How CBT Helps in Treating Depression
Clinically Reviewed by: Katie Moran, LCSW
Cognitive-behavioral therapy (CBT) is one of the most popular therapies for mental illness. Therapists have used CBT for depression for decades and it has proven effective for countless individuals.
CBT works on the basis that by changing negative thought patterns and behaviors, you can reduce distressing feelings. This is how CBT helps in treating depression. When a person is suffering from depression, negative thoughts and destructive behaviors increase their emotional turmoil. CBT provides a toolbox with various strategies and skills to challenge these distortions.
It’s normal for CBT, and therapy in general, to sound confusing for those who have not tried it. In this article, we’ll be further unpacking CBT for depression, with a focus on why it works and how it looks in practice.
Why Is CBT used for Depression?
Cognitive-behavioral therapy (CBT) is a structured, time-limited talk therapy. In contrast to other types of therapy which explore emotions in depth, CBT is mainly focused on the thoughts and behaviors associated with distress and mental illness.
Since the development of CBT in the 1960s, it has surged in popularity. An important factor in its widespread use is its evidence-based approach, drawing on a scientific understanding of the mind and body, as well as the mountain of evidence supporting its effectiveness.
CBT’s emphasis on the thought patterns linked to mental illness make it an excellent first-line treatment for depression. While intense emotions are often at the root of depression, it is the person’s cognitive interpretations that cause so much distress. Difficult feelings are undoubtedly painful, but pain is not inherently ‘bad’. In fact, pain is necessary for survival as it alerts us to potential problems, giving us the opportunity to respond effectively.
Emotional pain is also a meaningful part of being human. As difficult as grief may be, no one wants to feel indifferent to the loss of a loved one. Anger helps us respond with urgency to dangerous situations and facilitates the implementation of boundaries necessary for fulfilling relationships. Guilt gives us the opportunity to correct our mistakes and live true to our values.
When you are depressed, it is difficult to see the meaning in pain. Instead, your mind fixates on negative beliefs, like that it’s incompatible with happiness or that it will last forever. In CBT, you challenge those beliefs, which in turn allows you to better regulate your emotions.
Depression also affects behaviors, leading to resistance to or avoidance of self-care and responsibilities. In addition to cognitive interventions, CBT provides behavioral practices that help you manage tasks that seem difficult or overwhelming, providing a sense of achievement and reinforcing your ability to maintain routine.
Based on the results of decades of research, leading organizations such as the APA and NIMH recognize CBT as an effective treatment for depression. It is an excellent option if you are seeking therapy for depression or other mental illnesses.
How CBT Helps Treat Depression
To better understand how CBT helps treat depression, the following hypothetical scenario reflects a common experience.
At the age of thirty seven, Robert started experiencing regular bouts of what he called “the blues”. He’d be going through a normal work day, when a sense of melancholy arose in him. It felt like a combination of deep sadness and shame, and was accompanied by a hefty dose of fear.
Sometimes these feelings came about when he felt particularly overwhelmed. But at other times, they seemed to come out of nowhere. Nevertheless, they brought up certain thoughts.
“My life revolves around this meaningless job.”
“Life is full of pain and it only leads to death.”
“I’m so miserable all the time and everyone around me suffers for it. They’d be better off if I didn’t exist.”
These thoughts were not entirely new. He’d grappled with questions of meaning and the purpose of pain since adolescence. But whereas previously he’d been able to contradict or distract himself from them, they now seemed too compelling.
Soon, he was struggling to get out of bed in the morning, taking sick days once or twice a week. His partner became concerned and recommended that he seek treatment. He found a therapist who used CBT as their primary approach.
The Cognitive Triangle Facilitates Healing
The cognitive triangle makes clear that the thoughts, feelings, and behaviors Robert experienced were interdependent. Regardless of which, if any, had come first, they triggered or exacerbated each other, creating a loop. This causes depression to worsen when unacknowledged. However, with CBT, it is this very interaction that facilitates treatment.
A CBT therapist focuses on changing negative thoughts and behaviors, consequently reducing the negative feelings. For Robert, this meant identifying the thoughts causing distress and challenging them. When placed in the glare of the spotlight, and with the guidance of his therapist, he could see the holes in his reasoning. For example, he had the agency to choose what to prioritize in his life. Furthermore, he did find enjoyment in his job and its role in providing for his family brought him a great sense of meaning.
His therapist also guided him in changing negative behaviors. The simple act of shaving each day helped his self-esteem and increased his motivation. Taking a twenty minute lunchtime walk improved his mood. Sharing his experience with his partner reduced his sense of isolation and relieved some of the burden of carrying his struggles alone.
After the first few sessions, he was already experiencing some of the common benefits of CBT, including reduced rumination, a greater capacity for coping with challenges, and the ability to regulate his emotions.
His therapy lasted eight sessions, at the end of which he had a toolbox of strategies and techniques to maintain and build upon his much-improved mental health.
Octave’s Approach: Personalized CBT
One of the great benefits of CBT is that its strategies can be tailored to work with many different people in a range of different circumstances. That being said, it is most effective when personalized to best suit each individual.
Octave’s approach is to match you with the therapist who is perfect for you. The process of CBT then focuses on your specific needs.
So, if you prefer to take a targeted approach that most efficiently reduces symptoms, the right therapist can help with that. If you’d like to take time to gain insight into the experiences underlying your struggles, your therapist can adapt the process and even draw from other approaches. Everyone has their own preferences and needs, and your specific therapy journey will never be identical to someone else’s.
Examples of CBT Techniques for Depression
One of the benefits of CBT is that it provides a toolbox of strategies for managing any issues. You practice them during sessions with your therapist and continue working with them at home.
The following CBT techniques for depression will help you create sustainable change in how live your life:
Cognitive Restructuring
The most well-known and oft-used CBT technique, cognitive restructuring, trains you to identify and challenge problematic thoughts. When unchallenged, you assume them to be true. But with practice, you begin to notice these thoughts when they arise and recognize that they are not facts.
Through cognitive restructuring, you gradually change how you talk to yourself, replacing negative self-talk with positive thoughts. This fundamental shift reduces symptoms of depression and improves your mood.
Behavioral Activation
Evidence shows that acting counter to negative thoughts and feelings is an effective way to change them. However, a common symptom of depression is the lack of motivation to do things you enjoy. In CBT, your therapist helps you use behavioral strategies to overcome your resistance to engaging in enjoyable or interesting activities.
Activity Scheduling
Depression can make routine and structure seem overwhelming. This often leads to self-neglect, as well as the neglect of external responsibilities.
Activity scheduling helps you build routine and structure in a manageable way. It facilitates bringing enjoyable and healing activities, along with behaviors that can get you back on track at work, school or home, back into your daily life.
Thought Logs
This involves tracking the thoughts associated with depression by writing them down, helping you get into the habit of noticing problematic thought patterns without getting caught up in them.
Benefits of CBT for Depression
There’s a range of different evidence-based therapies you could choose. What specific benefits are there in CBT for depression?
Since CBT is a highly structured, time-limited therapy, its results can be seen within a relatively short amount of time. Improvements are measurable, so therapy neither ends prematurely nor continues in perpetuity. Depression can cause a lot of distress, and those struggling require interventions that provide timely relief.
The tools you learn in CBT are also very practical and your journey doesn’t end when you leave therapy. Rather, you build skills that help you increase your self-awareness in your normal, day-to-day life. So, while your outlook on life doesn’t change overnight, you continue to learn to see things through a lens of meaning and positivity.
Countless studies have shown that CBT is effective for depression. Recent data shows that 74% of people who do CBT with Octave’s therapists see progress within three months.
Why Choose Octave for Cognitive Behavioral Therapy (CBT)?
If you’re looking for a CBT therapist, you may not be sure where to start. Octave can guide you through the process, offering the following benefits:
800+ licensed therapists trained in CBT, vetted through rigorous processes.
Personalized, evidence-based treatment.
Assistance with your insurance provider.
An average out-of-pocket cost of $28 per session.
Virtual therapy that meets you wherever you are.
CBT vs. Medication
Many people suffering from depression find relief with antidepressant medications. Is CBT a better option than medication?
CBT and medication are both excellent first-line treatments for depression. Since depression has both biological and psychological components, experts often recommend a combination of therapy and medication. You can therefore see a CBT therapist in addition to taking medication for a truly comprehensive approach.
Research shows that a combined treatment of medication and psychotherapy is most effective for moderate to severe depression. For clients with milder symptoms, therapy can be effective on its own (although even in these instances, medication can make it easier to focus on your therapy process).
Discuss with your mental health provider if you are unsure whether you should take a combined or therapy-first approach to treatment.
FAQs
What are the strengths of CBT for depression?
CBT is a structured, time-limited approach that helps change thought patterns associated with depression. In doing so, it provides timely relief for the symptoms of depression.
How effective is cognitive therapy for depression?
Decades of research have shown that CBT is effective for treating depression.
What is the success rate of CBT for depression?
74% of Octave’s clients with depression see improvements within 3 months.
How long does CBT take to work?
CBT generally takes between 12 to 20 sessions for treating depression. However, every individual is different, and your process may be more short- or long-term.
Can CBT help with severe depression?
Yes, CBT can help with severe depression, but is often used as one component in a treatment plan which may include medication, hospitalization, and additional types of therapy.
Is CBT right for me if I’ve tried other therapies?
If you have tried other therapies without significant improvements, CBT’s structured, time-limited approach may help.
Ready to take the first step? Schedule a consultation and connect with a licensed CBT therapist through Octave.
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