Depression and CBT



Depression is one of the most common mental health problems, affecting millions of people worldwide, with 4.5% of people in the UK living with a depressive disorder [1]. Everyone experiences, describes, and labels their own feelings and emotions in different ways, regardless of an official clinical diagnosis. It is important to understand that although everyone feels low sometimes, when these feelings do not pass, they can develop into a more serious mood disorder and have marked effects on daily life. Anyone can experience depression at any stage in life, but some risk factors include genetics, grief, conflict, abuse, childhood trauma, life events and changes, and chronic illnesses [2].

Depression is characterised by the presence of a sustained low mood or diminished interest in activities occurring most of the day, nearly every day for nearly two weeks [3]. Accompanying emotional, cognitive, and physical symptoms are:

· Poor concentration, inattentiveness, and indecisiveness

· Feelings of worthlessness or excessive guilt

· Recurrent thoughts of death, suicidal ideation, or attempted suicide

· Insomnia or excessive sleep

· Significant changes in appetite or weight

· Psychomotor agitation or retardation

· Reduced energy or fatigue

· Noticeable slowing of thought and physical movement [4].

During a depressive episode, an individual may experience significant difficulty in personal, family, social, educational, occupational, and/or other important areas of functioning [5], which can make both living with depression and supporting someone with depression difficult. There is also a lot of stigma around depression, with many individuals feeling invalidated and/or unheard. The label of a clinical diagnosis can be reassuring for some but daunting for others. Either way, if you or someone you know has been experiencing any of the symptoms above, often the best thing to do is to address the issue and get professional help.

A common treatment for depression is Cognitive Behavioural Therapy, or CBT, which is often used on its own to treat mild to moderate depression, or alongside antidepressant medication in cases of more severe depression [6]. CBT is a talking therapy that can help to manage depression by changing thought patterns and behaviour [7]. It is rooted in the knowledge that thoughts, feelings, and behaviours are interconnected and dependent on one another. This relationship is represented visually in the image below.



Through this concept, we can understand how depression develops through negative patterns of thoughts, feelings and behaviours which become a vicious cycle. This cycle can be difficult to recognise and deal with alone, particularly when experiencing symptoms of hopelessness. However, CBT focuses on breaking bigger problems down into smaller parts in order to recognise the patterns and learn new skills to frame thoughts and feelings in a more positive way [8]. Unlike other talking and psychotherapies, CBT focuses on current problems and how to deal with them, as opposed to focusing on issues from the past.

Many therapists tailor their approach to their client’s specific situation and goals, for example working on challenging particular negative thought patterns and learning new behavioural responses to certain challenging or stressful situations [9]. This can be done by assessing current life situations and issues that may be contributing to the depression, which is often conducted by keeping a journal. This allows the individual to keep record of life events and their reactions to them, in order to work with the therapist to recognise and break down any obstructive or harmful cognitions and perceptions. From here, the individual and the therapist will discuss what changes can be made and how to incorporate these in daily life using skills learnt in therapy.

Although everyone responds to therapy differently, CBT has been proven to be effective in treating depression both short-term and long-term, protecting against subsequent relapse and recurrence once treatment has ended [10]. This is because over the course of CBT, the client learns how to utilise more balanced and constructive ways to respond to stressors. This makes CBT effective because even once the course of treatment is over, the client is equipped with skills and understanding that can be used to face future challenges. In order for CBT to be effective, the individual must be willing and committed to learn about and confront their emotions while working with the therapist to make positive changes to their thoughts, feelings, and behaviours.

Here at Surrey Therapy Practice, we have a team of experienced professionals who offer a range of treatments for depression including CBT. Many of our team members use an integrative approach to tailor their treatment plans to specific individual needs. Get in touch and make an enquiry here.


References:

1. https://cks.nice.org.uk/topics/depression/background-information/prevalence/

2. https://www.webmd.com/depression/guide/depression-are-you-at-risk

3. https://cks.nice.org.uk/topics/depression/background-information/definition/

4. https://cks.nice.org.uk/topics/depression/diagnosis/diagnosis/

5. https://www.who.int/news-room/fact-sheets/detail/depression

6. https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#choice-of-treatments

7. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

8. https://www.psych.ox.ac.uk/news/study-finds-cbt-offers-long-term-benefits-for-people-with-depression?ae3805a8-13f5-11ed-a465-06bfb1c3c94c

9. https://www.healthline.com/health/depression/cognitive-behavioral-therapy

10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933381/