Treating Depression With Cognitive Behavioral Therapy

Written by Journey Pure Staff

Life is a series of ups and downs, and like many people, you may feel down from time to time. Feeling down, or that life is against you, is an all too common feeling in today’s society. As many as 14.8 million adults in the U.S. are affected by Major Depressive Disorder, according to figures published by the Anxiety and Depression Association of America.

You might be working longer hours for the same pay, dealing with the stress of bills or having personal relationship problems. You may also be battling a drug or alcohol addiction. It’s only natural if you feel a little less than 100 percent sometimes.

However, if that low feeling of despair has taken hold of your life and just won’t shift, you could be suffering from depression. Depression can be incredibly lonely, as it makes “normal” functioning difficult — so much so that simply getting through your day can be completely overwhelming, and you turn to drugs and alcohol for comfort.

If you’re feeling hopeless and down, there is light at the end of the tunnel, and you don’t need to suffer in silence.

Cognitive Behavioral Therapy for depression (CBT) can restore your zest for life, help you think in a healthier manner and help you overcome an addiction. Before going into in-depth detail about what CBT is and how it helps in treating depression, though, it is helpful to understand the primary types of depression.

Types of Depression

There are several main types of depression that can occur alone or concurrently with an addiction. CBT can effectively treat all of these:

Major Depression. This involves suffering from five or more depressive symptoms for at least a two-week period. An episode of major depression is so disabling that it will interfere with your ability to sleep, work, study and eat.

These episodes may only happen a few times throughout your life. They can also happen spontaneously, after a traumatic life event such as a death in the family or the breakdown of a relationship.

Persistent Depressive Disorder (PDD). Formerly known as dysthymia, PDD is a type of depression that continues for at least two years. Generally, this is less severe in nature than major depression, but you will experience many of the same symptoms.

PDD often manifests itself as irritability, stress and the inability to enjoy life in general.

Bipolar Disorder. This type of depressive disorder manifests itself in your life as a shifting mood cycle that involves severe or mild highs (mania and hypomania) and terribly crushing, depressive lows.

Signs and Symptoms of Depression

If you are worried you might be depressed, ask yourself whether you identify with any of the following symptoms:

  • Feelings of helplessness and hopelessness
  • Loss of interests in things you used to enjoy
  • Unnatural tiredness
  • Appetite changes — eating much more or far less
  • Inability to concentrate — even on easy tasks
  • Uncontrollable negative thoughts
  • Irritability, aggression, and short-temperedness
  • Engaging in reckless behavior
  • Drinking more alcohol than usual
  • Using illegal or prescription drugs to excess
  • Self-loathing — feelings of worthlessness and guilt
  • Unexplained aches and pains — including stomach pains, sore muscles, back pain and headaches

If you answered yes to one or more of these, you might be depressed, and cognitive behavioral therapy might be able to help.

What Is Cognitive Behavioral Therapy?

Now that you know more about the major types of depressive disorders, their symptoms and just how common it is, it’s great to know there are effective treatment modalities for depression.

Cognitive Behavioral Therapy is a type of psychotherapy that modifies your thought patterns. It helps to change your behaviors and moods. The therapy has its origins in the work of Aaron T. Beck and Albert Ellis in the late 1950s and 60s.

In a nutshell, CBT treatment for depression is a blend of cognitive and behavioral therapy whereby the therapist helps you to identify particular negative thought patterns as well as your behavioral responses to stressful and challenging situations.

CBT is a way of talking about:

  • How your actions affect your feelings and thoughts.
  • How you perceive yourself, other people and the world.

Treatment involves guiding you to develop more constructive and balanced ways of coping with stressors. Ideally, this will eliminate or minimize your upsetting behavior or disorder altogether. CBT focuses on how to improve your state of mind right now, rather than on looking back on the past.

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What Does CBT Involve?

As with any new experience, going for CBT for depression can be daunting. However, we have put together a short guide of what’s involved so you’re prepared:


  • You may meet with your therapist for as little as five, to as many as 20 weekly or biweekly sessions. In general, sessions last between 30 and 60 minutes.
  • Throughout the initial two to four sessions, your therapist will ascertain whether you are right for the treatment and whether you feel comfortable with it.
  • Your therapist will ask you about your background and past. CBT focuses on the present, but you may, at times, need to open up about your past to understand how it is affecting you currently.
  • You make the decision on what you need and want to deal with.
  • Along with the therapist, you start by agreeing on what is to be discussed that day.

The work:

  • With the support of the therapist, each of your problems are broken down into different parts. To assist with this, you may be asked to keep a diary to help you identify emotions, thoughts, patterns of action and physical feelings.
  • You and your therapist will both look at your behaviors, feelings, and thoughts to see how they affect each other and how they affect you, and to see if they are unhelpful or unrealistic. Your therapist will then work with you to figure out how to change any negatives.
  • Your therapist will often give you “homework.” This involves practicing identified changes you need to make in everyday life.
  • During every meeting, you’ll have the opportunity to discuss your progress since the previous session. If a certain task hasn’t been working for you, your therapist will address this.
  • You will never be made to do anything you don’t want to do. You dictate the pace of your therapy. You can also continue to practice and develop your skills long after the sessions have finished. This will allow you to remain healthy for many years to come.

How Does CBT Work?

CBT, unlike psychodynamic and psychoanalytic therapies (that often take several years to discover, and treat), is a shorter-term approach that usually takes as little as six sessions or up to 20 sessions.

Throughout each session, you and the therapist will look at and identify situations within your life that may be contributing to or causing your depression. It is then that any of your distorted perceptions and current patterns of thinking can be identified and tackled.

You may be encouraged to keep a journal to record different life events and your reactions to them. This then helps the therapist to identify and break down your thought patterns and reactions into different categories of negative thought, including:

  • Overgeneralization – drawing conclusions that are far too broad in terms of one single event.
  • Allor-nothing thinking – viewing the world as completely black-and-white.
  • Automatically negative thoughts – experiencing scolding habitual thoughts.
  • Rejecting the positive – disqualifying positive experiences and feeling that they “don’t count.”
  • Unrealistically minimizing or maximizing the importance of events – building things up or diminishing them in ways that don’t match reality.
  • Taking things too personally –thinking that everything happening around you is because of something you did or said or a feeling that other people’s unrelated actions are specifically directed at you.
  • Focusing on one negative issue – dwelling on this consistently until your perception of reality is darkened.

Journal work is a very important aspect of Cognitive Behavioral Therapy. This prompts you to:

  • Use self-evaluation to respond and reflect in appropriate and healthy ways.
  • Practice balanced and accurate self-talk.
  • Learn how you can comprehensively and accurately assess emotional behavior as well as external reactions and situations.
  • Learn to modify and control your distorted reactions and thoughts.

Through utilizing these various techniques, you can learn how to live again in balance with your own body and mind.

How Does CBT Differ From Other Treatments for Depression?

The method and general focus of Cognitive Behavioral Therapy is a little different from many other, more traditional depression treatments. For instance, CBT:

  • Works on changing your thought patterns and on modifying behaviors in the immediate present.
  • Specifically addresses your problem thinking and undesirable behaviors.
  • Is goal-oriented. Clear goals are set out for each session as well as for the long-term.
  • Is educational. You monitor your own feelings and thoughts, and then you commit these to paper. The therapist will also teach you important coping skills, such as problem-solving.
  • Allows you to play an active part in your learning and recovery. You will also complete “homework” assignments that are reviewed at the beginning of the next session.
  • Employs multiple strategies, including role-playing, behavioral experiments, and guided discovery.
  • Is time limited.

How CBT Can Help With Your Depression

It’s likely that you’ve come to this page as you are all too aware of how debilitating depression can be. Depression is a very common condition, and it is one that is also very serious. The illness negatively impacts your life as well as the lives of your family and friends. It can also extend as far as affecting your coworkers and employers.

Depression has a significantly negative impact on the general functioning of society as a whole. For instance, it is a fact that the illness imposes a financial burden on you, the sufferer, as well as on your caregiver, family, insurance provider and your employer.

CBT can provide a new lease of life if you’re suffering from depression. If your condition is mild-to-moderate major depression, CBT as a standalone treatment can offer great relief. On the other hand, if you have severe major depression, CBT, delivered in conjunction with medication, is a very effective treatment.

Who Can Benefit From Cognitive Behavioral Therapy?

CBT works well if you have mild or moderate depression. It can be delivered as a standalone treatment without medication. 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 are most likely to respond well to Cognitive Behavioral Therapy if you:

  • Are motivated and have a desire for change.
  • Have the capacity for introspection.
  • See yourself as having the ability to control events that happen around you.

How the Behavioral and Cognitive Components Work

CBT can be divided into its behavioral and cognitive components.

  • Cognitive component.  With the support of your therapist, you will learn to identify the negative distorted thinking that creates negative emotions. You will both then question the validity of these emotions, and you will explore new and alternative balanced thoughts.

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.

You’ll also be given the chance to explore where your negative core beliefs stem from. You’ll be urged to explore whether there is actually any real evidence for or against these.

  • Behavioral component. Throughout the behavioral aspect of treatment, your therapist will guide you to measure and assess how your daily routine and activities have an impact on your mood. Your therapist encourages you to explore how your behaviors can help alleviate and improve your depression symptoms.

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. As you master the activities from easier to harder, you’ll begin to experience feelings of achievement, and your depression lessens.

CBT doesn’t just end at the clinic or facility, though. 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.

Depression and Addiction

Substance abuse is very common among people who are battling depressive disorders. When you’re depressed, there is often a temptation to abuse substances to help numb your painful feelings to make yourself feel “normal” again. 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. If you are trapped in such a cycle, it’s imperative to seek help as soon as you can.

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.

Figures from the National Institute on Drug Abuse show that compared to the general population, if you’re addicted to drugs, you are on average twice as likely to have anxiety and mood disorders, and vice versa.

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.

The Shared Triggers of Substance Abuse and Depression

So, we know that in terms of depression and substance abuse, it isn’t always clear which one began first. Interestingly though, according to a 2013 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:

  • Genetics – According to research published in Disease Markers, genetic factors and DNA can make you more likely to develop a mental disorder as well as an addiction.
  • The brain – Depression and substance abuse affect similar areas of the brain, such as the ones that handle responses to stress.
  • Developmental issues – Early mental health problems increase your likelihood of future substance abuse, whereas early substance abuse actually harms the brain’s development, making later mental illnesses far more likely.

More Information on Dual Diagnosis

The term “dual diagnosis” means you have both an addiction and depression. 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.S. 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. When substance abuse is added into the mix, the risk to your emotional and physical health is even greater. This is why enrolling in a CBT course can help you create a healthy and positive new life for yourself.

Ridding your life of bad habits and negative ways of thinking enables you to feel free and happy again. It takes time, but with the right support, you can return to a normal life.

Things to Remember About CBT

As with all new experiences, especially ones that are potentially life-changing, committing to Cognitive Behavioral Therapy can be worrying. It is perfectly normal for you to feel a sense of trepidation, but your therapist will help and guide you through it. It is also important to remember the following:

  • Exploring painful feelings and experiences during therapy can be uncomfortable. You may find yourself facing subjects and situations you’d generally rather avoid. Throughout this temporary phase, remember that you are learning to deal with these issues constructively and that these feelings will end.
  • The success of CBT depends entirely on you. Your therapist is similar to a personal trainer — they can encourage and advise you, but you have to do the hard work.
  • When you’re feeling down, motivation can be difficult to find. This is also true in terms of concentration. Sometimes, you will really need to push yourself.
  • To get over a problem, you need to confront it. This may lead to you feeling worse for a short time, however, that quickly dissipates and is replaced by feelings of achievement.
  • You are in control at all times as to what is covered in your sessions as well as the pace of them.
  • If your symptoms come back, your CBT skills will help you control them. CBT is a way of life, rather than being a short-term fix. Therefore, it’s important to keep practicing your CBT skills.

Getting Help for Depression and Addiction With Cognitive Behavior Therapy

Here at JourneyPure at the River, we recognize that you may be suffering from depression alongside your addiction. That’s why we offer effective therapies, including Cognitive Behavior Therapy, for dual diagnosis or a co-occurring mental health issue with your addiction. Our CBT treatments are a blend of therapeutic activities that address both your depression and addiction concurrently.

If you’re feeling depressed and have nowhere to turn, it’s time to get help. Call us today or contact us online to begin your journey toward wellness at our flagship drug rehab in Tennessee.

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