How CBT Helps With Depression: What Treatment Looks Like and When to Seek It
Dr. Tamar Gordon
Dr. Tamar Gordon is the founder and clinical director of the Gordon Therapy Group; Tamar Gordon Psychology, PLLC. Dr. Gordon is a NY and CT State licensed clinical psychologist and an expert in cognitive behavioral therapy (CBT) and evidence based mental health treatment for adults and children.
Dr. Tamar Gordon
Dr. Tamar Gordon is the founder and clinical director of the Gordon Therapy Group; Tamar Gordon Psychology, PLLC. Dr. Gordon is a NY and CT State licensed clinical psychologist and an expert in cognitive behavioral therapy (CBT) and evidence based mental health treatment for adults and children.
“Ugh, I’m so depressed. They haven’t texted me back.”
“The world is so depressing right now, I can’t stand it!”
“School is the worst. It’s so depressing.”
We use the word depressed, or depressing, all the time in everyday speech. But what does it really mean?
Are you actually depressed because someone didn’t respond to you, or because you don’t like your teacher? How do you know? And what can you do about it if you are?
Short answer? Sadness passes. Depression hangs on, and cognitive behavioral therapy (CBT) is one of the best-studied ways to treat it.
Is It Sadness or Depression?
First, let’s define terms. While sadness is a normal emotion that people experience all the time, it is also limited and transient.
We feel sad when something sad happens to us, like the loss of a pet, a bad grade, a romantic break-up, reading a sad article in a newspaper, or watching a sad movie. It is an emotional response to a situation that is temporary and appropriate to the situation and will pass with time.
Depression, on the other hand, lasts days, not hours. It is an unrelenting feeling of sadness or hopelessness that lasts most of the day, nearly every day, for at least two weeks.
It is accompanied by other symptoms, such as changes in appetite, sleep, or energy, difficulty making decisions or focusing, loss of pleasure in activities, and sometimes thoughts of death or dying or wishing one was dead.
When to Talk to Someone About Depression
If you are feeling sad every single day, it is a good idea to talk to someone about it, because there are things that can help.
That someone might be a parent, a school counselor, your pediatrician, or a therapist. Also worth knowing: in teens, depression doesn’t always look sad. It can look like snapping at everyone, skipping practice, or quietly dropping out of the group chat.
If there’s any concern for immediate safety, yours or your loved one’s, please contact your doctor, call 988 (Suicide & Crisis Lifeline), or dial 911 now.
Why CBT and Medication Work Best Together for Depression
Most people know that antidepressants like Prozac (an SSRI) can be prescribed for depression. However, research shows that an SSRI plus CBT is actually the most effective treatment.
This isn’t a hunch. In the NIMH-funded Treatment for Adolescents With Depression Study (TADS), which followed teens ages 12 to 17, 71 percent of those getting Prozac and CBT together had responded after 12 weeks. That beat either treatment alone.
We don’t prescribe medication ourselves. If medication makes sense for you, we work with your pediatrician or psychiatrist so the whole team is pulling in the same direction.
How CBT Helps With Depression
CBT helps with depression through a couple of different pathways.
Tracking Your Patterns
The first step is tracking patterns. Your therapist will help you monitor thoughts, feelings, and behaviors to see what makes you feel better and what makes you feel worse.
Usually this is a simple daily log, nothing fancy. You rate your mood from 0 to 10 a few times a day and jot down what you were doing and thinking. A week or two in, patterns start to jump out. Maybe your mood dips every night after scrolling alone in your room. Maybe it lifts after practice.
Getting Moving Again With Behavioral Activation
Often, folks who are depressed have stopped engaging in social activities, work, school, or exercise, all of which improve mood. Behavioral activation is a CBT strategy that involves planning activities every day to help you feel better, even though you may not feel like doing them at first.
You and your therapist will track different activities and rate how your mood changes in response to them, helping motivate you to do the things that make you feel better.
Start small. Really small. A 10-minute walk counts, and so does texting one friend back or showing up to one club meeting. With depression, motivation tends to show up after you act, not before, so waiting until you feel like it can keep you stuck.
Shifting Unhelpful Thoughts With Cognitive Restructuring
Another tool in the CBT toolbox is cognitive restructuring. This is a technique for noticing what thoughts might be making you feel worse, and ways to change them.
Take the text that never came. A depressed mind might jump straight to “Nobody actually likes me.” Your therapist would help you slow that thought down and look at the evidence. Maybe your friend is at practice, or their phone died, or they just haven’t gotten to it yet.
You and your therapist will consider other ways of thinking that might be more helpful, or more accurate. Sometimes a simple shift of perspective can change the landscape of your mood. Other times, it is the first step toward changing a bad situation or engaging in more helpful activities.
What CBT Treatment for Depression Looks Like
Most CBT for depression runs once a week. At the start, you and your therapist pick a few goals that actually matter to you. Getting back to soccer. Sleeping before 1 a.m. again. Answering your friends’ texts.
Then there is the part between sessions, which is where a lot of the change happens. You might keep your mood log, try one planned activity, or catch one unhelpful thought and write down another way to see it. For teens, a parent may sit in on part of a session so they know how to help at home.
How long does it take? Timelines vary, but many people notice early improvement within the first several weeks, and a course of CBT for depression often runs 12 to 16 sessions. We move at your pace.
Getting Back to Feeling Like Yourself
When you put all the strategies together, CBT for depression helps you identify thought, feeling, and behavior patterns and make healthy changes that improve your mood throughout the day.
Working together with a CBT therapist can help you re-engage with life in ways that feel valuable and productive so you can get back to feeling like yourself again.
Ready to talk? Our depression therapy team sees teens and adults in person on the Upper West Side, a short walk from the 1/2/3 and B/C trains, and by HIPAA-secure telehealth across New York, New Jersey, and Connecticut. Request an appointment or call (917) 972-5671.
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