Depression

Depression is a very common problem and has been referred to as the “common cold of psychiatry.” At some point in their lives one in three of us will suffer a period of depression. Sometimes this will follow a stressful life event but sometimes the onset is less obvious. The outlook is however very good with both medication and psychological interventions such as cognitive behavioural psychotherapy both being effective.

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Cognitive behavioural psychotherapy has been found in controlled studies to be an effective form of treatment for depression - in fact, it appears to be as effective as antidepressant medications. cognitive behavioural psychotherapy for depression focuses on the clinical observation that depressed mood often seems to result from or be maintained by negative patterns of thinking, beliefs about the self, relationship with others and the world and self defeating behaving patterns and reduced activity levels.

For example, depressed people often have thoughts like, “I'm a failure,” “I can't do anything right,” “I'll never succeed with anything I do,” “No one cares about me,” “I'll be alone forever,” or similar thinking.

These thoughts are automatic can feel powerful and compelling, but usually do not tell a balanced, reasonable story and people who are depressed do not readily think to question their validity. These thoughts then effect how the person feels e.g. more depressed or anxious with a further effects on behaviour such as difficulty getting going or completing daily activities and the achievement of personal goals at home or at work. Lack of achievement then often lead to the person feeling even worse and more depressed.

In cognitive behavioural psychotherapy, client and therapist work together to determine what types of negative thinking are problematic for the depressed client, and what types of coping or balanced thoughts can be used to provide a better perspective, to lift the depressed person's mood, and help him or her function better. The therapy also often focuses on helping the depressed person increase his or her activity level or find more gratifying, pleasurable activities and setting new and realistic goals as well as establishing acceptable self standards.

In therapy sessions, the therapist takes an active approach to teaching here-and-now coping strategies to help clients understand and change cognitions and behaviors that contribute to depressed mood. This is an active, problem-solving approach to therapy. Practicing new skills outside of sessions is a central part of treatment. A key goal of cognitive behavioural psychotherapy is to provide the client with tools that he or she can use to work on his or her depressive symptoms and to prevent future episodes. Treatment can be done in individual or group or couples format.

Cognitive behavioural therapists, being both practical and collaborative, can discuss the advantages and disadvantages of medication with you. Many patients are treated without medication at all. Some disorders, however, respond much better to a combination of medication and cognitive behavioural therapy. If you are taking medication, or would like to be on medication, you might want to discuss with your General practitioner or Psychiatrist. If you are not on medication and do not want to be on medication, you and your therapist might commence therapy but reassess, after four to six weeks, how much you've progressed and determine whether you might need medication to help with your recovery.

Cognitive Behavioural Psychotherapy is a very effective short term therapy (usually 10-20 sessions for depression. It is an active form of therapy where the therapist and client work together. Home work and the carrying out of activities and behavioural experiments to test out and change unhelpful thinking and behaviour are needed for therapy to be effective.