Psychotherapy for Depression
Cognitive Therapy
At the heart of cognitive therapy is the idea that our thoughts can affect our emotions. For example, if we choose to look for the silver lining in every experience, we will be more likely to feel good, as opposed to if we only focus on the negative.
Negative thoughts can contribute to and exacerbate depression. It's hard to feel good when you're stuck in a constant loop of negative thoughts. Cognitive therapy helps people learn to identify common patterns of negative thinking (known as cognitive distortions) and to turn those negative thought patterns into more positive ones, thus improving mood.2
Cognitive therapy is usually short-term and goal-focused. Therapy sessions are structured with a specific plan for each session, and there is "homework" practice to do outside of therapy. Cognitive therapy usually lasts between six weeks to four months.3
Behavioral Therapy
Whereas cognitive therapy is focused on the negative thoughts that contribute to depression, behavioral therapy is centered on changing behaviors that affect emotions. A central focus of behavioral treatment for depression is behavioral activation. This entails helping patients engage in activities that will enhance their feelings of well-being.
How Behavioral Therapy Works
Cognitive-Behavioral Therapy
Because cognitive therapy and behavioral therapy work well together to treat depression and anxiety disorders, the two are often combined in an approach called cognitive behavioral therapy (CBT). CBT focuses on addressing both the negative thought patterns and the behaviors that contribute to depression.
Your therapist may ask you to keep a journal to track the events of the week and any self-defeating and negative reactions to those events. Habitual negative responses to events (known as automatic negative reactions) are just one pattern of thinking you might address over the course of CBT. Other response patterns include all-or-nothing thinking and overgeneralization, which are two common cognitive distortions.
Once you have learned how to recognize your response patterns, you will work with your therapist to learn new ways of thinking and ways of responding. You might also practice positive self-talk.
Like cognitive therapy and behavioral therapy, CBT is usually brief and goal-oriented. It generally involves between five to 20 structured sessions centered on addressing specific concerns.4
CBT sessions are often accompanied by "homework," which may include keeping a journal, practicing relaxation activities, completing readings, and using worksheets focused on specific goals. Research suggests that CBT can be effective in the treatment of depression and may have lasting effects that prevent future relapses of depressive symptoms.5
How Cognitive Behavioral Therapy Works
Dialectical Behavior Therapy
Dialectical behavior therapy is mostly based on CBT. The key difference is that it asks individuals with depression to acknowledge and accept their negative thoughts and behaviors. Through the practice of validation, individuals can come to terms with their negative emotions, learn to cope with stress and regulate their reactions to it, and even improve their relationships with others.6
This type of psychotherapy also incorporates mindfulness practices from Buddhist traditions to inform crisis coaching, in which an individual can call the therapist to receive guidance on how to handle difficult situations. As the person continues to practice these new skills, they will eventually become better equipped to handle their challenging situations on their own.
The National Alliance on Mental Health states that DBT has been shown to be effective in the treatment of mental illnesses, including depression.
Psychodynamic Therapy
Psychodynamic therapy, also known as psychoanalytic therapy, assumes that depression can occur because of unresolved—usually unconscious—conflicts, often originating from childhood. The goals of this type of therapy are for the patient to become more aware of their full range of emotions, including contradictory and troubling ones, and to help the patient more effectively bear these feelings and put them in a useful perspective.
Unlike some of the other treatment approaches for depression, psychodynamic therapy tends to be less focused and longer-term.7 This approach can be useful for finding connections in past experiences and seeing how those events might contribute to feelings of depression. This approach can also be helpful for building self-awareness and increasing certain emotional capacities.
How Psychoanalytic Therapy Works
Interpersonal Therapy
Interpersonal conflict and poor social support can also contribute to feelings of depression. Interpersonal therapy is a type of therapy that focuses on these issues by addressing past and present social roles and interpersonal interactions. During treatment, the therapist generally chooses one or two problem areas to focus on.
This type of therapy is usually brief and involves examining social relationships with important people in your life. This can include your relationships with your partner, friends, family, and co-workers. The goal is to identify the role these relationships play in your life and find ways of resolving conflicts.
Your therapist might ask you to roleplay different scenarios in order to practice and improve your communication. By doing this, the idea is that you will be able to implement these strategies in your relationships and build a stronger social support system.