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Cognitive behavioral therapy is one of the most well-studied depression treatments around. It may benefit you as a stand-alone treatment or in combination with antidepressants.

Depression is one of the most common mental health struggles around — about one in every four women and one in six men will struggle with it at some point during their lives. The good news is that this means that depression is extremely well-studied and effective treatment guidelines have been developed. If you're diagnosed with depression, depending on the severity of your symptoms, your doctor will most likely suggest antidepressants, talk therapy, or a combination of both. Of all the different kinds of talk therapy that exist, cognitive behavioral therapy has been most widely researched.

What do you need to know if your healthcare provider has suggested you try CBT for your depression?

What is cognitive behavioral therapy?

Cognitive behavioral therapy is one of the most popular and successful forms of talk therapy out there. Its basic idea is to analyze your thoughts (cognitions — hence the name) to see which ideas you hold may be false, negative, or unhelpful. You will then begin working, together with your therapist, on changing them. 

Cognitive behavioral therapy recognizes that the situations people find themselves in, the thoughts, feelings, and physical reactions we have in response to them, and our behavior are all interconnected. Think differently, and you'll also feel different, react differently, and get different reactions from other people you interact with. 

What can you expect from cognitive behavioral therapy in practice?

Your first session will essentially consist of a chat during which your therapist can familiarize themselves with your current struggles and anything you want to tackle in therapy. You will then start doing the real work — your therapist isn't there to fix you, but to teach you strategies, help you problem-solve, help you decide which goals you want to set, and provide insights as you discuss your circumstances and thoughts. You'll do the work, in other words, but your therapist is there to help you decide what works needs to be done, and how. Yes, there will be homework, as you put your newly-learned strategies in place in real life to test how they work out for you, which you can then discuss with your therapist during the next session.

CBT doesn't go on forever — it's a solution-focused therapy that will yield fairly quick results if it does work for you, making it a good treatment option for pragmatic people who are eager to see results. You will typically meet with your therapist once a week for an hour. Though the number of sessions folks have varies, research shows that people with depression tend to benefit more from six to eight sessions than from less, but that having more than eight sessions doesn't necessarily offer additional benefits. 

Is CBT helpful for depression?

Yes. Many people find cognitive behavioral therapy to be extremely helpful in the treatment of depression and it is, along with interpersonal therapy (which focuses more on how your relationships with other people impact your feelings and behavior), the talk therapy that has been studied most. Time and time again, research has shown that cognitive behavioral therapy is effective — sometimes even as effective as antidepressant medications.

CBT may be most helpful for those depressed people who are also experiencing objectively stressful life circumstances, like social isolation, conflicts with loved ones, or a bereavement, research suggests. 

Cognitive behavioral therapy may be for you if you are depressed and:

  • Your depression was diagnosed as mild but it isn't getting better. 
  • Your depression is moderate to severe and you are also taking an antidepressant — that is to say, CBT in combination with antidepressant therapy is more likely to yield positive results than CBT alone for most people. 
  • Your depression is moderate to severe and you have a specific reason to avoid antidepressant medications, such as being pregnant or breastfeeding. In this case, cognitive behavioral therapy can be tried as a stand-alone treatment. 

Studies have shown that the effects of cognitive behavioral therapy last far beyond the treatment itself. People who were previously diagnosed with clinical depression and then participated in CBT are less likely than others to become depressed again. This is important, because half of all people who have been depressed in the past suffer from another bout of depression at some point in the future. Cognitive behavioral therapy may also play a role in preventing those relapses, and it may be helpful to periodically see a therapist even after you recover from depression — as a kind of "maintenance dose", similar to the way in which antidepressants are used to prevent relapses. 

In conclusion

Cognitive behavioral therapy helps some people overcome depression as a stand-alone treatment, while others recover from major depressive disorder through a combination of CBT and antidepressant therapy. While there are other forms of talk therapy that can also benefit depressed patients, cognitive behavioral therapy is the most widely studied therapy, and research suggests good results on the whole. If your doctor has referred you for CBT, you can expect hard and sometimes exhausting work, but hopefully also positive results. 

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