With 1 in 4 of us struggling with mental illness, lots of us are no stranger to periods of low moods. Around 9% of Americans struggle with depressive illnesses (such as major depression or bipolar disorder) and many opt for a combination of medication and talking therapy to help tackle it head on. You might have heard of Cognitive Behavioural Therapy already (if you haven’t, don’t worry, we’ll explain exactly how it works later) but is it an effective option for those living with depression? Let’s take a look.
Many of us feel fed up or experience low moods from time to time. It’s completely normal (especially in the world we’re living in right now!). But depression is much more than that. Depression is feeling of sadness that lasts for long periods of time. It can cause emotional changes, feelings of hopelessness and even physical symptoms too.
“Clinical depression is debilitating and prolonged. Feelings of deep persistent sadness, loss of pleasure in doing things and becoming withdrawn amongst others, are present almost every day for at least two weeks and affects a person’s ability to work, carry out usual daily activities and have satisfying personal relationships. “ says Dr Noreen Nguru-Berkou, Founder of What The Doctor Recommends.
Depression can impact people in lots of different ways. Firstly, it can impact your emotions. Your mood might be constantly low and you might feel hopeless and teary (and not just at that kitten video on Tiktok!). It might feel as if nothing excites you and, as a result, you might lose interest in things you previously loved doing.
That’s because depression can really suck the enjoyment out of life-which is why it’s really important to seek help for it as soon as you can. In case of severe depression, people may have suicidal thoughts or think about harming themselves. In these cases, it is vital to seek urgent medical attention without delay.
It’s also really common to experience physical symptoms of depression too.
“The most common physical symptoms that clients describe are of a musculoskeletal and gastrointestinal nature. These range from frequent headaches, tight neck and shoulder muscles, vague aches and pains, fatigue and exhaustion, changes in their bowel habit (either constipation or diarrhea), changes in appetite (either binge-eating or loss of appetite) and for most, sleep disturbance (either insomnia or difficulty waking up), “ says Dr Noreen Nguru-Berkou.
All of these symptoms can have a huge impact on your life-including your work and relationships with others.
When it comes to the cause of depressions, that’s where things get a little trickier. Depression can happen for all sorts of different reasons; from a stressful life event to a certain time in your life (e.g. postnatal depression). Depression can also run in families: if your parent or sibling has major depression, you’re 2 or 3 times more likely to develop it compared to the average person.
CBT stands for Cognitive Behavioural Therapy. It’s a type of talking therapy that is often recommended for depression or anxiety. It might be suggested you try this first or do it along with taking an antidepressant.
It’s a little different than other types of talking therapy you might have heard of, since it doesn’t delve into the past but instead centres around the present.
“CBT understands how problems can be maintained by looking at the interaction between our thoughts, feelings, physical sensations and behaviours. There are lots of different CBT exercises, but they commonly focus around how to re-frame unhelpful and unrealistic thoughts by focusing on facts and evidence rather than habits and opinions” says CBT therapist Navit Schechter.
CBT is usually delivered by a therapist in the first instance. You’ll likely see them regularly (such as once a week) for a course of treatments for a set period of time. The therapist will introduce practical exercises you can then use and implement outside of the session, to ensure you are equipped to deal with any worries and anxieties. Even after you’ve stopped these sessions, you might find you need to do these regularly to keep on top of your mental health.
“A typical CBT session will start by setting an agenda, where you and your therapist can decide together how to spend the session. CBT is a collaborative approach which means that you and your therapist will be working together jointly to help you overcome your difficulties. Your therapist will support you to understand the factors that are maintaining your difficulties and support you to put into practice the exercises and take the steps you need to overcome these.
They will likely ask you open questions to help you to expand your awareness and develop new perspectives and should be unconditionally non-judgemental and compassionate, helping you to feel understood and supported. CBT sessions end by setting “homework” decided upon by you and your therapist which will help you to experience the benefits of sessions quickly,” explains CBT therapist Navit Schechter, founder of Conscious and Calm.
Like most treatments for depression, CBT isn’t instantly effective or a cure-all. However, it has been found effective for mild to moderate clinical depression. For example, for every three patients that are treated with CBT, one will get better solely through therapy and combining it with antidepressants has been found more effective than just taking medication alone.
“As a CBT life coach myself, I would say the meta-reviewed evidence backs CBT as the most effective form of talking therapy for depression to date, either a stand-alone therapy for some forms of less severe forms of depression or in combination with medication. The method of delivery can range from computerized self-help CBT and group CBT to individual CBT.” says Dr Noreen Nguru-Berkou.
However, some research has found it’s not effective for tackling severe depression by itself so your doctor may ask you to start taking an antidepressant first.
When it comes to mental health, we often have to do some experimenting to find the right approach for us. It’s important to stress that CBT may not be the right treatment if your depression is acute and severe; you may need to work with your medical team and revisit CBT when your depression is under control.
If your depression is mild and moderate, it could be time to research and learn about CBT and chat to a therapist before you begin to make sure you feel really comfortable. CBT does require regular time to meet with a therapist and to do follow-up homework. You’ll also need to be able to travel to a therapist (or find an online CBT therapist instead).
“CBT is relatively solution-focused and proactive so it’s great if you’re ready to make the changes you need, but are unsure how. It’s always worth having a conversation with a therapist to see whether you resonate with them and feel like they’d be able to support you in the way you need,” says CBT therapist Navit Schechter.
CBT isn’t a mental health miracle cure which is why it’s so important to keep an open mind about the process.
Tracking your CBT sessions alongside your depressive symptoms may help you uncover subtle improvements to your mental health you hadn’t realized. You can use the notes section of Bearable to record information of your sessions or you might invest in a separate CBT notebook.
CBT can be a great potential for all mental health conditions and that includes depression. Whilst not a cure for depression, it may be an effective treatment in helping you deal with the intrusive, negative thoughts that can often accompany it.
If you or someone you know is needs support for depression, know you’re not alone and help is out there. Below is a short list of resources available for people in the US & UK.
The information provided is for educational purposes only, and is not a substitute for professional medical advice. Consult a medical professional or healthcare provider if you’re seeking medical advice, diagnoses, or treatment.
Mental Health Disorder Statistics, John Hopkins Medical Center.
Dr Noreen Nguru-Berkou, WhatTheDoctorRecommends.com.
Symptoms of Clinical Depression, NHS.
The Link Between Depression and Physical Symptoms, Madhukar H. Trivedi, 2004.
Major Depression and Genetics, Stanford Medicine.
CBT Therapist, Navit Schechter.
Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators, Driessen & Hollon, 2011.
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