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Evidence Based Treatment of Depression

distress_October-15-2013By Dr. Donna Ferguson, Psychologist with the WSIB Psychological Trauma Program

Some people diagnosed with depression may have difficulty with task performance – a depressed mood can make it hard to manage work responsibilities, including sustaining effort over time and dealing with change. Some common symptoms of depression include the following symptoms most of the day nearly every day: low mood, loss of interest in previously enjoyed activities, concentration difficulties, problems with appetite and weight (whether loss of appetite and weight or increase in appetite and weight), fatigue, feelings of worthlessness or guilt over things you shouldn’t feel guilty about, and suicidal ideations and/or intent or plans.

The above symptoms of depression can be quite debilitating and distressing for individuals. Sometimes it is helpful for a psychiatrist or family doctor to prescribe certain psychotropic medications that are helpful for depressive disorders. But sometimes other treatment can be helpful, such as psychotherapy that is structured and evidenced based.

Cognitive Behavioural Therapy (CBT)
One kind of treatment that has proven to be helpful for treating depression is called Cognitive Behavioural Therapy (CBT). This treatment is helpful in a number of ways. It is meant to be structured brief treatment ranging from 12-16 or 16-20 sessions on average , although that can vary depending on the individual.

Depending on the severity of the depression, CBT techniques for depression start with behavioural activation, which involves helping the individual to schedule activities that they are good at and might enjoy. This might also include helping the individual to socialize more with friends and/or family and to spend time outside of the home. When the individual has more energy and can engage more in the treatment process it might be time then to introduce cognitive restructuring using thought records. These can be useful for helping the individual to challenge thoughts that have become distorted and have strayed away from the usual way the individual might think based on the depression.

Other important strategies for treating depression could include providing the individual with adaptive coping strategies, or helping them find ways to cope with distress by using techniques in the past that have been successful and helpful (i.e., exercise, listening to music, talking with a trusted friend or family member, or going for regular walks). It is also helpful to remind the individual of their strengths – things that have helped to make them feel useful and worthwhile.

How do you maintain gains made in treatment?
Once gains are made in treatment, it is important that the individual understands how to maintain these gains for the long term. A discussion of relapse prevention is necessary for the individual, as is discussing what was learned in treatment. Knowing what was helpful and what concerns they has about moving forward once therapy is complete is vital in preventing relapse. It is helpful to also discuss a relapse prevention plan in case something happens and the depression becomes worse again. Knowing the difference between setbacks that are minor, versus a more serious relapse will be beneficial in future treatment and maintenance.

CBT Resources
To learn more about Cognitive Behavioural Therapy and to find resources online, check out this page.

2 Comments Post a comment
  1. G Incognito #

    “CBT techniques for depression start with behavioural activation, which involves helping the individual to schedule activities that they are good at and might enjoy.” So this approach doesn’t apply to people who do not enjoy anything any more? (
    “This might also include helping the individual to socialize more with friends and/or family and to spend time outside of the home.” What if the individual has no friends, has never had any, and has no family nearby?

    July 14, 2015
    • Donna Ferguson #

      My blog was referring to evidence based treatments for Depression using a CBT approach, but you are right – for some, socializing and engaging in pleasurable activities might be very difficult for some, particularly those who don’t have the support of friends or no longer enjoy participating in activities. Sometimes it could be helpful to volunteer for a charity if this is appropriate, in order to meet others if the individual does not have a close group of friends or family to lean on for support. This is just one suggestion.

      But treatment is very much individualized to each person and treatment planning would be discussed with each individual person at the point of therapy.

      July 15, 2015

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