It’s totally natural to feel a little down once in a while, but if those blues don’t ever seem to go away, that could be a sign of depression. Major depression is defined as a period of sadness along with other emotional and physical symptoms (lethargy, lack of interest in usual activities, etc.) that lasts for at least two weeks in a row, and is serious enough to interrupt your daily life. It does not mean you are a weak or negative person. Depression is a major public health concern, and medical condition that can be treated.
Signs and symptoms (emotional)
- Melancholy mood and/or general loss of interest in life
- No longer finding previously enjoyable things appealing
- Feelings of guilt or worthlessness, loss of hope
- Recurring thoughts of suicide or death
- Inability to concentrate
Signs and symptoms (physical)
- Fatigue and lack of energy
- Insomnia, routinely waking too early
- Sleeping excessively
- Persistent aches and pains, cramps, digestive issues, cramps, headaches, etc. that can’t be relieved by treatment
- Change in appetite (and related weight gain or loss)
Depression can make other health issues, such as chronic pain, feel even worse. Because key brain chemicals affect both mood and pain, treating depression has been shown to improve other ailments as well.
Left untreated, the emotional and physical upheaval caused by depression can do serious damage to your relationships, career, and hobbies, as depressed people usually have trouble concentrating and making decisions, and often abandon activities they used to enjoy—including sex. In severe cases, depression can be life threatening.
Cognitive behavioral therapy (CBT) is known to be effective in treating depression, since at the core of CBT is that dysfunctional thinking can affect your mood, behavior, sense of self, band even physical health. The goal of cognitive behavioral therapy is to help you recognize thought patterns that are negative, evaluate how legitimate they are, and substitute healthier ways of thinking.
CBT therapists can also help you change behavior patterns that result from such dysfunctional thinking. Negative thoughts and behavior can make you prone to depression, and trap you in an inescapable downhill battle. But when you change those negative patterns, say CBT researchers and therapists, you change your mood.
How is cognitive behavioral therapy different from other treatments for depression?
- Is based on cognitive restructuring (therapist and patient collaborate to change thought patterns) and behavioral activation (patients learn to overcome barriers that prevent them from doing things they normally enjoy). It focuses on what and how you think, rather than why you think that way.
- Focuses on particular problems, thinking, and behaviors. Once they’re identified, they’re prioritized and specifically addressed.
- Is goal oriented. You’ll be asked by your therapist to define your goals for every session, as well as your long-term goals—which may take weeks or months to achieve. Your treatment plan may also include goals to be met after your sessions are finished.
- Uses an educational approach. Structured learning assignments teach you to observe and write down your negative thoughts and mental images in order to recognize how they affect your moods, behavior, and physical state. You’ll also learn coping skills, such as problem solving and planning enjoyable experiences. As a CBT patient, you will be expected to actively participate in your own learning, both during and between sessions. There are homework assignments in each session—some graded—and the assigned tasks are reviewed at the beginning of the next session.
- Uses a number of strategies, including role play, behavioral experiments, Socratic questioning, imagery, and guided discovery.
Who can benefit from CBT treatment?
Patients (both adults and adolescents) with mild or moderate depression can benefit, even without medication. Several studies have shown CBT to be at least as effective as antidepressants, and have also found that a combination of antidepressants and CBT can effectively treat major depression. In addition, it can reduce the occurrence of relapse in those who have a tendency toward frequent relapses after completing other treatments.
Nearly two out of three patients successfully treated for depression do well with medications alone. Others, however, still experience symptoms even when medication is partially working. CBT can treat many of these patients.
Although all kinds of people benefit from cognitive behavioral therapy, experts say those likely to have the most success are motivated, believe themselves capable of controlling things that happen around them, and have the capacity for self-reflection.