (CBT) is an evidence-based form of depressive therapy. The foundation is the connection between actions, thoughts, and emotions. In fact, the goal is primarily to help you learn about your cognitive patterns and when to apply coping mechanisms to challenge your negative thoughts, attitudes, beliefs, and actions (especially when they are harmful).
The core focus of cognitive behaviour therapy is to help you learn, take what you’ve discovered in sessions, and apply the skills to everyday life.
How Can Cognitive Therapy Treat Depression?
Cognitive behavioural therapy (CBT) is a therapy style that’s used to treat or lessen the severity of mental health disorders. Studies have indicated that it is effective for depressive episodes and depressive disorders that could impact your lifestyle, especially for those with mild or moderate symptoms. It’s effective for these depressive types:
- Major depressive disorder
- Schizoaffective disorder (depressive)
- Situational depression
- Depressive episodes of bipolar disorder
- Postpartum depression
- Seasonal affective disorder
- PDD (persistent depressive disorder)
Depression/Cognitive Behavioural Therapy – How It Works
CBT utilises a combination of behavioural and cognitive approaches to reduce a person’s depression. Therapists might challenge those negative thoughts that lead to self-harming behaviours or inaction. When you target actions and thoughts, CBT can change your feelings and reduce the issues of many mental health conditions.
Cognitive Methods Changing Depressive Thinking Patterns
Cognitive methods will teach you how to challenge and rationalise your negative thought patterns, which eventually reduces their power over you. Cognitive restructuring and other techniques help you understand those thought patterns, the actual reality of your situation, and the trigger or emotion behind them. Then, your therapist presents a more realistic or rational perspective to reduce cognitive distortions.
One common cognitive distortion among people with depression is “mind reading.” You believe you know what the others are thinking. When you challenge these depressive thoughts, you build a healthier pattern of self-talk and thinking.
Behavioural Methods Improving Motivation and Energy
Behavioural methods can effectively treat depression and involve rewards for small behavioural changes. Depression might cause low energy or less motivation. When you reward yourself for putting away a few dishes, you will change the chemical output of the brain. Likewise, rewards make you want to repeat the behaviour.
Though it’s not necessarily a form of behavioural medicine, CBT will employ many behavioural methods to lower your power of not engaging in certain behaviours.
Common CBT Techniques Available for Depression
The common CBT techniques for depression include mindful meditation, thought journaling, and cognitive restructuring. Most of them are used in conjunction with each other to show the connections between your behaviours, emotions, and thoughts.
Here are the most common techniques:
1. Cognitive Restructuring
When you challenge your thought patterns, self-talk, and tone, you learn about cognitive distortions and any unhealthy patterns that might increase suicidal thoughts or depressive emotions. Cognitive restructuring will help you form healthy patterns, reduce those cognitive errors, and practise rationalising distortions.
2. Activity Scheduling
Activity scheduling means rewarding yourself for scheduling some low-level activities that will encourage self-care and positive regard. When you do these things, you’re motivating yourself to complete tasks, even when you don’t want to. This also increases your chances of finishing those tasks once you’ve conducted formal therapy sessions.
3. Thought Journaling
When you journal about your thoughts, emotions, and behaviours, you create space to identify and process potential triggers and how those thoughts influence the behaviour. This increases your self-awareness and helps you learn about coping techniques you can use later.
4. ABC Analysis
ABC analysis is similar to journaling, and the skill focuses solely on breaking down those behaviours related to depression, such as sleeping all day or snapping at people.
The ABC model features this structure:
- The activating event
- The belief about the event
- The consequences of the event, such as your behaviours and feelings
Analysing your consequences and triggers lets you explore “consequential” behaviours and find common causes for your depressive triggers.
5. Fact-Checking
The fact-checking technique allows you to review all of your thoughts. You understand that you’re stuck in a harmful or depressive thought pattern, but they are not facts. They’re only opinions that are based on emotion.
Fact-checking also helps you identify the behaviours you engage in because of your emotions or opinions instead of those actual facts.
6. Successive Approximation (Breaking Things Down)
When you break things down into smaller goals, they are easy to complete, and you’re less overwhelmed. Practising successive approximation means you’re more likely to finish objectives and cope with bigger tasks in the future, even when your depression is heightened.
7. Mindful Meditation
Engaging in meditation for depression helps you learn to stop focusing on negative thought patterns and boost your ability to stay in the present. Meditation also enables you to recognise and learn about acceptive thought patterns and detach from them so that they don’t take over when your depressive disorders are heightened.
CBT Types for Depression
Cognitive behavioural therapy isn’t just a treatment type; it’s the main branch for many therapy styles. Though it’s the basis for them, it’s not the only effective one for treating depressive episodes and symptoms. These are the most common offshoots of CBT for depression:
1. ACT (Acceptance and Commitment Therapy)
ACT therapy isn’t as common, but it might be helpful for treating depression. It engages many techniques to boost your mental flexibility.
The techniques used include various strategies, such as:
- Acceptance – Allowing feelings and thoughts to exist without pushing them away or judging them
- Mindfulness – Encouraging an individual to focus on the present
- Commitment to Behavioural Change – When something isn’t in line with the values or meaning for the individual, they can change the behaviour to meet the value
In treating depression, ACT may help you reduce the difficulties surrounding negative thoughts or self-talk, judgment, and anxiety. You will also increase your ability to focus.
2. DBT (Dialectical Behaviour Therapy)
DBT is common, but it’s mainly used to treat people with BPD (borderline personality disorder). However, it was originally developed to treat those with frequent suicidal thoughts. Likewise, those with bipolar disorder or BPD engage in self-harm, which is often seen in depressive episodes.
Similar to ACT, DBT will help you learn to accept difficult thoughts and feelings. Likewise, it teaches you how to accept and address your irrational thoughts while making maintainable and healthy changes to cope with life.
3. REBT (Rational Emotive Behaviour Therapy)
Rational Emotive Behaviour Therapy was created on the idea that people make choices in life to meet their needs, feel fulfilled, and help them survive. Therefore, REBT teaches you how to address those unhealthy and irrational behaviours and thoughts, changing them to have a more fulfilling and functional life.
When used to treat depression, REBT helps you feel happy or fulfilled, which reduces depressive symptoms. This approach uses various CBT techniques to help you change your thought processes. That leads to creating healthier behaviour patterns and eventually moving out of those depressive thoughts.
Effectiveness of CBT in Depressed Patients
Cognitive behavioural therapy is monitored and certified by the Beck Institute, which was primarily started by the CBT founders. It must provide training of CBT to mental health professionals and constantly monitor the research to ensure it’s being effective for mental health disorders.
Outside of that, studies have proven that CBT is effective for depression:
- Studies indicate that CBT behavioural activation techniques are helpful in treating those with severe depression.
- When compared to traditional antidepressant medication, CBT alone could be effective for recovery and relapse prevention.
- Cognitive therapy shares efficiency with medication to treat moderate and major depression, but this is impacted by the experience of the therapist and the patients treated.
- One study on bipolar disorder saw that CBT treatment led to fewer episodes, shorter episodes, and fewer hospitalisations. These psychological interventions had lower depressive moods and mania symptoms, as well.
What to Expect During Treatment
CBT therapy requires rigour and homework, which is daunting for some. However, it’s not necessarily bad. The treatment is short-term and helps people thrive with the help of a therapist and then on their own. Traditionally, treatment lasts between eight to 12 CBT sessions, depending on that person’s history. The Beck Institute indicates that many people improve within eight to 10 sessions.
Each CBT session lasts about 50 to 55 minutes and happens once per week, which is similar to other therapies. The format is very structured and consists of:
- Setting goals or problems to process that day.
- Working on the reported problem, which could include processing the barriers in the problem and the person’s thoughts
- Creating the action plan to address the issue in/out of session
- Measuring the person’s movement on that problem (discussing homework, communication, and reported issues)
Those steps might not always happen within the CBT treatment plan, but it’s the treatment expectation. Your therapist might use different approaches, but the goal is to have a short-term treatment and be active in reducing the impact those mental health symptoms have on your life.
At-home Cognitive Behavioural Therapy Exercises to Consider
Those with mental disorders should always seek professional help for depression. CBT exercises can be done at home without the assistance of a therapist to relieve mild or moderate depression. However, a therapist will help you develop those techniques to be prepared when symptoms arise.
Here are a few at-home exercises to try:
Journaling
Keeping a journal of your feelings, behaviours, and thoughts can be useful, even if you’re not seeing a therapist. When you write things down and monitor them, you might learn more about yourself, identifying the difficulties you often face. That means you can prepare in the future.
Schedule Enjoyable Activities
Schedule events that will improve your mood, such as lunch dates, concerts, and road trips. Even doing it on a small scale, such as making a to-do list, will inspire you to keep going.
Meditate
Meditation is often helpful for decompressing, managing your emotions, and helping you fall asleep. It’s been proven to help with anxiety disorders, depressive disorders, and addiction. If you don’t know where to begin, you can find free online videos or apps. However, it might be wise to consider online therapy from a trained therapist.
Challenge Negative Thoughts
Many people start the practice of challenging their negative thoughts in a journal. However, it’s helpful to reframe your thought process in the moment, as well. When you say affirmations and reframe your thoughts in your head, you might learn to stop those negative ideas in their tracks.
Start Gratitude Practises
It will generally feel difficult, but it’s crucial to identify the positive areas of your life. Studies indicate that using gratitude helps people significantly reduce their continuous negative thoughts and reduce the risk of them coming back during an episode of depression or anxiety. Consider writing down three things that you are grateful for every day.
Generally, there should be a systematic review of your needs, so talk therapy is often the best choice to treat your mental health condition and deal with life events as they come up, though.
Conclusion
CBT can help you in many ways if you’re experiencing chronic depression. In most cases, people are dealing with various mental health conditions, and it’s important to treat them at the root. Therapists might also prescribe medications along with the CBT options.
Though at-home tools are beneficial, in-person or online therapy is generally the best course of action. If you’re interested in using cognitive behavioural therapy, it’s wise to work with a professional.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001356/
https://www.healthline.com/health/depression/cognitive-behavioral-therapy#an-experts-take
Author:admin
