What is the best therapy for depression and anxiety
There are many different types of therapy to treat depression and other mood disorders. Psychotherapy can be an effective form of treatment for depression because it can help you delve into possible underlying reasons for your depressive feelings and learn new skills to cope.
Finding out which type of psychotherapy is best for you will depend on a number of factors, including the severity of your symptoms, your own personal preferences, and your therapy goals. The therapeutic modalities described below have evidence supporting their benefits as treatments for depression.
What Is Psychotherapy?
Psychotherapy is the process of treating psychological disorders with verbal and psychological techniques.
Most types of psychotherapy foster a relationship between therapist and client to help individuals identify and overcome negative thoughts or behavioral patterns.
Psychotherapy is often called “talk therapy” because it involves an individual and a psychotherapist sitting in a room together talking. But it is so much more than that. Psychotherapists have formal training in a variety of techniques that they employ to help people recover from mental illness, resolve personal issues, and create positive changes in their lives.
What is the best approach?
Several studies suggest, however, that the combination of an antidepressant and psychotherapy is the best approach, because of the complex mix of causes of mood disorders like depression.
While psychotherapy is its own professional field, other professionals offer this modality as well, including psychiatrists and clinical psychologists, substance abuse counselors, mental health counselors, marriage and family therapists, social workers, and psychiatric nurses.
If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Psychotherapy for Depression
The right type of therapy for depression depends on a variety of factors, and there is no approach that is right for everyone. The type of treatment you choose may depend on various factors, including your preferences and the severity of your symptoms. Consider some of the following commonly used types of therapy for depression to better determine which one might be right for your needs.
At the heart of cognitive therapy is the idea that our thoughts can affect our emotions. For example, if we choose to look for the silver lining in every experience, we will be more likely to feel good, as opposed to if we only focus on the negative.
Negative thoughts can contribute to and exacerbate depression. Feeling good is hard when you’re stuck in a constant loop of negative thoughts. Cognitive therapy helps people learn to identify common patterns of negative thinking (known as cognitive distortions) and turn those negative thoughts into more positive ones, thus improving mood.
Cognitive therapy is usually short-term and goal-focused. Therapy sessions are structured with a specific plan for each session, and there is “homework” practice to do outside of therapy. Cognitive therapy usually lasts between six weeks to four months.
Whereas cognitive therapy is focused on the negative thoughts that contribute to depression, behavioral therapy is centered on changing behaviors that affect emotions. A central focus of behavioral treatment for depression is behavioral activation. This entails helping patients engage in activities that will enhance their feelings of well-being.
Because cognitive therapy and behavioral therapy work well together to treat depression and anxiety disorders, the two are often combined in an approach called cognitive behavioral therapy (CBT). CBT focuses on addressing both the negative thought patterns and the behaviors that contribute to depression.
Your therapist may ask you to keep a journal to track the events of the week and any self-defeating and negative reactions to those events. Habitual negative responses to events (known as automatic negative reactions) are just one pattern of thinking you might address over the course of CBT. Other response patterns include all-or-nothing thinking and overgeneralization, two common cognitive distortions.
Once you have learned how to recognize your response patterns, you will work with your therapist to learn new ways of thinking and responding. You might also practice positive self-talk.
Like cognitive therapy and behavioral therapy, CBT is usually brief and goal-oriented. It generally involves between five to 20 structured sessions centered on addressing specific concerns.
CBT sessions are often accompanied by “homework,” which may include keeping a journal, practicing relaxation activities, completing readings, and using worksheets focused on specific goals. Research suggests that CBT can be effective in the treatment of depression and may have lasting effects that prevent future relapses of depressive symptoms.
Dialectical Behavior Therapy
Dialectical behavior therapy is mostly based on CBT. The key difference is that it asks individuals with depression to acknowledge and accept their negative thoughts and behaviors. Through the practice of validation, individuals can come to terms with their negative emotions, learn to cope with stress and regulate their reactions to it, and even improve their relationships with others.
This type of psychotherapy also incorporates mindfulness practices from Buddhist traditions to inform crisis coaching, in which an individual can call the therapist to receive guidance on how to handle difficult situations. As the person continues to practice these new skills, they will eventually become better equipped to handle their challenging situations on their own.
The National Alliance on Mental Health states that DBT has been shown to be effective in the treatment of mental illnesses, including depression.
Psychodynamic therapy, also known as psychoanalytic therapy, assumes that depression can occur because of unresolved—usually unconscious—conflicts, often originating from childhood. The goals of this type of therapy are for the patient to become more aware of their full range of emotions, including contradictory and troubling ones, and to help the patient more effectively bear these feelings and put them in a useful perspective.
Unlike some other treatment approaches for depression, psychodynamic therapy tends to be less focused and longer-term. This approach can be useful for finding connections in past experiences and seeing how those events might contribute to feelings of depression. This approach can also help build self-awareness and increase certain emotional capacities.
Interpersonal conflict and poor social support can also contribute to feelings of depression. Interpersonal therapy is a type of therapy that focuses on these issues by addressing past and present social roles and interpersonal interactions. During treatment, the therapist generally chooses one or two problem areas to focus on.
This type of therapy is usually brief and involves examining social relationships with important people in your life. This can include your relationships with your partner, friends, family, and co-workers.
The goal is to identify the role these relationships play in your life and find ways of resolving conflicts.
Your therapist might ask you to roleplay different scenarios in order to practice and improve your communication. By doing this, the idea is that you will be able to implement these strategies in your relationships and build a stronger social support system.
Approaches to Psychotherapy
Psychotherapy can be delivered in a few different ways. In some cases, your treatment may incorporate two or more formats, such as meeting individually with your therapist followed by the occasional group session where you can practice new skills with others. Common approaches to psychotherapy include:
- Individual therapy: This modality involves one-on-one work between patient and therapist. It allows the patient to have the full attention of the therapist but is limited in that it does not allow the therapist an opportunity to observe the patient within social or family relationships.
- Family therapy: This approach is most useful when it is necessary to work on dynamics within the family group. Family therapy can be especially helpful for children and teens.
- Group therapy: Group therapy generally involves anywhere from three to 15 people. It allows everyone to give and receive group support in coping with their particular issues and allows therapists to observe how participants interact in group settings. It may also be a less expensive alternative to individual therapy.
- Couples therapy: This type of therapy is geared toward married couples and those in committed relationships who desire to improve their functioning as a couple.
Choosing a Technique and Therapist
Finding a psychologist or therapist can seem daunting since there are so many to choose from, and you might not know where to start.
- Ask friends and family: Recommendations from others can often be a great way to find a good therapist.
- Ask your doctor: Another place to start is by asking your doctor or another health care professional.
- Conduct your own online research: The American Psychological Association (APA) recommends contacting your local or state psychological association.
- Contact a local mental health center: You can also connect with a mental health center in your community.
- Use an online directory: The APA has a helpful psychologist locator service to help you find a therapist in your area.
When deciding on a potential psychotherapist, you will want to find out what their credentials are and whether they are qualified to treat you for depression. Ask if they take your health insurance or if they’re able to work with you on a sliding scale.
Once you determine that the therapist is adequately trained and licensed, you can read their bio on their website if they have one or send an email inquiry to find out where they received their education and how many years of experience they have. You’ll also want to know if they have any particular areas of expertise.
For example, one therapist may specialize in marriage or family counseling, while another may be an expert in substance abuse, but both may be skilled at treating depression. You might also be curious about their style of therapy and whether they’ve studied other modalities that inform their technique, such as mindfulness-based stress reduction.
Once You Find a Therapist
When you’re ready to try a session with a therapist, remember that it’s of the utmost importance that the two of you click and that you feel comfortable continuing your work together. Treatment is a collaborative two-way process of finding solutions to reinforce the constructive thoughts, behaviors, and emotions that will create positive change in your life.
A Word From Verywell
Psychotherapy should be a safe and supportive process, no matter which type of therapy you decide on. When working with a psychotherapist, you should always feel comfortable opening up and sharing your feelings and challenges with depression.
If you try a therapist and don’t feel connected or are concerned that their technique or approach isn’t the right fit for you, it may be a good idea to try a different therapist. It’s also OK to be upfront and honest with the therapist who didn’t work out, too. They might even have a better recommendation or referral for you.