This is the best known of the talking therapies shown to be effective in depressive illness, particularly in depressive illness which is mild or moderate in severity. The theory behind cognitive therapy is that depression is caused by the individual reading negatives into every aspect of their interactions with the world. The patient becomes convinced that everything is, was and always will be negative, and takes the worst possible interpretation, to a magnified extent, out of simple daily problems.
CBT (cognitive behaviour therapy or cognitive behavioural therapy) is a non-medication treatment for depression, and other problems, which has been around for many years, and which research has shown to be very effective for multiple psychiatric conditions.
Depression is a condition in which your thinking processes drift into being very negative. As we all take our automatic thoughts for granted, and we operate on the basis that they are correct of course, it then leaves people with depression seeing themselves, everything around them, and the future very negatively.
CBT is a way of attacking these negative thoughts, getting you to use your logic and intelligence to analyse what your emotions are telling you, to assess the “evidence” for what your emotions are telling you, and to put forward the opposite argument. For example, a standard thought in depression is “Everything is terrible”; but if you had to analyse this statement logically, or in a court of law, you would inevitably conclude that some things are bad and some things are good or average, so the statement that everything is terrible is obviously not quite correct.
Another way of understanding CBT is to tell yourself what you would tell a friend! We are all very good at listening to friends telling us problems, avoiding being swept along emotionally by what the friend is saying, and instead being able to come up with alternative outlooks and alternative suggestions which contradict what our negative friend is saying. Ideally, CBT will allow you to use the same calm and logical defence against negatives generated by your own mind.
Common problems in depression include taking casual events personally (e.g. your friend waits a day or two to return your call, and you see this as your friend hating you, rather than the more likely issue that your friend is very busy that week), making everything a catastrophe (e.g. a minor complication is seen as a disaster for the whole situation or project), and overwhelming pessimism. Again, if a friend took isolated aspects of a situation, or isolated events, and tried to tell you these items spelt absolute disaster, you would be able to calmly disagree, and present an alternative viewpoint which is far more balanced, not just totally negative.
CBT formal therapy normally involves rating your mood on a regular basis throughout the day, writing down your negative thoughts, writing down your logical retaliation against these negative thoughts, and discussing the progress with your therapist on a regular basis.
CBT has been shown to be effective for mild to moderate degrees of depression, and effective in fighting off relapses of depression in the future. For more severe depression, CBT is less effective, as the onslaught of negatives from your brain becomes almost irresistible.
While academic dispute continues about the relative merits of CBT and of antidepressants in the treatment of depression, there is general consensus at present that a combination of medication and CBT is better than either one alone.
CBT is offered by many psychologists (see www.thepsychologist.com.au) and by some doctors. On-line free CBT is also available through MoodGYM, offered by the Australian National University in Canberra
Therapy in Cognitive Therapy consists of relentlessly focusing the patient’s logiconto the events of daily life. The patient is asked to keep a rating scale of their mood on a daily basis, often a number of times per day, so they can see they are not continuously in the total depths of depression. They are asked to rate various events in their day, to show that in fact they do get some positives out of these events. They are asked particularly to examine their own thinking processes when they react negatively to a situation, to detect and correct inappropriate magnification of negatives.
Standard issues discussed in CBT are:
Am I taking events personally?
Am I being extreme?
Am I turning molehills into mountains?
Cognitive Therapy has repeatedly been shown to be effective in a range of conditions, including depressive illness. However, it does require considerable emotional and intellectual effort by patients, and requires many hours of therapy usually. However, some people believe this effort and time is better than taking antidepressant medication. It has been shown that antidepressant medication is better than Cognitive Therapy in severe depression, as severely depressed patients find it impossible to put in the intellectual effort required when they are in fact paralysed intellectually by their illness.
It has also been shown that the combination of antidepressant medication and cognitive therapy is better than either treatment used on its own.
There are many books and self-help manuals written on Cognitive Therapy for Depression.
Important Disclaimer: This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.