In treating depression, psychotherapy is a broad behavioral health service that encompasses many modules or frameworks for providing evidence-based therapeutic techniques. However, understanding the different types of psychotherapies, such as CBT, IPT, or DBT, can feel like reading alphabet soup. With so many therapies available, it can be challenging to understand which is best for you.

Many therapies are effective in treating depression and improving symptom management. Effectiveness is based on scientific studies of these therapies in practice, leading to them becoming evidence-based or supported by the most recent research. Of these, cognitive behavioral therapy has the most research supporting its effectiveness, and other evidence-based approaches include dialectical behavioral therapy, interpersonal therapy, and psychodynamic therapy.

However, this doesn’t necessarily make cognitive behavioral therapy the “best.” In truth, everyone responds to treatment differently, and the best option for you depends on your unique needs and what therapy you respond best to. In this article, we will explore the most evidence-based therapies for depression with considerations on whether each might be a good fit for you and your specific needs.

Cognitive Behavioral Therapy: Addressing Negative Thoughts

Cognitive behavioral therapy (CBT) is one of the most evidence-based therapies for treating depression and many other mental health conditions. It works by helping individuals identify the negative thought processes that contribute to depression, challenge them, and create more realistic and positive beliefs. It’s structured and time-limited, focusing on current challenges with direct strategies to manage symptoms in the short term and improve overall mental health in the long term.

CBT is especially beneficial for individuals who experience persistent negative thoughts and are motivated to actively participate in treatment. It’s suitable for people dealing with mild to moderate depression and for those looking for practical, goal-oriented therapy. Additionally, CBT has the most evidence supporting its efficacy as an online therapy, with no difference in outcomes between in-person and online CBT.

Dialectical Behavioral Therapy: Emotional Regulation and Mindfulness

Dialectical behavior therapy (DBT) operates on the principles of opposites (dialectics) that was originally developed for borderline personality disorder but has been shown to be effective in treating depression. It works by helping individuals accept and harmonize conflicting emotions and can be helpful with people whose emotions are very intense and disruptive to their lives. DBT helps people regulate their emotions, improve relationships, and make positive improvements in their lives.

The core components of DBT include:

• Mindfulness: Being fully present and aware of your thoughts and emotions without reacting.
• Emotion Regulation: Understanding those emotions and how to manage them.
• Distress Tolerance: Learning coping strategies for high-stress situations or triggers.
• Interpersonal Effectiveness: Communicating assertively and maintaining relationships.

DBT is particularly beneficial for individuals who experience intense mood swings, emotional sensitivity, or difficulty coping with stress. While longer than CBT (6-12 months vs. 2-4 months), the structured behavior modification approach helps individuals develop lasting techniques to manage their emotions and improve their quality of life.

Interpersonal Therapy: Navigating Relationship Issues

Interpersonal therapy (IPT) is another time-limited, goal-oriented therapy that focuses specifically on relationship issues, improving communication and assertiveness, and setting boundaries. The underlying premise of IPT is that social life events, such as conflict, role transitions, or grief, can heavily influence depressive symptoms. By improving relationships and their role in them, individuals can directly influence their emotional well-being.

Core areas where IPT seeks to improve relationship success and emotional well-being are:

• Grief and Bereavement: The loss of a loved one.
• Role Dispute: Conflicts with a significant other.
• Role Transition: Changes in one’s role in their relationship or family unit.
• Interpersonal Deficits: Lack of socialization due to social isolation or lack of meaningful connections.

Any of these areas can cause significant emotional upheaval for individuals who experience them. Interpersonal therapy is a direct way to help individuals manage these areas and work on ways to improve boundaries and assertiveness in all areas to directly reduce depressive symptoms that result from relationship issues or losses.

Psychodynamic Therapy: Exploring Unconscious Patterns

Psychodynamic therapy is an approach that looks at how unconscious thoughts and early life experiences influence our current mental health challenges. Unlike behavioral therapies, which focus on modifying present thoughts and habits, psychodynamic therapy delves into the deeper, often unconscious, emotional conflicts to better understand how past experiences and relationships impact current feelings and behaviors. Psychodynamic therapists do not “dig” for unconscious emotional conflicts, but rather create a comfortable, safe setting where these feelings can be expressed naturally as an outgrowth of the process.

For individuals with depression, psychodynamic therapy can help a person better understand themselves and their feelings which may have been covered over by months or years of burying them. It’s particularly helpful for individuals who have long-term emotional challenges which has led to years of neglecting their true selves.

Therapy Combined With Medication for Effective Outcomes

In many cases, therapy plus medication management offers the best efficacy in reducing symptoms, especially for individuals dealing with moderate to severe depression. Medication, most commonly SSRIs and SNRIs, can help directly reduce depressive symptoms, offering a higher quality of life while also improving outcomes in therapy. Psychotherapy, particularly CBT, offers individuals effective strategies to manage depressive symptoms and address triggers of emotional distress, sadness, or hopelessness.

A 2020 meta-analysis (a collective study of 101 individual trials) evaluating the effectiveness of psychotherapy and medication found that, on average:

• Combined treatment was 23% more effective in reducing symptoms than medication alone.
• Individuals were 25% more likely to respond to combined treatment than medication alone.
• Individuals were 27% more likely to respond to combined treatment than psychotherapy alone.

Medication reduces symptoms in the short term, allowing individuals to better participate and engage in the therapeutic process. At the same time, therapy helps individuals learn long-term strategies to maintain their mental health progress. However, the option to manage depression with medication is a conversation for you and your mental health care provider. It’s important to note that Psychiatrists, psychiatric nurse practitioners, or medical doctors can prescribe medication, and you will need a psychiatric evaluation and diagnosis before starting medication management.

Explore Therapy Options With Start My Wellness

Many therapies offer evidence-based approaches to managing depression and its symptoms. Each therapy type provides unique methods for addressing depressive symptoms and is tailored to your unique needs, such as interpersonal therapy for relationship issues or psychodynamic therapy for dealing with unresolved childhood grief. There isn’t a one-size-fits-all therapy; the best therapy depends on your needs and preferences.

At Start My Wellness, we are committed to providing personalized mental health care tailored to your needs. Our team of experienced therapists and Psychiatric Nurse Practitioners are trained in evidence-based practices in psychotherapy modalities as well as medication evaluations and management, ensuring you receive professional support for your depression.

Take the first step toward better mental health today. Contact us at (248)-514-4955 or schedule an appointment to begin your journey to a better you.

Sources

1. Indian Journal of Psychiatry: Cognitive Behavioral Therapy for Depression
2. Start My Wellness: Top 5 Benefits of CBT for Anxiety and Depression
3. Yale Medicine: Dialectical Behavior Therapy
4. World Psychiatry: Interpersonal psychotherapy: principles and applications
5. Brazilian Journal of Psychiatry: Depression and psychodynamic psychotherapy
6. National Institute for Health and Care Research: Combined drug and psychological therapies may be most effective for depression