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Working It Out

A man and a woman talking

A specific kind of "talk" psychotherapy called cognitive behavioral therapy (CBT) can help relieve depression.

Few people may have heard of cognitive behavioral therapy (CBT)—but people with depression and their doctors should take notice of this technique. Especially when combined with medications, it can help relieve depression. Research shows that it even helps reduce the likelihood of the most tragic outcome of extreme depression: suicide.

Unlike some other kinds of psychotherapy, CBT is meant to be short-term, usually 10 to 20 sessions with a health professional. The health professionals who provide CBT help patients work through the thoughts and emotions that are troubling them now, rather than trying to work through emotions and circumstances of the distant past.

To Find Out More

CBT is based on the idea that changing thought patterns and the behaviors that result from them can help change emotional reactions—including the negative emotional aspects of depression.

Thinking of Depression as a Major Illness

Thomas R. Insel, M.D., Director of the National Institute of Mental Health (NIMH), suggests thinking about treating depression the same way you would think about treating other major illnesses. For example, with mild high blood pressure, he says, your healthcare provider might start by prescribing lifestyle changes, like diet and exercise. But if your blood pressure was very high when you were diagnosed, you'd probably have to take a medication, and you might have to try different ones to find the one or drug combinations that worked best for you.

"Depression follows the same principle," Dr. Insel says. "If you have mild depression, your health professional might want to start with cognitive behavioral therapy. But if you're diagnosed with more severe depression, it's more likely that you'll get a medication, and you'll probably need to try a few before you find the one that's right for you. For some people, a combination of CBT and medication will be the best treatment."

Symptoms of Depression

Not everyone who is depressed or manic experiences every symptom. The severity of symptoms varies among individuals and also over time.

  • Persistent sad, anxious, or "empty" mood.
  • Feelings of hopelessness or pessimism.
  • Feelings of guilt, worthlessness, or helplessness.
  • Loss of interest or pleasure in hobbies and activities that were once enjoyable, including sex.
  • Decreased energy, fatigue; feeling "slowed down."
  • Difficulty concentrating, remembering, or making decisions.
  • Trouble sleeping, early morning awakening, or oversleeping.
  • Changes in appetite and/or weight.
  • Thoughts of death or suicide, or suicide attempts.
  • Restlessness or irritability.
  • Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain that do not respond to routine treatment.

Fall 2009 Issue: Volume 4 Number 4 Page 18