6 ways cognitive behaviour therapy helps overcome depression

Cognitive behaviour therapy – which teaches skills for identifying and modifying dysfunctional thoughts, feelings and behaviours – helps break unhealthy habits that lead to, and maintain, major depressive disorders, according to a clinical psychologist.

CBT (otherwise known as talking therapy) is the “leading evidence-based treatment for depression” and has become a well-established treatment for depression, especially for adolescents and young adults, said Dr John Kearney, director of psychological services at Wesley Hospital Kogarah.

“CBT is an increasingly popular approach for treating major depressive disorders and has proven to be as effective as – or even better than – antidepressant medications for many types of depression, as it provides long-term coping skills for individuals at risk of relapse,” he said.

But while people with depression can make great improvements with CBT, it is important for those people to be proactive and take practical steps to ensure they are making the most out of their therapy, Dr Kearney added.

“In today’s society, the flexible, individualised and practical nature of CBT makes it accessible for people who are looking for a hands-on approach to their treatment. The homework aspect of CBT is one of the most vital aspects of this process.”

“Through undertaking set tasks, people learn to better manage their thoughts and emotions in their day-to-day lives, and so it is imperative these activities are sustained beyond the end of treatment,” he said.

Dr Kearney shared six ways that cognitive behaviour therapy can help treat major depressive disorders:

1. Develop new ways to manage unhelpful and negative thought patterns

Chronic stress and worry can lead us to develop a mental filter in which we automatically interpret situations through a negative lens, Dr Kearney advised.

“CBT can teach you skills to manage negative and unhelpful thoughts more effectively, firstly by learning to shift your focus away from them and, secondly, by reappraising them. For example, if you are highly self-critical, CBT will teach you to challenge stress-producing thoughts by asking questions such as: ‘Would I be saying these things to someone else in this situation?’”

“You can then replace these thoughts with more constructive alternatives. Regularly practicing this skill will assist with managing strong emotions in response to stressors.”

2. Restore activity levels

One of the maintaining factors in depression is the reduction of physical activity and the vicious cycle that can follow, which can lead to further loss of enjoyment and achievement, contributing to a lower mood, he said.

“Activity scheduling and graded task assignments are a crucial part of CBT and help to rebuild activities that bring a sense of pleasure and achievement.”

3. Master relaxation techniques

“When the amygdala – the part of the brain that is primarily responsible for emotional processing – is activated, it can trigger the ‘fight-or-flight’ response, the reflex that gets your heart pumping in reaction to a threat. Relaxation is one of several skills taught in CBT that helps counter the physiological effects of this response,” Dr Kearney explained.

“One way to practice relaxation is to sit comfortably with your eyes closed. Working from your legs upwards, systematically tense and relax your muscles. Hold the tension for 10 seconds, then release. This skill is known as progressive muscle relaxation and can help you contextualise stressful situations and is transferable to other facets of life, including work, study and relationships.”

4. Reduce insomnia

Research has shown that CBT can significantly reduce insomnia in patients with depression, Dr Kearney said.

“If you struggle with sleep, CBT for insomnia, sometimes called CBT-I, is an effective treatment for chronic sleep problems. By recognising and changing thoughts and behaviours that cause or worsen sleep, this type of therapy can eliminate negative thoughts that keep you awake,” he said.

“This is important, as a good night’s sleep can increase emotional resilience and help with managing everyday stressors.”

5. Increase your problem-solving ability

“As CBT takes a practical problem-solving approach to issues, it teaches skills that can be applied to other problems in your life. Through a series of sequential stages, your therapist will assist you in developing new empowering skills in determining and implementing solutions to your everyday problems,” he said.

“Ultimately, it will refine and focus your problem-solving skills, enabling you to learn more about your own thought patterns, emotions and behaviours.”

6. Make improvements to your lifestyle, especially in the areas of physical activity and nutrition

CBT teaches behavioural strategies that focus on achieving and maintaining lifestyle changes, Dr Kearney concluded.

“These include treating physical illness, maintaining a balanced diet, avoiding mood-altering substances, getting a good night’s sleep and regular exercise. These strategies are extremely beneficial in increasing emotional resilience and improving coping skills, which helps prevent depression and improve mood.”