Best Therapy for Depression

Nancy Schimelpfening, M.S.

Nancy Schimelpfening is the founder of Depression Sanctuary. Unless otherwise stated, all of the content on Depression Sanctuary is written by and maintained by Nancy. Nancy has a master’s degree in community health education from Old Dominion University in Norfolk, VA. She was the About.com (now Verywell.com) expert on depression from 1998 – 2016. She has also written for other online publications, including Healthline and Health Digest.

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Best Therapy for Depression

You may be wondering what is the best therapy for depression?  What if I told you there is a type of  therapy that can often work just as well as, or even better than, antidepressants?  And, if you combine it with antidepressants, you will get even better results than medications alone?  Sounds pretty good, right?  Well, such a therapy does exist.  It’s name is cognitive behavioral therapy.

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is a type of talk therapy.  In other words, it involves sitting down with a trained therapist and talking in order to conduct the treatment.

It is based upon the idea that our thoughts and actions give rise to our emotions.  So, if a person has a habit of thinking negative thoughts, this can lead them to feel negative emotions.   

Cognitive behavioral therapy helps to teach people to recognize their negative thoughts and behaviors, change them to more helpful ones and thus begin to feel better.

What Makes It the Best Therapy for Depression?

Cognitive behavioral therapy is the best therapy for depression because it has the most research behind it proving its efficacy.  In many cases, it works as well as an antidepressant or even better.  It also increases the effectiveness of antidepressants when both treatments are given at the same time.  Research further indicates that people receiving cognitive behavioral therapy are half as likely as those on an antidepressant alone to relapse within the first year after treatment.

In addition to it’s effectiveness in treating depression, cognitive behavioral therapy has the added advantage of being a non-drug therapy.   If you respond well to it, you may be able to avoid the many side effects associated with medications.  And, even better, its effects tend to be long-lasting because it gives you the skills you need to prevent future episodes of depression.

Types of Cognitive Behavioral Therapy

There are several subtypes of therapy that fall under the umbrella of cognitive behavioral therapy.  Some examples include the following:

Cognitive Therapy

Cognitive therapy involves working with the patient to identify how their thoughts are influencing their emotions so that they can modify their depression by making changes in how they think.

While the terms cognitive therapy and cognitive behavioral therapy are often used interchangeably,  cognitive behavioral therapy is an umbrella term that includes cognitive therapy as well as several other types of therapy that are all based upon the same general ideas.

It was originally developed for treating depression, but it has applications in anxiety disorders as well as other conditions.

Dialectical Behavior Therapy

Dialectical behavior therapy is a modification to cognitive behavioral therapy that puts emphasis not only on helping the patient create change for himself, but also in balancing this need for change with an acceptance of the patient just as he is. 

It is particularly helpful for patients who may feel that no one understands or acknowledges their pain and suffering.

Dialetical behavior therapy is well-suited for those with borderline personality disorder.

Problem-Solving Therapy

This type of therapy has the goal of helping people better cope with stressful situations. 

Its basis is the idea that depression is the result of poor coping skills.

Problem-solving therapy seeks to help people develop the skills needed to cope with emotional distress and take a more optimistic approach to their problems.  It teaches people to create a healthy plan of action for dealing with the stessors in their lives.

It can be very helpful in cases where the problems in your life are contributing to your depression and anxiety.

Exposure Response Prevention

Exposure response prevention is a more behaviorally-based type of therapy.  It involves intentionally exposing yourself to thoughts, images, situations, etc. that tend to trigger an undesirable reaction in yourself.  You then make a conscious effort to refrain from whatever ritualized or maladaptive behavior that you would normally feel compelled to do in that particular situation.  Over time, exposure response therapy can help you extinguish the connection between the trigger and the behavior.

This variation of cognitive behavioral therapy is particularly good for those with obsessive-compulsive disorder.

Stress Inoculation

The goal of stress inoculation therapy is to help you prepare in advance for what you know will be a stressful situation so that you can successfully navigate it when it does occur.

The benefit of stress inoculation is in helping you cope better with stressful events when they occur.  When you are better able to cope with stress, you are less prone to depression and anxiety.

Who Can Provide Cognitive Behavioral Therapy?

There are several types of mental health professionals who might provide you with therapy, such a psychiatrist, a psychologist, a licensed counselor or a licensed clinical social worker.

What Is Cognitive Behavioral Therapy Like?

Cognitive behavioral therapy tends to be very goal-oriented and focused on your present feelings and thoughts. 

At the outset, you work with your therapist to set goals for treatment, such as improving your depression symptoms or dealing with any problem behaviors like excessive drinking. 

Your therapist will work with you over the course of about 10-20 sessions — though some may attend therapy for longer — to identify any maladaptive thoughts or behaviors you are experiencing and how those make you feel.  She or he will then teach you how to change those thoughts or behaviors in ways that are more conducive to a happy and effective life.  You will probably also be given “homework” to practice your new skills.

An additional part of treatment will be learning skills for the prevention of future depression episodes.

Is Cognitive Behavioral Therapy Right for You?

Cognitive behavioral therapy is particularly good for depression and anxiety, but it can be helpful with other disorders as well.

It works best when you have very specific problems that you wish to deal with.  For example, if you generally feel dissatisfied with life, but don’t know why, it may be less effective than if you have a specific goal like learning how to manage your anger.

You need to be open to the process.  If you feel defensive, doubt that it can help, or are resistant to exploring your thoughts and emotions, it will be more difficult for you to benefit from it.

You must be willing to work at it, both inside and outside of your sessions.  Cognitive behavioral therapy involves learning and practicing a new set of skills.  Like learning any new skill, you will get better the more you practice.

Previously failing with cognitive behavioral therapy does not mean it won’t work for you.  Many factors can influence the outcome of therapy. And, just because it failed before does not mean it will not work now.  For example, you may have simply not been ready at the time and now you are. Or it might be that your previous therapist was not a good match for you.

Under the right circumstances, cognitive behavioral therapy can be very effective.  Many even report it to be “life changing.” If you are suffering from depression and/or anxiety, it is definitely worth a try.

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