Here's how it works, what it costs, and whether it's…. When it comes to addiction, CBT can help you take steps to reframe your situation to avoid the triggers of your addiction. Online therapy is making mental health services accessible and more affordable for many people.
Here are our 10 recommended picks for online therapy. Reality therapy views behavior as a choice. Learn more here. Health Conditions Discover Plan Connect. Cognitive-Behavioral Therapy for Depression. Medically reviewed by Timothy J. Legg, Ph. How CBT works. What disorders can CBT treat? Are there any risks? What the expert says. Read this next. A Guide to Different Types of Therapy.
Cognitive behavioural therapy CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. It's most commonly used to treat anxiety and depression , but can be useful for other mental and physical health problems.
CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past.
CBT has been shown to be an effective way of treating a number of different mental health conditions. Although CBT cannot cure the physical symptoms of these conditions, it can help people cope better with their symptoms. Information from reference 6.
Numerous studies and meta-analyses 8 - 16 demonstrate convincingly that cognitive therapy or CBT effectively treats patients with unipolar major depression. Several studies 9 - 11 have shown that cognitive therapy is superior to no treatment or to placebo. Two comprehensive meta-analyses 11 , 13 showed that cognitive therapy is as effective as interpersonal or brief psychodynamic therapy in managing depression.
They also showed that cognitive therapy is as effective and possibly more effective than pharmacotherapy in managing mild to moderate unipolar depression. A meta-analysis 12 of four studies, which included patients with major depression, showed similar results for tricyclic antidepressants and CBT. The evidence suggests that cognitive therapy is a valid alternative to antidepressants for patients with mild to moderate depression and possibly for patients with more severe depression.
Figure 1 is an algorithm for determining if CBT is appropriate. Algorithm for determining if CBT is appropriate for treating a patient with depression. Early studies 15 , 16 on the effectiveness of combination cognitive and antidepressant therapy had conflicting results. Later evidence suggests that this combination may be more effective than either therapy alone for some patients.
A meta-analysis 17 that included six studies and patients showed that patients with severe depression benefited from the combination of psychotherapy and pharmacotherapy. However, only two trials studied CBT, and patients with less severe depression gained little from the combination.
In addition to effectively managing acute episodes of unipolar major depression, cognitive therapy also can prevent relapse. One study 4 showed that cognitive therapy significantly reduced the risk of relapse compared with discontinuation of medication. Cognitive therapy was similar to maintenance medication in preventing relapse.
However, the studies were small patients total , used tricyclic antidepressants, and did not specify the duration of therapy. Although these studies may not be conclusive for patients previously treated with antidepressants, cognitive therapy does seem to decrease the risk of relapse.
Several studies 19 - 21 have evaluated the effectiveness of cognitive therapy or CBT in patients who have residual depressive symptoms following adequate antidepressant therapy—a group with high rates of relapse and persistent symptoms. Two small studies 20 , 21 of 40 patients with unipolar major depression and residual symptoms following antidepressant therapy showed that patients treated with CBT initially had fewer residual symptoms and fewer depressive episodes after six years compared with those treated with clinical therapy.
A more recent, larger study 19 randomized patients who did not respond to adequate antidepressant therapy to receive cognitive therapy with clinical management or clinical management alone. All patients continued pharmacotherapy, which is a common practice. Although most studies have evaluated adult populations, few have evaluated the effect of CBT in adolescents. Although these findings were demonstrated only in mild to moderate depression, the results warrant further study.
Family physicians usually are the first to diagnose and treat patients with depression. They should inform patients that psychotherapy and pharmacotherapy are valid options, and that cognitive therapy, and therefore CBT, is the most studied psychotherapy.
If the patient and physician initially elect to use pharmacotherapy, and the patient does not respond adequately, the physician should again suggest adding psychotherapy or CBT. CBT should be strongly considered as initial therapy for patients with severe or chronic depression or for adolescents. If the patient declines referral, or if the family physician provides CBT, longer appointments could be scheduled. Resources are available for the physician and patient Table 2 , and further physician training should be considered.
Greenberger D, Padesky CA. New York: Guilford Press, Cognitive Therapy and the Emotional Disorders. Beck AT. New York: International Universities Press, Already a member or subscriber? Log in. Even if you have major depression, though, it can be alleviated by Cognitive Behavioral Therapy when used in conjunction with medication. CBT works both for adults and adolescents and is often used to reduce your risk of relapse. The coping and behavior modification skills CBT provides you with can be employed to treat many lingering symptoms for weeks, months and years.
Therefore, it is a wonderful tool to enable you to get mentally healthy and to stay that way. You uncover your core negative beliefs and discuss how they have affected you. This is a very important part of treatment, as negative thoughts create a lack of energy, focus, and motivation.
CBT re-educates you to be more realistic in terms of your thinking, which then helps alleviate your depression. Your therapist helps you to develop a plan of positive action based on your behaviors, which includes a list of activities in order from easy to more difficult to achieve.
An essential component of treating your illness successfully is practicing your exercises at home and in stressful situations. This prompts you to have a more rational approach to life to lessen the intensity of negative emotions. Substance abuse is very common among people who are battling depressive disorders.
In other cases, substances such as alcohol can actually depress your central nervous system, so overuse of the drug can trigger depression symptoms. According to statistics from the Anxiety and Depression Association of America, around 20 percent of American citizens with mood and anxiety disorders such as depression, have an alcohol or substance use disorder. Also, around 20 percent of individuals with substance or alcohol use disorders will also have a mood or anxiety disorder.
The connection between depression and addiction is very real. Substance abuse and depression often go hand-in-hand, with one condition making the other worse. Substance abuse and depression are so interlinked that is why doctors call it a dual diagnosis when you present with these issues. These two conditions feed off each other and often make the other worse. As a result, when you receive a dual diagnosis, life can be severely lonely and debilitating.
If you are suffering from addiction along with depression or another mental health disorder, an inpatient treatment center may be the best option for you to receive cbt. Interestingly though, according to a study published in the Journal of Clinical Psychiatry, depression can help predict alcohol dependence.
Looking at both depression and substance abuse, both conditions have certain triggers in common, these include:. A dual diagnosis can be made up of any addition — gambling, sex, alcohol or drugs — and any mental disorder — bipolar disorder, anxiety, depression and so on.
Dual diagnoses including depression are on the rise in the U. According to the Journal of Clinical Psychiatry , one in every three adults struggling with substance abuse also suffers from depression. Clinical depression increases your risk of hurting yourself. It is also an immune system suppressant that makes you more likely to get sick.
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