How do we use cognitive-behavioral therapy for depression?

How do we use cognitive-behavioral therapy for depression?

Vassilia Binensztok, PhD, LMHC, NCC

Cognitive-behavioral therapy (CBT) is a powerful tool to combat depression.  It can even be more effective than medication in many cases.  But what is CBT and how is it used for depression?

Cognitive-behavioral therapy is a type of psychotherapy that helps people change their thoughts and behaviors to alleviate stress and improve their moods.  Cognitive therapy helps us analyze the ways in which our thoughts are either helpful or hurtful and how we can change the hurtful thoughts to more helpful, productive ones.  Behavioral therapy helps us adopt new behaviors that help improve our moods and decrease behaviors that keep us depressed. The following are some cognitive-behavioral techniques commonly used to treat depression:

Changing negative thoughts

Our thoughts are one of the  biggest influences on our moods. When we think negative things, we cause our depression to worsen which, in turn, leads to even more negative thinking.  We can start to break this cycle if we notice our unhelpful thoughts and decide if we want to believe them, ignore them, or change them to something more balanced.  We are all vulnerable to negative ways of thinking, often called cognitive distortions. Common cognitive distortions include all-or-nothing thinking, filtering out the positive/focusing on the negative, and catastrophizing.

All-or-nothing thinking leads us to see things as either good or bad, rather than shades of grey.  Things could be going well in many aspects of our lives but if they are going poorly in one area, all-or-nothing thinking leads us to believe everything is bad.  When we filter the positive, we can have successes, receive compliments, but still feel like failures because we ignore those positives and only focus on the times things did not go well.  Catastrophizing leads us to believe that the worst possible outcome is the only possible outcome.  We imagine the worst scenario, making ourselves more miserable.

Behavioral activation

Depression traps us in cycles.  One of these cycles is a spiral of low motivation and reduced pleasure in life.  When we experience reduced pleasure and motivation, we usually start to do fewer things.  Additionally, the exhaustion and negative thinking from depression can cause us to feel completely stuck.  We might start neglecting things like paying bills, talking to people, doing chores, and even showering or cleaning our homes.  People experiencing depression often wait to feel better or motivated again but that motivation doesn’t come.  What we have to do is start using small behaviors to activate us.  When we make ourselves engage in these small behaviors, we actually feel more motivated and energized over time.  In order to break free of the depressive cycle, we must push ourselves to start doing the opposite of what depression tells us to do.  This leads us to more positive reinforcement, greater self-esteem, and desire to do more.

Increasing participation

Life is only as rewarding as far as we participate in it.  We are all connected to each other.  Isolation or feeling disconnected from humanity can worsen depression.  When we learn to participate, we learn to take an active role in our lives. We choose what we want and get the most out of life.  We can also connect to others and this connection can serve as a huge moral and emotional support. Figuring out what kind of life we want to live, and for what reasons, helps us make constructive, purposeful choices, rather than feeling helpless with what life throws at us.

These are just a few of the common cognitive-behavioral techniques that have been shown to be helpful in treating depression.  Therapy for depression can be extremely effective.  It helps us break the chains of depression and get into the life we want.  If you need a therapist for depression, I work with clients in Palm Beach Gardens, Jupiter, North Palm Beach, and Stuart, FL.

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