What Are The Most Effective Types Of Counseling For Depression?

Depression is an extremely common mental health condition that can affect people of all ages, genders, socioeconomic groups, and walks of life. This disorder can cause many symptoms, including a sense of hopelessness, difficulty maintaining relationships, and a loss of interest in normal activities. Depression is highly treatable in most cases, and some of the most effective types of counseling for this mental illness can include cognitive behavioral therapy, dialectical behavior therapy, acceptance and commitment therapy, psychodynamic therapy, behavioral activation, and interpersonal therapy. You may try any of these types of talk therapy online or in person.

What is depression?

Everyone can feel sad from time to time. Whether it's due to a breakup, a job loss, the death of a loved one, or another challenging situation, we may feel sadness, discouragement, and irritability. During these times, it can be difficult to get through our day. Usually, these periods resolve on their own, often with the support of our loved ones and friends.

For someone with depression, negative feelings and thoughts may become the new normal. You may constantly feel sad, hopeless, worthless, or numb. Your mind may endlessly race with worries or doubts. You may become tired, withdrawn, and lose your energy and passion for life. These symptoms can last for weeks, months, or longer, and often need professional assistance to resolve.

Symptoms of major depressive disorder (MDD), which is typically the most common type of depression, can include:

• Feeling sad, worthless, hopeless, or numb for most of the day, almost every day
• Losing interest in regular activities and hobbies
• Difficulty connecting with other people; social isolation
• Loss of energy, weakness, fatigue
• Even small tasks take much more effort than normal
• Trouble falling asleep or requiring much more sleep than usual
• Persistently negative thoughts about yourself and the world
• Difficulty concentrating or remembering
• Loss of appetite or frequent hunger with strong cravings for sugary or fatty foods
• Physical symptoms, such as headaches, muscle tension, or slowed motor functioning

If you've been experiencing some of the symptoms listed above for two weeks or more, you may meet the criteria for a diagnosis of major depressive disorder. You can contact your doctor or mental health professional to be scheduled for an evaluation.

What kind of therapies treat depression?

If you've been diagnosed with depression, the following types of therapy can be of benefit.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy is an evidence-based type of short-term talk therapy, with much clinical evidence pointing to its effectiveness in treating depression and anxiety. It is sometimes referred to as the "gold standard" in psychotherapy because it tends to have the most evidence to support it. 

CBT normally involves recognizing negative thinking patterns and the emotional states and behaviors that can be influenced by that type of thinking. When an individual is experiencing depression, their thoughts are often hijacked to skew negatively. First, the therapist may guide the individual to recognize their cognitive distortions. Then, the patient may be taught to replace their automatic negative thoughts with positive statements.

Since most of us don't analyze our thoughts as they occur, we tend to believe that these distorted assumptions are true. In this way, depression can lie to us and manipulate the way we view the world. By catching these thoughts and looking at them with a critical eye, we may be able to separate reality from depression's influence.

Dialectical behavior therapy (DBT)

Originally developed to treat individuals diagnosed with borderline personality disorder (BPD), DBT can be effective for other conditions, including depression. DBT is usually best for people who have difficulty with extreme emotions. With DBT, a therapist typically identifies deficits in emotional skills and coping behaviors and rectifies these missing elements through teaching and guidance.

DBT is generally viewed as a form of cognitive therapy, but the focus is usually on managing your emotions instead of changing your thoughts. The name comes from dialectics, a theory that states that everything may have an opposite, and change can happen when one side exhibits a stronger pull than the other.

Acceptance and commitment therapy (ACT)

ACT was developed in the 1980s, but only recently gained more widespread attention as research was done on its effectiveness. The ACT can be considered another subtype of cognitive-behavioral therapy that has been shown in over 300 clinical trials to help patients with depression, anxiety, and addiction, among other mental health issues. It can be at least as effective as CBT in improving moderate to severe depression symptoms.

Instead of changing thought patterns, you generally develop mindfulness of your negative thoughts and limiting beliefs in ACT. Then, you can act despite them. The idea behind acceptance and commitment therapy is usually that a change in your emotional state is not needed to change your behavior. Still, a change in behavior can influence how you feel.

ACT may help you develop a new way of looking at your depression and allow you to act mindfully despite how you're feeling. Many people struggle with desperately trying to control their feelings. They may feel the need to "fix" how they are thinking or feeling before making progress in life. With ACT, you may accept the way you feel in the moment and act in a way that benefits you in the long term.

Psychodynamic therapy

In psychodynamic therapy, the therapist usually guides the patient to explore the potential sources of their depression. The goal is generally to identify past reasons for current depressive feelings, including negative relationships, attachment issues, or traumatic events. You may work to unearth subconscious motivations for your actions and feelings.

Psychodynamic therapy has mostly fallen out of favor in recent years in favor of CBT and other therapy methods. Still, many people find psychodynamic therapy to be an excellent form of counseling for deeply rooted depression.

Behavioral activation

Behavioral activation is often seen as a relatively new type of therapy for depression. Instead of focusing on changing your thoughts or managing your emotions directly, behavioral activation mainly focuses on encouraging the patient to do things that will benefit their condition. In this way, it's much like acceptance and commitment therapy, but it may work better for patients who are experiencing learned helplessness.

People experiencing depression often tend to withdraw and isolate themselves from other people, including their loved ones. Since depression can cause a loss of pleasure, as well as fatigue, you may also stop doing the things that could help pull you out of depression. In this way, it can become a self-sustaining cycle.

Behavioral activation normally seeks to dismantle this cycle by focusing on establishing positive behavior patterns. As the name suggests, the therapist usually seeks quite literally to activate the depressed person to behave more healthily.

Interpersonal therapy (IPT)

Interpersonal Therapy (IPT) is generally a short-term type of therapy for depression and other mental health issues. Studies have shown IPT to be at least as effective as antidepressants in treating mild to moderate depression. It is often recommended to treat depression in children and teens.

The focus of interpersonal therapy is typically identifying and managing issues in relationships. The goal of treatment tends to be to quickly address and reduce symptoms of depression and improve the relationships in the individual's life. A strong social support system can mitigate the symptoms of depression, and interpersonal therapy can help develop positive social connections.

Sessions of IPT usually occur weekly for three to four months. During each session, the therapist may work to identify any issues and obstacles related to the individual's social functioning.

Finding the right therapist

Connecting with a therapist you feel comfortable opening up to can be one of the most important facets of successful treatment. It can be helpful to look for a therapist who has experience using the therapy method you're interested in to treat your condition. It may take a few times to meet with your therapist to get a feel for whether it's a good fit. Please don't hesitate to switch therapists if you feel like you're not getting the help you need.

Considering online therapy?

Depression can make it difficult to have the motivation to attend appointments. You may have other barriers to treatment as well, such as a packed work schedule or transportation issues. Online therapy may allow you to connect with a licensed therapist on your terms, no matter what difficulties you may be facing. You may schedule sessions at a time that works for you and attend them from the comfort of your home.

As this study explains, online therapy is typically as effective as traditional in-person therapy. Please know that either option can be valid and beneficial. If you feel working with a licensed mental health professional could improve your life, please don’t hesitate to reach out and get the help you deserve.