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    Depression and Risky Behavior

    Why self-destructive behavior may accompany depression and what to do about it.

    Treating Harmful Behaviors

    Treatment for self-destructive behaviors should focus on the underlying causes, experts say.

    “You have to find out, where is that coming from?” Curran says. “A lot of those behaviors come from having experienced trauma, either witnessing it or experiencing it personally. There’s all this pent-up energy, and it comes out in the anxiety, depression, and risky behaviors. Dealing directly with the trauma helps.”

    Besides supportive psychotherapy, antidepressant medications can be useful, says Cantor.

    Therapists can also teach avoidance techniques, she says. “If you can avoid a trigger, you can avert the behavior. One has to take oneself away from situations that prompt self-destructive behaviors.” For example, a person who clears alcohol or blades from his or her surroundings will find it harder to drink or to cut.

    Depressed people can also learn to substitute activities that don’t cause damage. For instance, relaxation techniques or meditation can help them to manage their feelings, rather than resorting to harmful behaviors, Curran says.

    Dialectical Behavior Therapy (DBT)

    For anyone who's depressed, therapy is a key part of treatment. One form of therapy, called dialectical behavior therapy (DBT), offers promise for some self-destructive behaviors, experts tell WebMD.

    DBT is a form of cognitive behavioral therapy that was originally developed to treat borderline personality disorder, which often involves self-destructive behaviors. Now, some therapists use DBT to treat substance abuse, eating disorders, anger, and other problem behaviors.

    According to Gardenswartz, a depressed person with a substance addiction still needs an inpatient rehab program, but DBT could help address other self-injurious behaviors.

    “It’s a fantastic treatment,” Andover says of DBT. But she adds that it is a highly intensive approach that requires lots of resources and may not be right for everyone.

    The cornerstones of DBT include: addressing dangerous and impulsive behaviors in order to improve control, learning how to deal with distress and manage extreme emotions, training in interpersonal skills, and finding effective and socially acceptable ways to handle life’s problems.

    It’s called dialectical behavior therapy because it combines two seemingly opposite ideas: fully accepting people in their current condition while actively helping them to change problem behaviors. According to DBT proponents, acceptance and empathy -- not rejection -- help motivate people to change.

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    Reviewed on June 23, 2011

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