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, and it's used to treat various conditions including depression, anxiety disorders, substance use disorders, eating disorders, bipolar disorder, and others. If you are interested in using CBT to address signs of depression, it may be beneficial to understand how this type of therapy works and what symptoms it can treat.   

What is depression? 

Depression, a common term for major depressive disorder (MDD), is a serious mood disorder primarily characterized by a persistent feeling of hopelessness or sadness that lasts for over two weeks. There are types of several depressive disorders that a person could 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. 

Physical and behavioral symptoms of depression 

This mental illness can look different from one person to the next, and not everyone experiences the same symptoms. That said, below are several of the most common physical and behavioral symptoms that may be seen in those with 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 decreased energy levels overall 

• 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 

• Increased substance use or misuse 

• 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? 

This type of cognitive 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. 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.

Over time, cognitive behavioral therapy can help clients form new, healthy coping skills instead of reverting to actions that have not served them in the past. CBT can also support the development of emotional control and improved stress-management skills.  

Techniques used in cognitive behavioral therapy for depression 

CBT’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, part of an approach called behavioral activation, focuses on helping the client identify and schedule activities they can partake in throughout the day that may help them build self-care habits and develop a more positive attitude toward themselves. Examples of these activities could include taking a shower, 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 also work together to create reward incentives to motivate yourself to continue to complete these activities even when your depression symptoms are more severe.  

Thought journaling  

Another CBT technique that could be helpful for depression is thought journaling, also called keeping 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 behavioral 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 developing 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 a beneficial alternative. With online therapy through a platform like BetterHelp, you can connect with a trained professional specializing in different therapeutic techniques, including cognitive behavioral therapy, and meet with them from the comfort of home 

Research has demonstrated that online cognitive behavioral therapy for depression may be an effective form of treatment in many cases. For instance, one systematic review suggests that internet-delivered CBT may effectively reduce depression symptoms.