Depression is a serious mood disorder, with an estimated 17 million American adults having at least one major depressive episode in the past year. It can affect how you think, feel, interact with people, and handle daily life. It can cause feelings of sadness and a loss of interest or pleasure in things you once enjoyed. Anyone can be affected by depression, and it can happen at any age, but it often begins in adulthood.
The good news is, depression is highly treatable, with reports of 80% to 90% of people eventually responding well to treatment. One of the reasons depression responds so well to treatment is that improvements can be found in medications, psychotherapy, or the combination of both. Finding the right psychotherapist who can help you understand and work through the underlying causes of depression as well as develop coping strategies to deal with the symptoms is often the first step to feeling better.
If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Types of Depression
Diagnosing depression requires an evaluation process involving a physician or mental health professional. In general, to be diagnosed with depression, symptoms need to be present for at least two weeks.
There are several types of depressive disorders as defined by the DSM-5, including, but not limited to, major depressive disorder and persistent depressive disorder. There are also specifiers for major depressive disorder such as major depressive order with a seasonal pattern (previously known as seasonal affective disorder) or major depression with peripartum onset (often known as postpartum depression).
Treating Depression
Depression is often treated with medications called antidepressants, therapy, or a combination of the two. There are several types of antidepressant medications available. It may take some time to find the right one for you, so working closely with your doctor is critical during this time. Even with the right medications, it often takes some time to notice an improvement in how you feel.
Treating depression with therapy or psychotherapy has proven helpful in both short-term and long-term cases of depression. Like medications, there are various forms of therapy and experts to choose from. Some of the more common evidence-based approaches include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), psychodynamic psychotherapy, and problem-solving therapy.
Counseling vs. Psychotherapy
Treating depression with “talk therapy” is often the first step with mild to moderate depression. Many experts will go this route prior to trying medication. If depression is more severe, medication will often be required and a combination of therapy and medication may happen at the same time. Before moving forward, it’s important to understand the differences between counseling and psychotherapy.
The terms “psychotherapy” and “counseling” are often used interchangeably. While the two are very similar, it’s important to note that sometimes, psychotherapy with a licensed psychologist or psychiatrist (MD) is considered more of a long-term approach that focuses on depression and deeper issues that are significantly impacting your life. Counseling, on the other hand, is seen more as a short-term therapy that may focus more on mild to moderate symptoms and outward functioning and behavior.
Counseling for Depression
The length and severity of the symptoms and episodes of depression often determine the type of therapy. If you’ve been depressed for a length of time and the symptoms are severe, working with a psychiatrist or psychologist (PsyD) may be necessary, since they deal more with issues from the past that may be deeply rooted in your present feelings. But if the symptoms of depression are more recent or not as severe, working with a therapist in a counseling relationship may be helpful.
During counseling, the therapist will use “talk therapy” to help you understand and work through the issues that are impacting your life in negative ways. Their role is to listen, provide feedback, and work with you to develop strategies to cope. They will also evaluate your progress and adjust the sessions accordingly. You may be asked to do homework that extends the learning from the counseling sessions. Often, this is in the form of tracking moods and feelings.
Counseling for depression focuses more on present thoughts, feelings, and behaviors and how these things are affecting your life currently. That’s why CBT has been a useful model to use in counseling sessions.
With CBT, the therapist can help you change negative thinking that may be making the symptoms of depression worse. The focus is goal-oriented, with you, the patient, taking an active role.
Since CBT is generally considered short-term therapy, it’s often a top choice for therapists when working with mild to moderate cases of depression that may not need long-term, in-depth psychotherapy. Evidence suggests that CBT works well in counseling for depression. It’s also proven to reduce relapse or recurrence rates of depression once counseling has ceased.
Interpersonal therapy (IPT) is another brief or short-term method used in counseling for depression that focuses on interpersonal conflict and poor social support, which can lead to feelings of depression. This type of therapy can help you communicate better and address issues that make the symptoms of depression worse. Evidence suggests that IPT is effective in acute treatment of depression, and it may help prevent new depressive disorders.
Other Treatment Options
There are also some other treatment modalities that may be worth considering. For more severe and refractory cases of depression, electroconvulsive therapy (ECT) may be useful. There are also complementary and alternative approaches that might provide additional benefits.
How to Find a Counselor
Finding the right counselor, psychologist, or mental health expert to work with may take some time. When it comes to counseling for depression, the relationship between patient and counselor is key to the success of the therapy. It’s important to be patient and open to the process. You may find that you need to see a few people before finding someone you can develop the best working alliance with.
If you’re not sure where to look, a good place to start is with your doctor. You can also contact any larger mental health facilities in your area. While they may not offer the services you need, they will likely know of counselors close to where you live that provide therapy for depression.
Another place to find referrals online is through one of the professional organizations such as the American Psychological Association or the Anxiety and Depression Association of America. Many of them have online directories that allow you to search for mental health experts in your area.
Finally, spend some time researching the experts in your area. Go online and read their bios. Send an email asking for more information about their preferred forms of treatment and how they interact with clients. Many therapists offer a free intro session to see if it is a good fit. Find out if they offer a free trial session and give it a try.
One other form of counseling to consider, especially for more mild forms of depression, is online therapy. The popularity of online therapy has increased in the last few years and has accelerated considerably in the current pandemic.
Online resources and apps such as Talkspace offer support via a desktop or mobile app with a variety of services including individual sessions and other mental health resources that can help you work through issues related to depression, and come up with and practice coping strategies.
A Word From Verywell
Living with depression can feel overwhelming at times. Working with a mental health expert in a therapeutic relationship provides you with a safe environment to identify the thoughts, feelings, and patterns of behavior that are contributing to your symptoms. Counseling can also help you learn new coping skills and techniques to better manage the symptoms.
Short-term counseling, which typically lasts less than six months, is often appropriate for mild to moderate depression. If you feel like you could benefit from counseling for depression, talk with your doctor about getting a referral. Finding someone you trust and feel comfortable opening up to is critical in the success of the counseling process.
Depression is a potentially debilitating mental health disorder. It’s also one of the most common. The CDC states almost 5% of adults report suffering from depression each year. However, cases may be underreported. Other sources place the actual number of individuals living with the disorder much higher.
There is good news: depression is highly treatable. Each year we continue to learn more about mental health disorders and effective methods for treating them. Therapy is one such depression treatment.
Therapists use a range of therapeutic techniques to help their patients overcome depression.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy, or CBT, helps an individual identify and change negative thoughts and associated behaviors.
People who suffer from depression often struggle with negative thought patterns. These thought patterns can influence our behavior. In turn, behavior reinforces the thought patterns. This creates a continual cycle of negative thoughts and depressed mood.
In many cases, our thought patterns are partly a result of our core beliefs. Therapists who use CBT help patients identify their core beliefs, address the negative thoughts that arise from them, and adjust their behavior accordingly.
How Effective is CBT For Treating Depression?
There have been many studies that show CBT is an effective treatment for depression.
One study found that CBT was as effective as antidepressant medications in treating patients with depression. The same study also found that patients who completed the full course of CBT sessions were less likely to experience a relapse of their depression symptoms after treatment than those who received only medication.
Another recent study found that patients treated with CBT showed a marked improvement in their depression symptoms.
However, it’s important to note that some studies do find mixed results, and patients with the most severe symptoms also typically show the most improvement from therapy.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy is very similar to CBT. In fact, many of its techniques are based on it. However, DBT differs in that it teaches patients to identify, accept, and regulate their emotions.
As the name implies, DBT helps patients engage in a “dialogue” with their emotions and behaviors. Patients are taught to challenge the contradictions in the attitudes and emotions that are preventing them from making positive changes in their life.
In other words, an individual learns to “talk back to” negative and self-defeating thoughts. During this process, they can begin to replace these thoughts and behaviors with positive ones.
DBT And Depression Treatment
DBT offers many benefits in treating depression. Studies have supported these benefits.
One study, published in a 2016 issue of Child and Adolescent Mental Health, reported an “improvement in depressive symptoms for adolescents following a course of DBT.” Additional studies show similar improvements for adults and even for the elderly.
Behavioral Activation (BA)
Behavioral activation shares similarities with both CBT and DBT. Like these other types of therapy, BA focuses on a patient’s thoughts and behaviors.
Often, behavioral activation is used in conjunction with other therapeutic techniques to treat depression. BA helps patients adopt a long-term coping strategy by identifying specific goals and working toward meeting them.
When a person is depressed, they may try to avoid certain activities like social events. Therapists use behavioral activation to build positive reinforcement and help patients create an action plan to help them overcome avoidant behaviors.
The patient becomes increasingly confident and begins striving to meet realistic goals. As a result, a sense of positivity and accomplishment is reinforced. In turn, individuals begin to overcome depressive thoughts and behaviors.
Is Behavioral Activation Effective For Depression?
Behavioral activation is rarely used on its own. It’s more likely to be used alongside other therapeutic techniques as part of a holistic treatment plan.
However, on its own, BA has been shown to help patients with mild to moderate levels of depression. Though, study authors note that the best results nonetheless come from a full-scale treatment.
It’s also important to note that behavioral activation is a relatively new therapy. This has led some studies to conclude more research must be done before the true efficacy of behavioral activation can be reported.
Problem-Solving Therapy (PST)
Problem-solving therapy is a therapeutic technique that helps individuals cope with life stressors that negatively impact their mental health.
We all experience stress, but major life stressors or chronic stress can take a heavy toll on our mental health. PST is designed to help people struggling with depression or anxiety identify and manage those stressors.
In practice, PST builds off of established techniques like adaptive problem-solving and mindfulness to help patients better understand and cope with stress. PST also helps patients to more effectively process negative emotions that can occur when we experience difficulties, like the loss of our job or the death of a loved one.
Interpersonal Therapy (IPT) For Depression
Interpersonal therapy was developed to help treat depression in adults. However, it has been increasingly used to treat other mental health disorders, as well.
IPT aims to help patients with mild to moderate depression address problems with interpersonal connections and improve relationships. Similar to problem-solving therapy, the focus of IPT is the patient’s actions and reactions.
Generally, IPT is time-limited, meaning treatment may only last for around 20 sessions. The length can vary based on the patient and their needs. During this time, the therapist and patient:
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Identify important interpersonal relationships in the patient’s life
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Address how these relationships affect their mental wellbeing
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Develop skills and strategies to improve these relationships
Studies have shown that IPT can have a positive impact for people suffering from depression. Although IPT may be more effective when incorporated into other forms of therapy, like CBT.
How Long Does Therapy Take For Treating Depression?
Each individual and their symptoms are different. Likewise, the treatment for their depression will vary based on their needs. In short, there’s no one-size-fits all approach to therapy or mental health treatment. However, the American Psychological Association states, “on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.”
The length of time a patient requires therapy to help treat their depression will depend on a number of factors:
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Severity of depression and symptoms
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Co-occurring disorders (such as anxiety, eating disorders, or substance abuse)
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Patient adherence to therapy and treatment
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Frequency of therapy sessions
These are only some of the factors that can impact the effectiveness of therapy.
Is Therapy or Medication Better For Depression?
Every patient is unique. As such, it’s important to tailor treatment to the individual. Antidepressant medications have proven to be effective for individuals with moderate to severe depression. Likewise, therapy has been shown to be as effective as medication for some patients.
However, the reality is many patients with severe or chronic depression will benefit most from a combination of therapy and an antidepressant medicine. The challenge is finding the right medication and the right balance between treatments.
For this reason, people with more severe depression should work with their doctor and a team of licensed mental health professionals to develop a complete treatment plan.
It’s important to understand that recovery from any mental health disorder takes time. Therapy can last for many months, while finding the right medication can take several attempts.
Get Help For Depression From An Experienced Team
If you or a loved one is struggling with depression, it’s important that you find the right level of care. At High Focus Centers, our team is composed of licensed mental healthcare professionals with experience treating a range of disorders.
If you’re searching for help with depression, contact our staff online or call us by phone at (877) 792-6430.
