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Cognitive Therapy for Depression

Are your thoughts dragging you down?

Cognitive Therapy for Depression: Evidence It's Effective

How well does cognitive therapy for depression work? And how well does it stack up when compared to other treatments for depression?

Robert DeRubeis, PhD, is professor of psychology and associate dean for the social sciences at the University of Pennsylvania. He tells WebMD, "The evidence is consistent and convincing that cognitive therapy is an effective treatment for depression. And," he adds, "[that means] not just the milder forms of depression."

Large, well-designed studies that include hundreds of subjects have shown the following:

1. Cognitive therapy works as well as antidepressant medicines alone to improve mild to moderate depression.

"When conducted well, cognitive therapy works as quickly and as thoroughly as antidepressant medications," says DeRubeis, who has led several large studies of cognitive therapy for depression. "Used consistently, cognitive therapy may work better than antidepressants in the long run," he adds.

2. Cognitive therapy works as well as antidepressant medicines at preventing depression relapses.

DeRubeis tells WebMD that when a person continues using the skills he learned with cognitive therapy, those skills help prevent relapses, a common problem with depression. "Cognitive therapy appears to prevent the return of symptoms as well as taking medication," he says. "And it does it without medication."

3. Cognitive therapy reduces residual symptoms of depression.

After a "successful" treatment for depression, many people continue to have mild depressive symptoms. Adding cognitive therapy to the treatment plan helps reduce these residual symptoms.

Cognitive Therapy for Depression: With or Without Antidepressants?

Cognitive therapy has become the standard "talk therapy" used to treat depression. In addition to its high rate of success, it is also cost-effective. The benefits from cognitive therapy often come in weeks rather than months or years, as may be the case with other treatments. 

But can cognitive therapy replace antidepressant medications? For some people, says DeRubeis, the answer is yes.

But it doesn't have to be an "either-or" decision. In some studies, cognitive therapy for depression worked even better when combined with antidepressants.

Because everyone's situation is unique, the decision about how to use cognitive therapy should always be made by the patient and the mental health provider together.

Cognitive Therapy for Depression: Think Well, Feel Better

Depression demonstrates how closely linked the mind and body are. People who are depressed, frequently feel bad physically, not just sad or "down." Besides helping to improve a person's mood, cognitive therapy can also improve the physical symptoms of depression. It does this by:

  • improving a person's overall energy level
  • increasing the quality and duration of sleep
  • improving appetite and restoring the pleasure of eating
  • heightening a person's sex drive

Cognitive therapy can also relieve chronic pain. Many people with chronic pain also have depression. According to Beverly E. Thorn, PhD, cognitive therapy treats both at once." Thorn is professor of psychology at the University of Alabama and author of Cognitive Therapy for Chronic Pain. She says that after a course of cognitive therapy for chronic pain, "patients' symptoms related to depression are reduced as well."

The effects of cognitive therapy are often longer lasting than pain medicines. "Pain medications have all kinds of side effects and can actually add to depression," Thorn says. With cognitive therapy, patients learn coping skills and how to apply them. When they do, there is less need for pain medications.

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