CBT for depression

Aaron Beck, MD, the founder of CBT, started his career working with depression in adults.  At the time, the prevalent theory was that depression was caused by retroflected hostility- anger at someone else turned inward.  

Dr. Beck wanted to scientifically prove that therapy was effective, but found that he wasn’t getting results with the current theories.  He switched his approach, and began to explore the thoughts of depressed patients.  Dr. Beck found that people suffering from depression shared a pattern of hopeless thoughts.  “This will never get better,” “I will always feel this way,” “Nothing matters.”  

Depression is inadvertently maintained by negative, hopeless thoughts.  These thoughts pervade a person’s life and lead to changes in behaviors that also reinforce the hopelessness. Depression impacts how a person sees themselves, others, and the world.   This is, of course, a vast oversimplification, but it is a very basic overview of the cognitive theory of depression.

There are multiple ways to intervene in depression, but one of the first steps is usually behavioral activation.  When we become depressed, our activity decreases.  We do less and therefore have less opportunity for good and rewarding events.  This makes us feel even worse, and the cycle is perpetuated.

Another first line intervention in cognitive work for depression is understanding and tracking thoughts and beliefs. Thoughts are the key to CBT. It becomes easier to identify belief systems if we can understand the thoughts that "fuel" our negative core beliefs. In CBT, we seek to identify the thoughts and behaviors that get in the way and the deeper core beliefs that allow these thoughts and behaviors to persist.

Research is always our guide,

Therapy isn't easy, but it isn't supposed to be. Through the process of our work, we create change on multiple levels. There is homework: skills, exercises, and practices you work on at home. And slowly, with effort, a significant change occurs. It's pretty cool.