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May 14, 2008

Cognitive behavioral therapy can change the way you think

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By Gabrielle J. Melin, M.D.

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Cognitive means thinking and so, cognitive behavioral therapy is one form of talk therapy that examines how your thinking affects your behavior and therefore, your mood as well.

For instance, if you and a few other people are having a conversation and one person is completely negative and pessimistic, it eventually leads to you feeling negative and pessimistic, too. We all have a certain amount of resiliency, but it can be very challenging when you're constantly bombarded with negativity.

This same type of negative voice can go on in your own head automatically and can affect the way you think, feel and view yourself, others and the world in general. It is like having a dark cloud over you. If you say things to yourself like "I am ugly and fat," you can see how this will lead to feeling down. This is simplifying the concept, but gives you a good idea.

The goal of cognitive behavioral therapy is to change the way you think so that you can feel better! This is an excellent, well studied form of talk therapy that can be as effective as medication for depression and anxiety. It can be used for other psychiatric disorders and insomnia. This is not a one size fits all, just as ECT and medications are not panaceas.

Keys are recognizing the presence of automatic, distorted thoughts, believing that you can change these thoughts and being motivated for change. Change can be difficult even if it is positive. It takes time and energy to change your thoughts and develop alternative, healthier thoughts, so be patient with yourself.

Two excellent resources used by mental health professionals are listed below. We would recommend that you work directly with a mental health professional who has specific training in cognitive behavioral therapy. Very few people will be able to work through these books alone and have success.

"Feeling Good: The New Mood Therapy," David D. Burns, M.D.
"Mind Over Mood: Change How You Feel by Changing the Way You Think," Dennis Greenberger, Ph.D. and C. Padesky, Ph.D.

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8 comments posted

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December 2, 2008 5:54 p.m.

I dont think i have depression. I suffer panic attacks - severe, they have stopped me from driving / working/ going out day or night time unless i am with someone. So my life through 'panic attacks has changed 100% downhill and so for this reason (change of lifestyle) I am now feeling depression! Help, this is a downward spiral and I feel i am in the vortex, i can't get out of the suction and i am doomed. i am 47 and for the last 4 months my life has stopped. I cry every day for no reason, i feel lonely even when i am with people. I feel a 'freak' as no one else will have ever felt like me before! and i am 'certain' i am about to die, death is following me, trying to catch me. I have no drug addictions, stopped smoking, stopped alcohol, stopped tea and coffee, and i suppose i have almost stopped living, yet i cannot break out of this, oh and for 2 months i have had a mental health nurse - Alison visiting my home weekly, working on CBT with me, I feel that also is failing. I look forward to her visiting but it also sets off a panic'y feeling of 'desperation in me that i need/want /have to get better' and it then dawns on me another week has passed me by when Alison visits and i have missed out on all my normal activities and routine including my job. Pressure is building up in me and is making me more ill, the stress of being unwell 'mentally' - an invisible illness that { I would not have understood before being a victim } Thank goodness i have the internet - i can speak here

- Sandy UK

May 30, 2008 3:27 p.m.

I suffered from depression on & off all my life. No one told me that the mood swings I had were curable. My mom and her family had emotional troubles, my gradmother alternately lived on the street and our family would go and get her put her back in her apartment and get her some help, but she always ended up on the street. I didn't know her very well but my mom suffered from depression and I think it is runs in the family but no one talks about it. When I was diagnosed I was 35yrs old.I suffered for at least 20 yrs my grandma suffered all her life, when my daughter had trouble at about 12yrs old I didn't reconize it, thought it was just teenage anzeity and growing up.I wish I would have gotten some help for her.My husband was afraid of the astigmatism, other peoples opinion so we let it go, she cut herself and did drugs and I still did nothing, talk therapy really helped me and years later my duaghter went to group therapy and she still needs more.anyone who says its in your head or it will go away is wrong. do what you feel is necessary and let go of your fears talk about it with a professional it really works and meds if necessary. I believe the first thing to solving a problem is reconizing you have one.

- Liz

May 24, 2008 10:09 p.m.

There is a poem by a Finnish poet which goes to the effect that ---I was walking with the kerchief of joy in my hand with which my step was lighter and into which I dried my tears.To others I was a bad little witch. I have often experienced this--others cannot understand the surge of joy or or flooding of dark waters over me.I read somewhere that bipolarity is a flooding of too much emotion into whatever it floods on.I agree.A glorious spring day with red or pink tulips against a backdrop of green will transport me into the joy of living.Being undervalued because of my stuttering and the fences I have had to jump will drive me to despair.With me other people have been the ones to drag me down.I am alone in a country into where I was not was born,with a different culture and an unpronouncable name.Someone somewhere said that bipolarity is a flooding in of too much of one or another emotion.I tend to agree

- Tuula Kahilahti

May 23, 2008 4:35 a.m.

i want to know can we assess the level of depression from other people's judgement i.e. who decides that somebody has depression how to avoid such comments?

- No name given

May 20, 2008 5:00 p.m.

I have been investigating the use of Ketamine for the treatment of TRD. Does Mayo or anyone else have information regarding the use of this in this country? Most info comes from other countries.

- eljay

May 17, 2008 7:41 p.m.

All the negative talk it is so hard to re-train the brain. It get better for awhile the next stressor happens then fall back to the old thinking. If only we could turn off all those negative emotions. One of the hardest part is to learn how to like yourself. When you don't think much of yourself it really makes you wonder what is the use. So many times I have thought of or almost ended things. It would be so nice for once things would be peaceful.

- Ann MN

May 16, 2008 12:43 p.m.

Getting off the ECT...I just think, like all treatments, that a certain treatment may work for others and be awful for someone else. My mom, who is bipolar, was put on Zoloft a couple years ago. Within 3-4 weeks, she was suicidal! She had never been suicidal before. Again, as patients, we have many choices of treatment, although exploring all the options is many times frustrating. My frustation lies within my husband not understand depression and the treatments. He thinks it's all in my head and to just "get over it." Coming from a family history of depression, he thinks I just want to treat all problems with doctor visits and medications...and now I noticing my son with anxiety issues and my husband will not seek any outside help. Uggg. Depression is still a lonely and frustrating disease.

- No name given

May 14, 2008 2:13 p.m.

I'm in therapy every other week and must say it makes a world of difference in my treatment plan. Some days I don't want to talk about relevant issues but then during the session I always break down and have minibreak throughs. I would not be making the progress at such a good rate without therapy and right now am engaged with negative self talk - I always cut myself off and insert negative outcomes instead of allowing things to rogress naturally. It's something I'm working hard at recognizing within myself so that I can hopefuly change behaviorally. Small steps and daily doses of joy are what I strive for and I try to take things a moment at a time so as not to overwhelm myself.

- Marie