Multiple factors may be involved in triggering depression, including biological factors such as genetics and changes in body chemistry that affect mood and thoughts. Major life transitions or stressors, such as job loss, divorce, or death of a loved one, can also lead to depression. Depression is not a weakness, but a sign that something is out of balance. Once you’ve had an episode of depression the risk of having another greatly increases. A person who suffers from a serious depressive episode can’t just snap out of it and feel better spontaneously, so it’s important to take steps to reduce that risk.

Studies consistently show that psychotherapy is effective in helping to treat depression in its acute form. There is also some evidence that ongoing psychotherapy may lessen future incidents or reduce their intensity. If you suspect that you or a loved one suffers from depression, it’s critical to seek help from a licensed mental health professional who is trained and experienced in helping people recover from depression. Keeping feelings bottled up or becoming isolated can make depression worse, so it’s important to seek help as soon as possible.

The founder of CBT, Aaron T. Beck (see What is CBT?) defined the thought patterns that both characterize depression and serve as a kind of glue that keeps people stuck in their depression. These thought patterns include a negative view of yourself, of your personal world, and of the future.

• Self: It is all my fault. I am no good, a failure, worthless. I can’t change.
• Personal world: My life is a mess. Nothing I do turns out right. Nobody can or wants to help me.
• Future: It will never get better. It is hopeless.

People who are depressed often don’t realize the impact their thoughts have on how they feel. This kind of ‘Depression Mind’ powerfully maintains the depression, and a vicious circle ensues. Depression actually “forges a connection in the brain between a sad mood and negative thoughts, so that even normal sadness can awaken major negative thoughts.”**

Fortunately, as individuals learn to recognize these thought patterns they find that their moods can shift. Current brain research supports that a shift in perspective, changing the way we think about a particular situation, can open up our mind to things we haven’t considered before. Considering alternatives to what we perceive as the truth actually changes the brain and encourages creativity.

CBT offers tools to help reduce symptoms and to recognize negative thought patterns. Together we work to shift perspective, change behaviors, evaluate the effect of the environment, and consider medication if appropriate. We also explore how to keep the depression symptoms from returning – preventing relapse involves education, mindfulness, and work on core beliefs. Numerous research studies have consistently shown that CBT is as effective as antidepressant medication for the treatment of depression.

Please see the Academy of Cognitive Therapy website for Information for Patients About Depression.

Physical symptoms	Insomnia Sleeping more or less than usual Being tired Eating less or more, weight changes
Cognitive symptoms	Self-criticism Hopelessness Suicidal thoughts Concentration difficulties Overall negativity
Behavior changes	Withdrawal from other people Difficulty “getting started” with activities
Emotional symptoms	Sadness Irritability Anger Guilt Nervousness