Depression is one of the most common problems encountered in clinical practice. The term depression refers to a broad range of mood disorders and is a complex, multifaceted illnessthat affects your body, mind, and spirit. Depression can be mild, severe, episodic, or persistent. Symptoms usually include depressed mood or loss of interest, appetite and sleep disturbance, psychomotor agitation or retardation, decreased energy, feelings of worthlessness or guilt, difficulty thinking, concentrating, or making decisions, and recurrent thoughts of death or suicidal ideation in the form of plans or attempts. These symptoms persist most of the day and nearly everyday throughout the course of the illness and cause significant distress and dysfunction in one’s occupational, social, and interpersonal life.
| Are there specific treatments available for depression? |
There are a number of specific psychotherapy treatment approaches that exist. While my overall approach is relational, I integrate cognitive-behavioral techniques (especially in the early phases of treatment) when working with depressed patients.
CBT for Depression
CBT views depression as resulting from a negative cognitive triad (i.e., the tendency of the depressed individual to hold a negative view of themselves, their world, and their future). |
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Depressed people experience the world through a set of organized depressive belief system. An integral part of the cognitive approach is that between the experience and the emotional response lies a schematic interpretation of the world that is automatic (i.e., the individual is unaware of them). Characteristic cognitive distortions are: 1) arbitrary inference (i.e., assuming one is the cause of some negative event), 2) selective abstraction (i.e., the individual focuses on the negative aspects of an otherwise positive experience), 3) magnification and minimization (or the individual magnifies negative experiences while minimizing positive ones), 4) all-or-none thinking (or polarization), and 5) over-generalization (or making unjustified generalizations on the basis of one event).
CBT is a time-limited, directive therapy designed to challenge the automatic thoughts listed above that perpetuate the depression cycle. Treatment begins by having the psychotherapist describe the reasoning behind the approach and the means by which change purportedly occurs. Behavioral strategies are utilized early on in treatment to increase activities which will allow for the monitoring of thoughts associated with these activities. The therapist and patient prioritize a set of goals to be addressed and begin to examine the relationship between the automatic thoughts and subsequent feelings as they are related to the agreed upon goals. The critical component here is to develop an understanding as to how your thoughts are related to your feelings. Once you develop this understanding, we beging to explore the schemas that underlie these automatic thoughts. These schemas develop early in life and reflect your overall world view. |
