Cognitive behavioral therapy (CBT) is one type of psychotherapy that effectively treats depression. It is a short-term, goal-oriented therapy that helps people change their thoughts and behaviors to improve their mood and functioning.

Depression is a serious mental health condition that can cause intense sadness, feelings of hopelessness, and changes in mood and behavior. It can also lead to thoughts of suicide and self-harm.

Doctors may recommend a combination of medication and psychotherapy to manage symptoms of depression. Research has shown that CBT is one of the most effective treatments for depression.

This article explores CBT for depression and how it can help someone manage their symptoms.

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CBT is a structured therapy that involves working with a therapist to identify and change negative thoughts and behaviors.

It can effectively treat a range of mental health conditions, including depression, anxiety disorders, and substance misuse, and can significantly improve a person’s functioning and quality of life.

Several core principles, including the following, form the basis of CBT:

  • Psychological concerns are rooted in unhelpful thoughts and feelings.
  • Psychological concerns stem from learned patterns of unhelpful and negative behavior.
  • People with psychological concerns can learn new coping skills that relieve their symptoms and allow them to lead healthier lives.

CBT is a collaborative therapy. This means the therapist and the individual work together to identify and change potentially harmful thoughts and behaviors. The therapist helps the individual understand how they behave and learn new ways of thinking and acting.

A typical CBT regimen involves 60-minute weekly sessions for 8–12 weeks.

CBT helps a person identify how their understanding of life situations is contributing to their experience of depression.

When a person starts CBT, their therapist may ask them to keep a journal. In this journal, they can record daily events, their thoughts and interpretations of the events, and their resulting emotions or mood.

During a therapy session, the therapist helps the individual evaluate these reactions and thought patterns. The therapist also teaches the person how to identify cognitive distortions — errors in thinking or logic that cause them to come to conclusions that are not necessarily true.

These automatic thoughts often reflect what doctors call the cognitive triad: negative views of oneself, the world, and the future. In the context of depression, this can mean a person feels helpless, hopeless, and worthless.

A person may disqualify positive experiences, discount the importance of good things that happen to them, and remember only negative events. They may also overgeneralize, take things too personally, dwell on negatives, and catastrophize.

During CBT, the therapist helps the individual challenge these distorted thoughts, develop more realistic perspectives, and learn new ways of thinking. They may also help the person identify and change behaviors that are contributing to their depression.

The therapist can help the person by using cognitive techniques such as:

  • managing and modifying distorted thoughts and reactions
  • learning to accurately assess situations and reactions or emotional behavior
  • practicing accurate and balanced self-talk
  • using appropriate self-evaluation to support responses
  • learning more confidence in their abilities
  • using problem-solving skills to cope with challenging situations

They can also teach people behavioral techniques such as:

  • scheduling tasks
  • scheduling pleasurable activities
  • visualization
  • mindfulness meditation
  • breaking large tasks into smaller tasks

CBT helps an individual learn to be their own therapist and focuses on developing more effective ways of coping with life challenges.

If a person is seeking treatment for depression, it is important that they work with a licensed therapist. Although self-therapy techniques are not a replacement for working with a professional, they may be helpful.

Here are some at-home CBT techniques for depression:

  • Practicing gratitude: Identifying the positives in life can help shift a person’s perspective to focus on what is going well. One study suggests that a gratitude practice can help significantly reduce negative thought processes.
  • Scheduling pleasurable activities: People with depression often stop doing activities they once enjoyed. Scheduling small, pleasurable activities into one’s day — such as going for a short walk or getting a coffee — can help reintroduce these activities.
  • Creating a worry-free zone: When someone is in a worry-free zone, they must focus their mental energy on the task at hand rather than let their mind wander. They can use this technique while doing a specified task, when in a certain place, or during a set time.

Even if a person is not seeing a therapist, keeping a journal of their thoughts, feelings, and behaviors can be helpful. Through writing and monitoring, they can begin to learn more about themselves and the issues they are facing. However, if a person experiences suicidal thoughts or ideation, they should seek help immediately.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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In addition to CBT, healthcare professionals use several other psychotherapies to treat depression. Some examples of these are:

  • Dialectical behavioral therapy (DBT): DBT focuses on helping the individual regulate their emotions. It combines CBT with mindfulness techniques and teaches a person how to balance accepting and addressing irrational thoughts and behaviors.
  • Acceptance and commitment therapy: This therapy comes from the theory that pain, disappointment, grief, and anxiety occur naturally in life. It aims to help people develop the mental strength to address these challenges rather than suppress them. It can help with depression, anxiety, and obsessive-compulsive disorder.
  • Rational emotive behavior therapy (REBT): The aim of REBT is to teach individuals how to address unhealthy behaviors and thoughts so that they can change them, leading to a more functional and fulfilling life. REBT leverages the desire to feel happy or fulfilled to reduce depressive symptoms.

Anyone experiencing symptoms of depression should contact a doctor for a diagnosis. A doctor can rule out other causes of symptoms, such as medication side effects, thyroid problems, and sleep disorders.

A doctor can also recommend the best course of treatment, which may include medication or therapy such as CBT.

CBT is a type of therapy that helps individuals develop more effective ways of thinking and behaving. Mental health professionals can use it to treat depression by helping people challenge distorted thoughts and change negative behaviors.

Anyone experiencing symptoms of depression should contact a doctor for a diagnosis and to develop a treatment plan.