Depression & Low Mood

Cognitive behavioral therapy (CBT) is an effective treatment for depression. At the heart of CBT is an assumption that a person’s mood is directly related to his or her patterns of thought. Negative, unhelpful thinking affects a person’s mood, sense of self, behaviour, and even physical state. The goal of cognitive behavioural therapy is to help a person learn to recognise unhelpful patterns of thought, evaluate their validity, and replace them with healthier ways of thinking.

At the same time, the aim of therapy is to help you change patterns of behaviour that come from unhelpful thinking. Unhelpful thoughts and behaviours predispose an individual to depression and make it nearly impossible to escape its downward spiral. When patterns of thought and behaviour are changed, so is mood.

The focus and method of cognitive behavioral therapy sets it apart from other, more traditional therapies:

CBT is based on two specific tasks: cognitive restructuring, in which the therapist and patient work together to change unhelpful thinking patterns, and behavioral activation – in which patients learn to overcome obstacles to participating in enjoyable activities. CBT focuses on the immediate present: what and how a person thinks more than why a person thinks that way.

– CBT focuses on specific problems. In sessions, unhelpful behaviours and unhelpful thinking are identified, prioritised, and specifically addressed.

– CBT is goal oriented. Patients working with their therapists are asked to define goals for each session as well as longer-term goals. Longer-term goals may take several weeks or months to achieve. Some goals may even be targeted for completion after the sessions come to an end.

– The approach of CBT is educational. The therapist uses structured learning experiences that teach patients to monitor and write down their negative thoughts and mental images. The goal is to recognise how those ideas affect their mood, behaviour, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences.

– CBT patients are expected to take an active role in their learning, in the session and between sessions. They are given homework assignments at each session and the assignment tasks are reviewed at the start of the next session.

– CBT employs multiple strategies, including Socratic questioning, role playing, imagery, guided discovery, and behavioural experiments.

– CBT is time limited.

Anyone with depression can potentially benefit from cognitive behavioural therapy, even without taking medication. A number of studies have shown CBT to be at least as effective as antidepressants in treating mild and moderate depression. Studies also show that a combination of antidepressants and CBT can be effective in treating major depression.

Although a wide range of people respond well to cognitive behavioral therapy, experts point out that the type of person likely to get the most benefit is someone who: