Cognitive Behavioral Therapy (CBT) for Depression

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Read Time: 6 Minutes
Written by:Ashley Ertel, LCSW, BCD

Published On: April 22, 2022

Medically reviewed by: Meaghan Rice, PsyD., LPC

Reviewed On: April 22, 2022

Updated On: November 2, 2023

Overview

In 2019, it was estimated that 7.9 percent of American adults — approximately 19.4 million people — had experienced at least one episode of major depression. By 2020, that number had risen substantially to roughly 21 million adults. These stats show us just how common depressive disorders are among adults, but the truth is that depression is a mental health condition that can affect people of all ages, genders, races, and ethnicities.

The challenges depression results in can include a host of quality-of-life issues. People living with a depressive disorder often have difficulty funtioning, experience trouble with interpersonal relationships, battle suicidal ideation, and find themselves facing lost income due to high rates of absenteeism. Most often, the condition has a negative impact on family members and friends, too.

There is some uplifting news, though. When treated with psychotherapy — especially cognitive behavioral therapy for depression — along with the possible use of medication and holistic treatments, depressive symptoms can be managed quite well in most people.

While there are several types of therapy that can effectively treat depression, research tells us that CBT, used in addition to medication, is one of the most effective forms of therapy for depressive disorders.

Keep reading to learn more about this powerful therapy that has changed the lives of countless people living with depression.

How Does CBT Work for Treating Depression?

Cognitive behavioral therapy for depression uses real-life scenarios, pulled from your current reality and situation, in your treatment plan. The goal of CBT for depression therapy is to identify and correct distorted thought patterns that result in negative outcomes.

During an initial CBT session, initial sessions, your therapist will first help you examine why you’re experiencing acute or severe depression. The goal here is to rule out imbalances in certain brain chemicals. You’ll review medications you might be currently taking and discuss any major life events where experiencing short-term depression would be appropriate.

Cognitive behavioral therapy for depression works by helping you look at your perceptions of events and interpretations of reality. Most people living with acute or severe depression find that a lot of their thought patterns are actually false, though automatic and disruptive.

Next, you’ll learn to substitute more appropriate, healthier alternative thinking patterns. Your new way of thinking can help you overcome distorted views that are contributing to your depressed and low moods.

As your cognitive therapy sessions progress, you’ll begin immediately reframing your life situations. The final outcome? You’ll be able to actively alter your thought processes and related behaviors, resulting in changed and improved mood, behavior, and physical reactions.

Common CBT techniques for depression

There are several proven techniques used in CBT. Some examples of CBT treatments for depression can include:

  • Fact-checking — While in a depressive state of mind, fact-checking your thought patterns and situations can be really helpful. You’ll learn to determine if what you’re thinking about people, situations, or yourself is truth, just opinions, or a temporary state of mind leading to a fatalistic mindset.
  • Thought journaling — Writing down automatic thoughts and emotions allows you to better process events in your life. It’s also an effective way to identify triggers and things that might be contributing to or causing your depression.
  • ABC analysis — Changing reactions and behaviors can be easier if you learn to break down life events using the A-B-C method. To do this, you’ll qualify things as:
    • (A) Activating events
    • (B) Beliefs about that event
    • (C) Consequences of different paths of behavior

This lets you examine specific parts of an event to recognize where your old belief patterns are so you can choose more effective ways to cope.

  • Cognitive restructuring — Restructuring is an effective technique that teaches you how to challenge your automatic thoughts and the tone of your self-talk. You’ll learn how to recognize distorted and unhealthy or negative thought patterns that are likely contributing to your depression.

iconExpert Insight

“CBT is an effective approach to treating a wide range of mental health challenges, especially depression. CBT is easy for clients to follow along and stay fully engaged in their own healthcare. CBT is diverse enough to be tailored exactly to your individual needs and never has to be cookie-cutter.”
Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

Types of Depression CBT Can Treat

CBT for depression can be used to treat various types of depression. It’s especially helpful for people who haven’t responded well to medication and/or other forms of therapy. The various types of depressive episodes and disorders that cognitive behavioral therapy can treat include:

  • Persistent depressive disorder (PDD) — Formerly known as dysthymic disorder, PDD is a mild to moderate chronic depression that doesn’t seem to go away on its own.
  • Major depressive disorder (MDD) — Also known as clinical depression, MDD is an extreme form of depression that causes a variety of emotional and physical problems.
  • Seasonal affective disorder (SAD) — Depression that occurs with a change in the seasons; most often occurs in the winter months, but can happen during warmer months for some people.
  • Postpartum depression — Now known as a major depressive disorder with peripartum onset or just peripartum depression, this form of depression is associated with pregnancy and childbirth.
  • Situational depression — Clinically known as adjustment disorder with depressed mood, situational depression is caused by a stressful, traumatic, or life-altering event.

There are also forms of depression that occur comorbidly (simultaneously) with other mental health conditions, including bipolar disorder and schizoaffective disorder.

Finally, it’s extremely important to also consider people who experience secondary depression. This type of depression is common when you’re experiencing a life-threatening medical illness or end-of-life hospitalization.

Effectiveness of CBT in Treating Depression

CBT for depression has been widely proven as an effective treatment for continued and long-term recovery, especially when CBT treatment therapy is in conjunction with medication for depression.

Research and reviews done by NCBI show that cognitive behavioral therapy (CBT) for depression is one of the most effective evidence-based therapeutic interventions for the treatment of several mental health conditions, including depression.

One meta-analysis reviewing more than 100 studies found that CBT combined with medication is drastically more effective than just medication alone. Further, there’s research that suggests the combined treatment also is better at preventing relapse.

A peer-reviewed journal study found that most patients tend to stay with their CBT for depression treatment plans (the dropout rate was just 17.5%). Other exciting findings show:

  • 44% of people showed significant improvements in their depression symptoms after treatment
  • 30% had recovered

The numbers improved even more during a follow-up:

  • 57% reported significant improvement in depressive symptoms
  • 40% reported recovery

No predictors of dropout or treatment response were found. Needless to say, the science is encouraging.

How long does it take to work?

Results can vary and will depend on several factors, including severity of symptoms and personal motivation.

Traditional CBT treatment, when you visit a therapist on a weekly basis for 30- to 60-minute sessions, can often offer a significant reduction in depression symptoms within 12 to 20 weeks.

iconExpert Insight

“CBT is one of the most widely accepted evidence-based treatment approaches for depression. The benefits are frequently seen within the first few months, though some people prefer to continue treatment longer for continued positive gains.”
Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

Conclusion

If you experience acute bouts of depression or have long-term symptoms, speak with your doctor about cognitive behavioral therapy for depression. CBT is just one of the many therapy methods for depression and other disorders. Another interesting therapy method is Dialectical Behavioral Therapy which is a modified version of CBT that focuses on radical acceptance of pain and situations. DBT for borderline personality disorder and DBT for PTSD are also options that you could explore with a licensed medical professional if you struggle with other disorders. You might consider finding online therapy programs that are more convenient and easy to access. Be prepared to discuss your mental health history and current circumstances to discover if CBT can be an appropriate form of treatment.

Cognitive behavioral therapy requires a willingness to try new practices. You also must be open to changing your current belief systems and alter how you process information. Successful CBT can allow you to replace any negative thought or behavior with more effective, healthier, positive choices. You don’t have to allow your depression to rule your life. There is help available. CBT for depression might be your path to healing.

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Ashley Ertel

Ashley Ertel, LCSW, is a Nationally Board Certified Licensed Clinical Social Worker. She has over a decade of experience specializing in trauma and depression, working primarily with first responders, military personnel, and veterans, and sexual assault survivors.

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