My name is Dr Emma Gray, and I’m the Lead
Clinical Psychologist at the British CBT & Counselling Service.
And in this video, I’m going to talk to you about CBT for depression.
Now a significant number of people suffering from depression go undiagnosed and, as a result,
untreated. So, let’s start by working out if you actually
have depression. So, ask yourself these questions. Do you feel
sad a lot of the time? Do you find that you have nothing to look forward to? Do you look
back over your life and see lots of failures? Do you find that you get no real satisfaction
from things anymore? Do you feel guilty a lot of the time? Maybe you find you have to
push yourself quite hard to get anything done? Do you struggle to fall asleep, and then find
you wake only a number of hours later? Are you becoming easily tired? Have you noticed
a change in your appetite—either it’s increased, or it’s decreased? Do you find you’re less
interested in sex? If you’re answering ‘yes’ to one or more of these questions, it’s quite
likely that you’re suffering with depression—or low mood.
The best therapy, currently available, for depression, is Cognitive Behavioural Therapy—or
CBT. So now we’re going to look at what a good
CBT programme looks like. A good CBT programme consists of 4 key phases.
The first phase is a kind of assessment where your therapist will try and understand why
your symptoms have developed, and why they’ve stayed with you—this will enable them to
develop an approach that will bring you the quickest and most enduring relief. And this
is really important; the treatment programme has to be tailored to what you need as an
individual. If your therapist is just using an off-the-shelf treatment that they use with
everyone, it’s far less likely to be effective. The second phase of treatment is where we
look at trying to reduce your symptoms and help you to function better on a day-to-day
basis. And this will involve a combination of psychological and practical strategies
which you’ll need to practise outside of the session. And this is quite important because
it’s what you do in between your sessions that is going to make the biggest difference.
It’s not enough just to come to your session and talk to your therapist once a week.
So, let’s look at these psychological techniques first.
So the idea is that it’s our thoughts—the way we think about the world—that affects
how we feel. Specifically, in depression, you’ll find that your thoughts are very self-critical.
You may have a tendency to underestimate yourself, compare yourself negatively to other people,
to take responsibility for things that might not be your problem (or responsibility), to
take what other people do as a personal attack, to generally be quite unkind towards yourself.
So in your CBT, what you’ll be doing is identifying these thoughts, assessing their accuracy and
their helpfulness. And if they’re found to not be accurate, or helpful, you will be helped
to develop alternative thoughts which will improve your mood and bring you a little bit
more peace and happiness. In terms of the practical techniques that
you’ll be learning; when we become depressed we behave in ways that tend to make our mood
worse—more specifically, we withdraw from people and from doing the things that might
have, in the past, brought us a sense of achievement and pleasure.
Now it’s quite hard to reconnect with the world—to start doing these things again—but
your therapist will gradually help you to do this through a range of practical techniques.
And, over time, this will help to lift your mood.
Once you’re feeling better on a day-to-day basis, you will begin the third phase of therapy
which is about future-proofing the changes that you’ve made. This is quite important
because depression doesn’t just strike people down randomly—there will be something in
your past that has happened that has made you vulnerable to developing your depression.
And it’s really important that you identify that—and limit its impact on you—otherwise,
you will find that your symptoms just return. The final phase of therapy is about consolidating
the changes that you’ve made and building your confidence so that you can manage your
mood independently. Hopefully, I’ve answered all the questions
that you have about CBT for depression, but if not, please post them in the comments below,
and I will do my best to answer them. I’ll see you soon.