Cognitive behavioral therapy, or CBT, is a common type of talk therapy that for some people can work as well or better than medication to treat depression. It can be effective if your depression is mild or moderate. It also can help with more severe cases if your therapist is highly skilled. In some cases, CBT can help you the most if you combine it with other treatments, like antidepressants or other drugs.
How CBT Works
A therapist helps you identify negative or false thoughts and replace those thoughts with healthier, more realistic ones. For example, you might feel worthless or believe that your life is bad and will only get worse. Or you might obsess over your flaws and shortcomings.
First, CBT makes you aware you have these thoughts. Then it teaches you to swap them for more positive ones. The change in your attitude leads to a change in your behavior. That can help ease your depression.
You may wake up in the morning and wonder, “What’s the point of trying?” With CBT, you learn to tell yourself, “That’s not a helpful thought. Making an effort has lots of rewards. I’ll start by getting out of bed.”
You may need weeks or months of CBT before you start to feel better.
How Well Does It Work?
CBT is the best-proven form of talk therapy, also called psychotherapy. It sometimes works as well as antidepressant drugs for some types of depression. Some research suggests that people who get CBT may be half as likely as those on medication alone to have depression again within a year.
Medication works well to treat depression. If you also get CBT, your treatment might work even better and the benefits might last longer. Most people who get CBT for depression or anxiety continue to keep using the skills they learned in therapy a year later.
If you are on medication for depression, never stop taking it without talking to your doctor first, even if you’re working with a CBT therapist. If you quit suddenly, it can cause severe depression and other problems.
What to Expect
You can get CBT from a psychologist, licensed counselor, licensed clinical social worker, or other professionals with mental health training. Sessions can be one-on-one, in a group, or with self-help materials under your therapist’s guidance.
Your therapist will work with you to set treatment goals, like to feel less depressed or to cut back on alcohol. Usually, you won’t spend much time focusing on your past or your personality traits. Instead, your therapist will help you focus on what you feel and think now, and how to change it.
Treatment usually lasts 10-20 sessions. Some people go just a few times, while others may get therapy for more than a year. Your therapist may give you tasks to do on your own.
Before your treatment ends, your therapist will show you skills to keep your depression from coming back. If it does, it’s a good idea to pick up therapy again. You can also do it any time you feel bad or need to work through a tough problem.
Work only with trained psychotherapists. Their job titles can differ, depending on their role and their education. Most have a master’s or a doctoral degree with specific training in psychological counseling. Psychiatrists, for example, are medical doctors who can prescribe medication and offer psychotherapy.
Before you pick a therapist, check their:
- Certification and license in your state
- Area of expertise, and if it includes depression. Some therapists specialize in eating disorders, PTSD, and other conditions.
It’s important that you trust your therapist and feel they’re on your side. If you’re uncomfortable or don’t see any improvements, you may want to switch therapists.