Cognitive Behavioural Therapy (CBT) is one of the most popular talking therapies for depression. It’s practical, structured, and focuses on the connection between your thoughts and your behaviour.
But does CBT help manage depression? The answer is: it can, but it depends on what is going on
Here’s how it works, when it helps, and when you might need a different approach.
How CBT Works
CBT is based on the idea that your thoughts, feelings, and behaviours are linked. Change one, and you can influence the others.
Here’s a simple example. Imagine you scream and run every time you see a wasp. You’ve even run into walls trying to get away. If you wanted to change that behaviour, CBT would help you figure out what you were thinking and feeling in those moments.
Maybe you believe all wasps sting, so they feel like a threat. With your therapist, you might challenge that thought. You’d learn that while wasps can sting, they also eat pests like aphids and blackfly, protecting gardens without chemicals.
With practice, you’d train your mind to replace “danger!” with “helpful garden ally.” Over time, the panic fades. You still notice the wasp, but instead of running, you might think, “Hello, beautiful wasp. Thank you for eating those aphids.”
CBT and Depression
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| Target, my cat, who always makes me happy |
For example:
John gets a glowing annual review and a bonus, but tells himself his boss secretly hates him, he’ll be fired, and he’s destined to fail.
Sally gets top marks during her degree, but convinces herself she’ll fail the exam, fail the course, and end up in a dead-end job.
In both cases, it’s the thought patterns that trigger the depression. CBT works well here because it teaches you to spot these thinking traps and replace them with more accurate, balanced thoughts.
Why CBT Isn’t Always the Answer
Depression isn’t one single illness with one single cause.
It shows up differently for different people:
Some feel deeply sad, others feel emotionally flat.
Some sleep too much, others can’t sleep at all.
For some, it appears suddenly and fades quickly; for others, it creeps in and lingers.
And the causes can vary just as much. Depression might be linked to:
• A thyroid problem
• Side effects from medication
• An emotional shock, grief, or trauma
• Genetics
• A mix of factors
As it’s not straightforward, I think of depression as spots which is useful for starting out to manage it.
How to Choose the Right Approach
Depression is complex! Instead of starting with “I want CBT” or “I won’t take medication,” start with a proper assessment.
First step is to see your doctor, so you can rule out physical issues. If you have a wonky thyroid, no amount of talk therapy will change that. Click here to read more
If you’re all good physically, then talk to a qualified therapist (me!)
We work out how your depression works: what is going on in your life, if there are triggers, if a family history may be at work, and so on. Then we create a customised approach that will help you manage.
In my experience, CBT alone can work. However, many people benefit from a blend of approaches. I often combine CBT with positive psychology techniques.
As for medication, this can be a useful extra tool alongside therapy. Read more at: "I'm depressed. Should I pop a pill, go for therapy, or both?"
Bottom line: CBT is a powerful tool when your depression is driven by unhelpful thought patterns. But it’s not a magic bullet for every type of depression. Start by finding the cause, then choose the treatment that fits.
