Cognitive psychotherapy for depression

Every year, 15% of adults aged 18 to 74 years experience decreased mood, unwillingness to communicate, apathy, sleep disturbances and anxiety. It is with depression that 75% of all visits to psychiatrists and psychotherapists are associated .       

There are two main proven treatments for depression: drug therapy and psychotherapy. The combination of these two methods gives the greatest effect. The use of drugs alone, according to the estimates of controlled studies in the field of pharmacotherapy of depression, leads to a pronounced improvement in only 60-65% of cases. This means that in relation to 35-40% of depressed patients, various methods of psychotherapy should be used.    

But in order to achieve that very pronounced improvement, a long-term intake of an antidepressant in sufficiently high doses is necessary . Despite the relative safety of modern drugs, we would like to reduce the duration of their administration and the dose to the minimum possible, thereby minimizing side effects (drowsiness, lethargy, liver and stomach damage, etc.). The best option for treating depression is to combine antidepressant medication with cognitive therapy. Improvement of the condition in this case will be prompt and clearly felt, and most importantly, a lasting effect of the treatment will be obtained. Indeed, thanks to psychotherapy, the patient receives a “powerful weapon” in his hands – during psychotherapy he learns methods of controlling his own negative emotions, the ability to recognize the approach of depression, take the necessary measures and even prevent the return of the disease. In this case, the percentage of persistent cure is achieved in 98-99% of cases (according to reliable sources). Cognitive psychotherapy has proven itself best in the treatment of depression, anxiety, phobias, and panic attacks. The cognitive approach is based on the statement: “A person’s emotions and behavior are determined by how he evaluates the world.” That is, if in the depths of the subconscious a person has the belief that the world is unfriendly, then his behavior and emotions will be appropriate: how can you feel good and comfortable in the place where you are treated badly in advance? But few are ready to admit that they have such a belief, and yet it is it, or something similar to it, that leads to the development of anxiety and depression. The identification of these basic attitudes, their correction and the development of a new way of thinking is the task that the psychotherapist and the patient successfully solve together in sessions. In the first sessions, the patient explains the interconnection of thoughts, emotions, behavior on the example of his own experience. Then they teach to recognize, track, fix their negative thoughts in a special “Diary of Automatic Thoughts”. After that, together with the therapist, the recorded automatic thoughts are analyzed and irrational (incorrect and illogical) are identified. Basic beliefs are identified using special techniques for working with automatic thoughts: in our example, this was the basic belief “The world is unfriendly.” The next stage is the correction of the irrational basic belief and the development of a new, adequate and realistic one. In the course of all this work, responsibility for one’s own condition is gradually transferred into the hands of the patient himself. And by the end of therapy, the patient begins to play the role of a psychotherapist in relation to himself, independently questioning his own predictions or conclusions, skillfully carrying out their correction. The course of cognitive psychotherapy, as a rule, consists of 15-25 sessions with an interval of 1-2 times a week at the initial stages, once a week at subsequent stages, at the last stages meetings are possible once every 2 weeks. After the end of the course, “booster therapy” is recommended – visiting a psychotherapist, if necessary, 3-4 times a year – to monitor the condition and obtain further clarifications and homework.  

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