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CBT Cognitive Behavioural Therapy for Depression

Evidence suggests that CBT cognitive behavioural therapy is at least as effective as medication for depression, and leads to lower relapse rates. This is because it gets to the heart of the 'vicious cycle' of negative thoughts, feelings and actions that depression can trap us in.

The many symptoms of depression

Perhaps you’re experiencing a persistent emotional slump. You might feel sad, anxious, empty, hopeless, helpless, worthless, guilty or irritable. Perhaps you’ve lost interest in doing things that you once used to find fun, or you struggle to get excited about things that used to interest you.

You might have lost your appetite or be eating much more than usual, have problems concentrating, remembering details or making decisions. You may find it hard to sleep, wake up unusually early in the morning, or feel fatigued throughout the day; you may experience aches and pains or digestive problems with no clear cause; you may even have thoughts of ending it all.

These are all symptoms of depression which can be felt to varying degrees and in varying combinations by different people.

The ways in which we think, feel and behave are all intimately connected. This is particularly true of the symptoms of depression, which can involve negative thoughts and low mood, and make it hard to do even simple things we can find so easy to achieve when we are happy. Contrary to popular belief, depression isn’t always just about ‘feeling sad’.

Depression isn't just about 'feeling sad'

CBT Cognitive Behavioural Therapy–the most popular therapy used in the battle against depression–aims to explore the negative aspects of these connections and empower you to make the necessary changes that can pull you out of unhelpful patterns of thoughts, mood and behaviour and towards a more enjoyable way of living.

Problems maintained styles of thinking

It is based on the premise that emotional problems are maintained by our styles of thinking, and that we can instigate positive changes in these factors through cognitive and behavioural techniques. In undertaking them, these techniques help us to develop more adaptive and healthy thoughts and actions with a recognition that what we think and what we do are deeply connected and can have a strong impact on how we feel.

CBT can be tailored to each person’s needs at a number of levels of intensity, making it useful whether you’ve only just started feeling mildly out of sorts, or if you have been battling depression for a long time. The techniques that the therapist will take you through depends on the ‘cognitive biases’ and underlying deeply-held assumptions about yourself, the world and others (‘schemas’) that they can identify through talking to you.

Cognitive biases that are commonly held by depressives include:

  • Dichotomous thinking: Viewing everything as either entirely good, or entirely bad, with even the smallest problem or flaw rendering a situation hopeless
  • Overgeneralization: Extrapolating from one negative event to view everything as negative
  • Magnification or minimization: Inflating the negative details and ignoring or minimizing the positive details

Restructuring cognitions

CBT aims to restructure these negative biases into a more realistic and balanced view of the world. This involves helping you to identify the thoughts and beliefs that are fuelling your negative emotions, evaluating them for their accuracy or usefulness with the use of logic and evidence (often helped by behavioural experiments as ‘homework’, which allow you to confirm or dis-confirm the accuracy of your cognitive biases by testing them out in the real world) and, if need be, replacing your negative thoughts with more accurate and adapting thinking habits.

Evidence suggests that relapse rates of depression are much lower for people who undergo CBT either alone or in conjunction with medication, compared to those who take medication alone or use no intervention. This is thought to be because CBT is essentially training that arms you with the tools to tackle problems out of the context of therapy, long after your time with your therapist has ended: CBT empowers you to be your own therapist.

The House Partnership, 5th August 2015


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