What is Depression?
According to Singh and Gotlib (2014), Major Depressive Disorder (MDD) is the most prevalent mental disorder and the most expensive illness in the world. Researchers discovered structural and functional abnormalities in the brains of people with MDD in order to gain a better understanding of the disorder’s pervasive deficits in a variety of areas of functioning.
Corticolimbic brain areas exhibit dichotomous changes in the neurobiology of depression. For instance, the prefrontal hippocampus as well as cortex exhibit neuronal shrinkage along with synaptic dysfunction, while the nucleus accumbens together with the amygdala display neuronal hypertrophy along with increased synaptic activity. Certain subgroups of depressive patients exhibit abnormalities in both their peripheral and central immune systems, which contribute to their neurobiology. Stress-exposed rats exhibit immunological abnormalities comparable to those observed in clinical populations (Singh and Gotlib, 2014).
Microglia, the brain-resident macrophages that mediate neuroplasticity in both normal and pathological conditions, integrate neuroimmune signals. The function and activation of microglia are regulated by both soluble and contact-dependent signals provided by neurons. Most commonly used antidepressant medications regulate serotonin and noradrenaline, two monoamines involved in mood regulation and immunological dysregulation. Certain subgroups of depressed individuals may benefit from antidepressant medications that inhibit neuroimmune activation and promote anti-inflammatory pathways. Further investigation of the active function of microglia in neurobiology and synaptic role may disclose novel therapeutic targets (Singh and Gotlib, 2014).
Psychological Aspect of Depression
Based on the National Institute of Mental Health (2018), depression is a common yet serious mood disorder. To summarize, it has a profound effect on a person’s mental and physical health, as well as daily routines. Depression must be present for a minimum of two weeks before a diagnosis can be made. Depressions come in different forms and can be triggered by numerous factors, including the following:
- Persistent depressive disorder: The term “persistent depressive disorder” refers to depression that lasts longer than two years (also known as dysthymia).
- Suffering from postpartum depression: A condition that is significantly more severe than the “baby blues” (a moderately mild case of melancholy as well as anxiety that usually subsides after two weeks of childbirth), which many mothers experience following childbirth (National Institute of Mental Health, 2018).
- Psychotic depression: This takes place when a person suffers from severe depression along with some form of psychosis, such as delusions or seeing or hearing troubling things that others are unable to see or hear (hallucinations).
Even if an individual only experiences one episode of depression in their lifetime, the majority of people experience several. According to Mayo Clinic (2018), the following symptoms may be present for the majority of the day, practically every day, during these episodes:
- Depression can be accompanied by tears, sadness, emptiness, and hopelessness
- Overreacting to minor irritations, impatience, or annoyance, regardless of how trivial the issue is
- Most or all typical activities, such as hobbies, sex, or sports, are no longer enjoyable.
- Sleep disorders including inability to sleep and excessive sleeping
- Even simple tasks require additional effort due to exhaustion as well as a lack of energy
- Weight loss as a result of reduced food intake or gain as a result of increased food intake
- Stress, nervousness, or irritability
- Feelings of inadequacy or remorse, as well as intrusive thoughts about previous mistakes or self-blame, are all exacerbated by emotional or physical restraint.
- Making judgments and remembering things is difficult
- Back pain or headaches with no obvious cause
Depression cannot be attributed to a single factor. As is the case with many mental illnesses, there may be a number of contributing factors, and according to Mayo Clinic (2018), they including the following:
- Disparities in biological composition. According to new research, those who suffer from depression experience physical changes in their brains. Although the significance of these changes has not been determined, they may aid in the discovery of the underlying causes.
- The brain’s chemistry. Depression is thought to be caused by brain chemicals called neurotransmitters. According to recent research findings, neurotransmitters such as serotonin and norepinephrine may play a critical function in the development as well as treatment of depression.
- Hormones. Hormones are the body’s chemical messengers. Depression can be triggered or exacerbated by disturbances in the body’s hormonal balance. Pregnancy, postpartum, thyroid problems, menopause, and a variety of other illnesses can all result in hormonal changes that can have a negative impact on a woman’s health.
- Genetic traits that are passed down through generations. Individuals who suffer from depression are more likely to have relatives who do as well. To gain a better understanding of depression, researchers are looking for genes that may be associated with it.
How CBT Aids in the Treatment of Depression
CBT is a type of psychotherapy that combines cognitive and behavioral techniques to treat depression. Therapists can intervene to break the depression-induced cycle of inactivity or self-harm. CBT aims to alter a person’s feelings by focusing on both their thoughts and behaviors, believing that each may have an effect on the other.
Cognitive therapy can be used to alter depressive thinking patterns
Cognitive therapy teaches patients to question and justify their own negative beliefs, giving them greater control over their own mental health. Cognitive restructuring techniques can aid in the comprehension of thought patterns, emotions, and reality. The therapist may then offer a more rational or realistic perspective in order to aid in the reduction of cognitive distortions. Mind reading is a very common cognitive distortion in people who suffer from depression. By confronting these and other negative ideas, one can develop a healthy self-talk and thinking habit (Skedel, 2021).
Behavioral techniques for enhancing one’s energy and motivation
Behavioral strategies, such as rewarding oneself for making small behavioral adjustments, are particularly effective in treating depression. A lack of motivation or energy, for example, may be a symptom of depression. By rewarding yourself for completing a simple task such as putting away a few dishes, one can influence their brain’s chemical outputs. By including a reward, the likelihood of a person repeating the activity increases (Skedel, 2021).
Additionally, CBT employs a variety of different behavioral techniques to mitigate the negative consequences of inaction.
CBT Techniques for Depression That Are Frequently Used
Thought journaling, cognitive restructuring, as well as mindful meditation are all examples of common cognitive behavioral therapy (CBT) strategies for treating depression. Several of these strategies are used in tandem to demonstrate the interconnectedness of ideas, emotions, and behaviors. The following are some of the most frequently used cognitive behavioral therapy (CBT) approaches for treating depression:
- Cognitive Restructuring
By examining your thought patterns, tone, and self-talk, you can identify possible cognitive distortions and harmful thinking patterns that may be aggravating depression symptoms or suicidal thoughts. Restructuring one’s thinking can aid in the development of better habits, the elimination of cognitive errors, and the acquisition of techniques for rationalizing distortions.
- Activity Scheduling
Activity scheduling is a term that refers to rewarding oneself for organizing low-intensity activities that promote positive self-esteem and self-care. By arranging certain activities and incentives, you can teach yourself to encourage yourself even when you’re depressed. Additionally, you’ll have a better chance of completing these activities even after your official therapy sessions conclude.
- Journaling of Thoughts
Writing allows patients to examine their emotions and thoughts, as well as the ways in which their ideas and feelings have influenced their actions. This experience teaches self-awareness and coping skills (Skedel, 2021).
- Implementing the ABC Model
Through writing, depressive behaviors such as snapping at others or sleeping all day can be deconstructed. The ABC model is built around the following components: The “activating” event. One’s “Beliefs” about an event. The event’s “consequences,” as well as one’s thoughts and actions in response to the event (Skedel, 2021).
To gain a better understanding of their own triggers and consequences, individuals may look for “consequential” behaviors and common causes in their depressed triggers.
- Verification of Facts
This method teaches individuals to examine their beliefs and recognize that, while they may be trapped in a depressive or harmful thinking pattern, these beliefs are not facts but feelings (e.g., “I am a failure”) that can be replaced with more positive ones. Along with revealing whether behaviors are motivated by ideas or emotions rather than facts, fact-checking can help an individual identify their own biases (Skedel, 2021).
- Approximation or “Breaking It Down”
Overwhelming feelings can be alleviated by breaking down large tasks into smaller objectives. Practicing successive approximation can assist them in achieving their goals and coping more effectively with massive jobs in the future, even if they are currently depressed.
- Mindfulness meditation
Meditation assists a person suffering from depression in becoming more aware of the present moment and less preoccupied with worrying about the future. Through meditation, one can recognize and accept one’s thoughts as they are, rather than allowing them to take over one’s life (Skedel, 2021).
The Efficacy of CBT in Depression Treatment
CBT is the most thoroughly researched form of talk therapy, or psychotherapy. It may be just as effective as antidepressant medication in certain types of depression. Individuals who receive CBT may have a 50% lower chance of relapsing into depression within a year than those who only take medication. Medication is an effective way to treat depression. If CBT is included in the treatment, it may be more effective and have a longer-lasting effect. After a year of CBT for anxiety or depression, the majority of patients continue to use the techniques learned during treatment. If a patient is taking medication for depression, they should not stop taking it without first consulting their doctor. If a person abruptly quits their job, it may result in sadness and other complications (Pagan, 2020).
Additionally, a number of additional studies have established the effectiveness of cognitive behavioral therapy (CBT) in the treatment of depression:
- Studies demonstrate that CBT’s behavioral activation approaches are effective for patients with severe depression (Skedel, 2021).
- Combining Cognitive Behavioral Therapy (CBT) and antidepressant medication may be an effective way to treat depression.
- Cognitive therapy (CT/CBT) is as effective as medication in the treatment of moderate to severe major depressive illness, but this effectiveness can be modified by the therapist’s expertise with CT/CBT.
- CBT was found to be an excellent intervention for reducing depressive symptoms and relapse rates when compared to a control group (Skedel, 2021).
- According to a study on bipolar disorder, those who received CBT therapy had fewer relapses, shorter episodes, and fewer hospitalizations. Depressed mood and manic symptoms were also significantly reduced in this group (Skedel, 2021).
The Advantages and Disadvantages of Cognitive Behavioral Therapy for Depression
- CBT teaches individuals how to deal with real-world situations.
The goal of CBT is to teach you effective and healthy coping mechanisms that you can use in any real-world situation, even after your treatment is complete. Learning how to cope with real-world anxiety and stress strengthens your resilience, which can only be a good thing (Sharma, 2021).
- CBT can be used in an individual or group therapy setting.
Cognitive Behavioral Therapy is most frequently used in group and individual settings (CBT). Unlike other forms of treatment, it has a defined framework and purpose, and it may be delivered via self-help books and other media.
- CBT is just as beneficial, if not more so, than medication in treating mental health illnesses.
Although it is not clear whether CBT is superior to medication in treating mental health conditions, research indicates that it may be more effective than medication in treating mental health conditions. Unlike medication, CBT can have a long-lasting effect even after the therapy is completed (Sharma, 2021).
- CBT focuses exclusively on current and specific problems.
One disadvantage of Cognitive Behavioral Therapy (CBT) is that it is limited to current or specific concerns. The technique aims to interrupt the negative thought pattern and restructure it into a more constructive one. The issue is that CBT does not address the underlying causes of the issue (Sharma, 2021).
- CBT focuses on an individual’s capacity to change.
When it comes to Cognitive Behavioral Therapy (CBT), an individual must be willing to change for the therapy to be effective. CBT will be ineffective if the individual lacks the capacity to change their behavior and thinking. CBT will be ineffective if the patient refuses to reframe or retrain their thoughts, actions, and emotions (Sharma, 2021).
Mayo Clinic. (2018, February 3). Depression (major depressive disorder). Mayo Clinic. Retrieved December 18, 2021, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
National Institute of Mental Health. (2018). Depression. Retrieved December 18, 2021, from https://www.nimh.nih.gov/health/topics/depression
Pagán, C. N. (2020). Cognitive behavioral therapy (CBT) for negative thinking & depression. WebMD. Retrieved December 18, 2021, from https://www.webmd.com/depression/guide/cognitive-behavioral-therapy-for-depression
Sharma, S. (2021, April 16). The Pros & Cons of Cognitive Behavioral therapy (CBT). Calm Sage – Your Guide to Mental and Emotional Well-being. Retrieved December 18, 2021, from https://www.calmsage.com/pros-and-cons-of-cbt-therapy/
Singh, M. K., & Gotlib, I. H. (2014, November). The neuroscience of depression: Implications for assessment and Intervention. Behaviour research and therapy. Retrieved December 18, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253641/
Skedel, R. (2021). CBT for depression: How it works, examples, & effectiveness. Choosing Therapy. Retrieved December 18, 2021, from https://www.choosingtherapy.com/cbt-for-depression/