Cognitive-behavioral therapy and depression: How can CBT help?

If you are seeking methods to treat depression or another mental health condition, you may have encountered the term “cognitive-behavioral therapy.” Cognitive-behavioral therapy (CBT) is one of the most well-known and widely practiced forms of talk therapy, treating various conditions, including depression, anxiety disorders, substance use disorders, eating disorders, and others. If you are interested in using CBT for depression, it may be beneficial to understand how this therapy works and what symptoms it can treat.  

What is depression?

Depression, a term for major depressive disorder (MDD), is a serious mood disorder characterized by a persistent feeling of hopelessness or sadness that lasts for over two weeks. There are several depressive disorders that one can be diagnosed with, including major depression, persistent depressive disorder, and seasonal affective disorder, among others. 

Depression is more than feeling sad or “down.” Depressive disorders are characterized by a range of physical and emotional symptoms that can significantly impact a person’s ability to function. This mental illness can look different from one person to the next, and not everyone experiences the same symptoms. 

Physical and behavioral symptoms of depression

Below are several of the physical and behavioral symptoms that may be seen in depression: 

• Noticeable changes in sleep schedules and patterns, including insomnia or excessive sleeping
• Dramatic shifts in eating habits, including decreased appetite or increased food consumption
• Weight loss or gain as a result of changed eating habits
• Exhaustion, regardless of how often one sleeps 
• Lethargy and overall decreased energy levels
• Persistent pain or aches with no identifiable cause 
• Difficulty making decisions 
• Memory lapses 
• Difficulty concentrating 
• Agitation
• Restlessness
• Slower movements and slowed speech
• Isolation from others
• Substance use
• Unhealthy coping mechanisms
• Neglect of personal responsibilities or close relationships
• Decrease in attention paid to personal hygiene 
• Nervous behaviors like wringing hands or pacing back and forth
• Missing work or school
• Self-harm 
• Self-destructive behavior 

Emotional symptoms of depression

Below are some of the most common emotional symptoms that may arise with depression: 

• Ongoing and persistent negative thoughts
• Persistent and severe sadness 
• Irritability and anger 
• Hopelessness
• Poor self-esteem 
• Perceived emptiness or numbness 
• An increased tendency to blame oneself
• Guilt and shame 
• Sensitivity to criticism
• Perceived worthlessness 
• A tendency to hyper-focus on past mistakes and criticism 
• Relationship conflict 
• A loss of interest in previously enjoyed hobbies 
• A bleak worldview
• Frequent thoughts of death or suicide 

What is cognitive-behavioral therapy?

Cognitive-behavioral therapy operates on the premise that shifting a person’s thoughts and attitudes can result in positive behavioral change. In CBT, a therapist can work with an individual to identify unhealthy or ineffective thought patterns or assumptions they may hold. Once those patterns have been identified, the client can better understand the negative effect they may be having on their life, learning to comprehend the link between thought and behavior. After identifying these patterns, the client and therapist can work to replace them with more positive or productive ones. Restructuring can lead to more beneficial behaviors and outcomes, including significant life changes.

Cognitive-behavioral therapy can help clients form new, healthy coping skills instead of reverting to actions that have not served an individual in the past. CBT can also support the development of emotional control, and stress management techniques. 

Techniques used in cognitive-behavioral therapy for depression

Cognitive-behavioral therapy’s focus on shifting maladaptive thought patterns may be vital in addressing depression symptoms, as one of the central aspects of depression is persistent and distressing negative thoughts. Below are a few of these techniques. 

Activity scheduling 

Activity scheduling focuses on helping the client identify and schedule activities they can partake in throughout the day that build self-care habits and develop a more positive attitude toward themselves. These activities could include taking a shower to combat the personal hygiene-related symptoms of depression, going for a walk, or repeating affirmations. 

Affirmations might include phrases like, “I am good enough exactly as I am” or “I’m proud of myself for trying.” You and your therapist can work together to create reward incentives to motivate yourself to continue to complete these activities even when your depression symptoms are more severe. Some people use sticker charts to “cash in” stickers for certain “prizes.” 

Thought journaling 

Another CBT technique that could be helpful for depression is thought journaling, also called a thought diary or thought record. Thought journaling involves building a journaling practice where you write about your thoughts and feelings, particularly in response to stressful situations. With this writing practice, you can note when a stressful event arises, the thoughts you have when it happens, the emotions it prompts, and your behavior urges.  

Thought journaling can help you identify aspects of your life that may prompt unhappy thoughts and understand how these thoughts influence your behavior. Once you understand the relationship between your thoughts and behaviors, this increased self-awareness can help you learn coping mechanisms for addressing your depression symptoms. 

Finding support for depression

If you are interested in pursuing cognitive-behavioral therapy treatment options to address your depression symptoms, consider reaching out to a licensed therapist. A therapist can aid you in identifying unhelpful patterns and finding evidence-backed coping mechanisms to address them.  

People experiencing depression may sometimes have difficulty leaving the house due to fatigue, exhaustion, and other symptoms. If this is the case for you, online therapy may be beneficial. With online therapy through a platform like BetterHelp, you can connect with a trained professional specializing in different therapeutic techniques, including cognitive-behavioral therapy, meeting with the therapist from home. In addition, you can choose between phone, video, or chat sessions. 

Research has demonstrated that online therapy can be an effective treatment option for mental illnesses like depression. For instance, one systematic review study found that internet-delivered CBT, both guided and unguided, effectively reduced symptoms in the participants. These impacts were experienced in those with mild to severe depression, showcasing the range of symptoms online therapy may treat.