CBT for depression
author image Jennifer Chen, Psy.D.
author image Jennifer Chen, Psy.D.

Depression is treated through various modalities including meditation and cognitive-behavioral therapy. Read below to learn what cognitive-behavioral therapy for depression looks like.

Example 1: Jeff

Jeff is a middle-aged man who was recently laid off. Although he has had multiple job interviews, he has been unemployed for the past six months. His confidence is wearing away and he finds it more and more difficult to get out of bed each morning. When friends ask him to go out to dinner, he declines, preferring to stay home watching TV.

He has gained significant weight over the last few months, has no energy or motivation, and feels hopeless about his future.

Example 2: Lisa

Lisa has struggled with depression on and off since she was a child. Her bouts of depression may last for a few weeks to a few months. Usually able to get herself out of them. She has a stable career and friends in her life, but sometimes she becomes very negative; this has become more of a problem lately. This time around, she is unsure how to kick this depression. She feels “empty.She has trouble making decisions and getting her day started and feels easily irritated. She has even entertained thoughts of hurting herself. Recently, her negative mood has begun to become more noticeable to her co-workers and boyfriend.

Despite having different stories, Jeff and Lisa are both suffering from clinical depression and have decided to seek help.

Cognitive-Behavioral Therapy for Depression

Cognitive-Behavioral Therapy (CBT) is a proven treatment for depression. CBT is based on the idea that our thoughts impact our mood and our actions, and, in turn, our actions also impact our thoughts and mood. For people like Jeff and Lisa who are suffering from depression, it may be that their thoughts are so negative as to be unhelpful.  This sort of negative thinking is common in people like Jeff and Lisa, and can play a major role in perpetuating depression.

How CBT for depression addresses our thinking

First, let’s look at how CBT for depression might help Jeff and Lisa work with their relevant negative thoughts. By identifying negative thoughts and examining the evidence for and against them, they can begin to “˜catch’ themselves when they are in a negative thought pattern and can change it by carefully examining some of their thoughts.

Jeff’s thinking

For example, Jeff often thinks, “I’m never going to get a job because no one wants to hire a lazy deadbeat like me.” Jeff might be encouraged by his CBT therapist to look at the evidence for and against this.  The evidence supporting the thought might be that he has been out of a job for six months. The evidence against it is that Jeff was employed for many years, and received great reviews while at his previous firm. To add to that, none of his friends would ever consider him “˜lazy.’ He may have fallen victim to some of the common unhelpful thought patterns that crop up in depression, such as disqualifying the positive, catastrophizing, and labeling. By discussing these thoughts in therapy, Jeff found a more helpful and balanced thought by telling himself, “It’s a tough job market and I am qualified and hard-working, as evidenced by my past reviews. I just haven’t found the right job yet.”

Lisa’s thinking

Following a fight with her boyfriend, Lisa thought, “I’m going to be alone forever because I keep screwing up.” She tried to apply what she learned in CBT. In looking for evidence that supported the thought, Lisa recalled times when she was single and depressed. She also realized there was evidence that contradicted this thought: she had gotten into bad fights with her boyfriend before, but they had talked it out afterwards. Lisa decided that this negative thought was a product of all-or-nothing thinking, emotional reasoning, and fortune-telling.  Lisa’s therapist taught her to battle this negative thought by mentally responding to it with, “My boyfriend and I have had arguments in the past. We’ve felt much better once we communicated what was going on. This is an opportunity to get closer rather than more distant.”

How CBT Focuses on Behavior

Jeff’s therapist also encouraged him to keep an activity log and begin monitoring exactly what he does each day. Jeff agreed to go out for a 30-minute walk four times a week (as part of a form of CBT called behavioral activation). Although Jeff resisted at first, he gave it a try. He found it more satisfying than he originally expected. In subsequent sessions, Jeff was even able to add going to the gym to his routine.

Lisa always prided herself in her cooking. But in talking with her CBT therapist, Lisa realized that she had not been making meals at home in months. After realizing that cooking leads her to feel better about herself, Lisa decided to cook at least once a week. Further, she would invite a friend or two over to enjoy the meal with her. Lisa found that including this activity in her busy schedule was rewarding. Eventually she began implementing other pleasurable activities into her week. Discussing her progress in therapy each week helped her to see how making changes in her environment could lead to a more positive outlook on life.

These are just some examples of techniques and approaches that CBT uses to address depression.

Take-Home Message About Cognitive-Behavioral Therapy for Depression

CBT is meant to be a time-limited therapy that uses a structured and collaborative approach. CBT is goal-oriented and problem-focused. Clients are taught skills during each session and are asked to practice these skills between sessions. The skills learned can then be used even after therapy is over, essentially teaching clients to be their own therapist. Still a skeptic? The proof is in the pudding — and also in hundreds of clinical research studies.

Contact us to learn more about whether CBT makes sense for you, or to start the treatment process.

author avatar
Jennifer Chen, Psy.D.

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