Treatments for Depression

Types of Psychotherapy
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Depression can bring everything in your life — work, relationships, school, and even the most minor tasks — to a grinding halt, or, at the very least, gum up the works. The aim of psychotherapy is to relieve you of symptoms and to help you manage your problems better and live the healthiest, most satisfying life you can.

Some evidence suggests that by encouraging more constructive ways of thinking and acting, psychotherapy makes future bouts of depression less likely. Three schools of psychotherapy — cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy — play a primary role in combating depression.

Which type of psychotherapy works best? There’s no simple answer. Just as people respond differently to different drugs, you might do better with one type of therapy than with another. Many people find that a blended approach — one that draws on elements of different schools of psychotherapy — suits them best.

Cognitive behavioral therapy

Cognitive behavioral therapy aims to correct ingrained patterns of negative thoughts and behaviors. To accomplish this, you are taught to recognize distorted, self-critical thoughts, such as "I always screw up"; "People don’t like me"; "It’s all my fault." During cognitive behavioral therapy, your therapist may ask you to judge the truth behind these statements, to work to transform such automatic thoughts, and to recognize events that are beyond your control.

Along with cutting down on the number of negative thoughts, cognitive behavioral therapy also focuses on breaking jobs into smaller, more manageable pieces that set you up for success. You rehearse new ways of coping with problems and practice social skills that can help wean you from actions that provide a fertile breeding ground for depression, such as isolating yourself. Your therapist may assign you tasks to reinforce your learning. For example, you might keep a log of thoughts that occur as you try out your new skills. As negative patterns become clearer, you can learn to redirect them.

Interpersonal psychotherapy

Interpersonal psychotherapy concentrates on the thornier aspects of your current relationships, both at work and at home. Weekly sessions over three or four months will help you identify and practice ways to cope with recurring conflicts. Typically, therapy centers on one of four specific problems:

grief over a recent loss
conflicts about roles and social expectations
the effect of a major change, such as divorce or a new job
social isolation.
Psychodynamic therapy

Psychodynamic therapy focuses on how life events, desires, and past and current relationships affect your feelings and the choices you make. In this type of therapy, you and your therapist identify the compromises you’ve made to defend yourself against painful thoughts or emotions, sometimes without even knowing it. For example, someone with an overbearing parent may unconsciously find it difficult to risk developing intimate relationships, out of fear that all close relationships will involve a domineering partner. By becoming aware of links like this, you may find it easier to overcome such obstacles.

You and your therapist may talk about disruptions in your early life — perhaps the death of a parent, your parents’ divorce, or other disappointments — to determine their effect on you. While the duration of psychodynamic therapy can be open-ended, a variation called brief dynamic therapy is limited to a specific amount of time (generally 12–20 weeks). It applies a similar lens to a specific emotional problem.

Not just for individuals

Group, family, or couples therapy may also be part of a plan for treating depression or bipolar disorder. Group therapy draws on support generated from people in the group and uses the dynamics among them, along with the leader’s help, to explore shared problems. Family therapy and couples therapy also delve into human interactions. Like group therapy, the aim is to define destructive patterns — such as scapegoating one family member or enabling a spouse’s alcohol abuse — and replace them with healthier ones. These therapies can uncover hidden issues and establish lines of communication. Family therapy is especially useful when one person is struggling with emotions that spill over into the family.