Cognitive Therapy For Depression Essay

This essay has a total of 3038 words and 12 pages.

Cognitive Therapy For Depression

COGNITIVE BEHAVIORAL THERAPY FOR DEPRESSION
Introduction
Cognitive behavioral therapy helps improve people's moods and behavior by changing their
way thinking; also, how they interpret events and talk to themselves. This form of
psychotherapy helps guide people into thinking more realistically and teaches them coping
strategies to deal with their depression. Cognitive therapy is in most cases a short-term
treatment that can have long-term results. I will discuss depression in adolescence and
how it effects personal adjustments, which may often continue into adulthood. I will also
discuss depression in the elderly. There are different approaches to treating depression,
the main approach that will be discussed is cognitive behavioral therapy, which is a way
to break the cycle for depression.

What is Cognitive Behavioral Therapy?
Cognitive behavior therapy helps people break the connections between difficult situations
and their habitual reactions to them. This can be reactions such as fear, rage or
depression, and self-defeating or self-damaging behavior. It also teaches people how to
calm their mind and body, so they can feel better, think more clearly, and make better
decisions. Cognitive therapy also teaches people how certain thinking patterns are causing
their symptoms. This is accomplished by giving people a distorted picture of what's going
on in their life, and making them feel anxious, depressed or angry for no good
reason.(Francis, 2000) When people are in behavior therapy and cognitive therapy, it
provides them with various tools for stopping their symptoms and getting their life on a
more satisfying track. In cognitive therapy, the therapist takes an active part in solving
a patient's problems. He or she doesn't settle for just nodding wisely while the patient
carries the whole burden of finding the answers they came to therapy for initially.
Cognitive therapists teach patients to identify their negative thoughts, recognize their
erroneous nature and devise a corrective plan that leads to more positive assessments and
an ability to deal more realistically with every day problems.(Burns, 1996-2000) Dr.
Frances M. Christian, a clinical social worker and cognitive therapist at the Medical
College of Virginia in Richmond, says, ?Thoughts and beliefs have a lot to do with how
people feel and behave. Early in life, people develop core beliefs about themselves and
other people and about how the world operates.?

Cognitive behavioral therapy has been very thoroughly researched. In study after study, it
has been shown to be as effective as drugs in treating both depression and anxiety. In
particular, cognitive behavioral therapy has been shown to be better than drugs in
avoiding treatment failures and in preventing relapse after the end of treatment. A
cognitive therapist directs a patient's attention to automatic thoughts, the things people
say to themselves, that result in unpleasant feelings. (Stopa, 2000) For example, someone
prone to anxiety attacks might automatically think, I'm going to mess up, when taking an
exam, participating in a school event or being interviewed for a job. After failing such a
task, the person might conclude, again automatically, I'm a loser. In therapy, the person
is helped to recognize delusions in thought, which include exaggerating the sense of
threat, anticipating disaster as the outcome, and over generalizing from one negative
experience and ignoring times when things went well. Finally, once the damaging automatic
thoughts are recognized, the person is helped to examine how realistic they are, and they
consider alternative explanations, then imagine other outcomes and realize that the
symptoms of anxiety are not the prelude to a heart attack or some other medical disaster.
(Stopa, 2000) This same approach is practiced for depression.

The difference in the therapeutic approach versus medicating is dramatic, and the relief
people feel is immediate. Instead of dwelling on the negative, which the other therapists
sometimes do, they acquire therapeutic tools the depressed can apply on his or her own, in
case they may find themselves slipping into old patterns of thought or behavior. (Stopa,
2000)

Furthermore, studies have shown that the results of cognitive therapy are long lasting,
with relapse rates much lower than with other modes of treatment, including psychiatric
drugs. And while medication is sometimes used, at least briefly, to relieve intense
emotional disturbances and improve receptivity to therapy, most patients can be spared the
side effects of drugs, which may include the inability to function sexually, upset
stomach, difficulty sleeping and difficulty concentrating.(Brody, 1996) While no one
approach to psychotherapy is appropriate for everyone, many thousands of patients have
benefited from the strategies unique to cognitive therapy. In the 30 or so years since the
approach was developed by Dr. Aaron T. Beck, a world-renowned psychiatrist at the Beck
Center for Cognitive Therapy in Philadelphia, it has become the most scientifically tested
model of psychotherapy. (Brody, 1996)

What is Depression?
According to Dr. Judith S. Beck and Dr. Aaron Beck, her daughter, ?Patients have continual
unpleasant thoughts and that each thought deepens the depression.? However, these thoughts
are not based on facts and result in feelings of sadness this is far beyond what the
situation guarantees, it has to do with hypothetical situations. ?Depressed persons make
such mistakes over and over,? Quinn has written. ?In fact, they may misinterpret friendly
overtures as rejections. They tend to see the negative, rather than the positive side of
things. Plus they do not check to determine whether they may have made a mistake in
interpreting events.?(Quinn, 1998) Depressed thinking often takes the form of negative
thoughts about oneself, the present, and the future. The mood in depression is almost
always experienced as sad.

According to a patient's letter written and later published with the permission of William
Morrow and Company, (publisher of Moodswing): from the book, ?Depression and it's
Treatment?, her experience with this mood disorder was despair and uselessness. Eventually
she found herself going to sleep earlier at night just to stop the anxious thoughts
entering her mind. The patient says her appetite got worse and she became physically ill
with the progression of her depression. The statement later reads, ?If I had to see a
psychiatrist, it meant that I was probably going insane, and this thought made me even
more frightened. It was more than I could stand. The fear of being mentally ill was so
horrible that I decided to take my entire bottle of sleeping pills rather than face the
shame of being a mental patient.?(Griest & Jefferson, 1992)

Depression can strike anyone at any given time. It affects 5% of the population at any
time and at least 10% of the population at some point in their lifetime. At least 10% of
the people with major depression end their lives by suicide. (Greist & Jefferson1992)

Depression in Adolescents
How prevalent are mood disorders in children and is an adolescent with changes in mood
considered clinically depressed? Oster has said the reason why depression is often over
looked in children and adolescents are because ?children are not always able to express
how they feel.?(Oster & Montgomery 1997) Sometimes the symptoms of mood disorders take on
different forms in children than in adults. Adolescence is a time of emotional turmoil,
mood swings, gloomy thoughts, and over sensitivity, it is also a time of rebellion and
experimentation. Therefore, the diagnosis should not lie only in the physician's hands but
be associated with parents, teachers and anyone who interacts with the child on a daily
basis. Unlike adult depression, symptoms of adolecent depression are often camouflaged.
Instead of expressing sadness, teenagers may express boredom and irritability, or may
choose to get involved in risky behaviors. (Oster & Montgomery, 1995) The key indicators
of adolescent depression include a drastic change in eating and sleeping patterns,
significant loss of interest in previous activities, aggression and boredom. The signs of
clinical depression include marked changes in mood and associated behaviors that range
from sadness, withdrawal, and decreased energy to intense feelings of hopelessness and
suicidal thoughts. Depression is often described as an exaggeration of the duration and
intensity of ?normal? mood changes (Oster & Montgomery, 1995), constant boredom,
disruptive behavior, peer problems, and increased irritability and aggression. (O'Connor
1997)

For many teens, symptoms of depression are directly related to low self-esteem coming from
increased emphasis on peer popularity. For other teens, depression arises from poor family
relations which could include decreased family support and perceived rejection by parents
(Quinn, 1998). Adolescent suicide is now responsible for more deaths in children age 15
to19 than cancer (Oster & Montgomery, 1997).

Whereas, Oster & Montgomery stated that ?when parents are struggling over marital or
career problems, or are ill themselves, teens may feel the tension and try to distract
their parents.? This ?distraction? could include increased disruptive behavior,
self-inflicted isolation and even verbal threats of suicide. So how can the physician
determine when a patient should be diagnosed as depressed or suicidal? Quinn suggested the
best way to diagnose is to ?screen out the vulnerable groups of children and for the risks
factors of suicide and then refer them to treatment.? Some of these ?risk factors? include
verbal signs of suicide within the last three months, prior attempts at suicide,
indication of sever mood problems, or excessive alcohol and substance abuse. Many
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