If you had a friend or family member suffering from depression what would you advise?
Depression is not a single condition and overall treatment planning should consider whether it is Bipolar or Non-Bipolar (or Unipolar) Depression and whether it is recurrent episodes of major depression as opposed to persistent depressive disorders. Most of the literature in psychological treatments of depression refers to treatment of depressive episodes rather than chronic depression.
Depression is hard on the sufferers, but the good news is that there are several effective psychological treatments, which also reduce the probability of relapse.
Several national guidelines (Gelenberg et al., 2010; NICE, 2018; Parikh et al., 2016)recommend cognitive therapy, behavioural activation therapy and interpersonal therapy as first-line options for the treatment of depression. Although there are other therapies which may be helpful, these have the most evidence.
The premise of cognitive therapy is that depression is maintained by negative thinking patterns. Whereas behavioral activation treatment (BAT) proposes that avoidance and decreased participation in pleasurable activities reduce rewards in life and maintain depression. Interpersonal Therapy understands depression as a result of certain types of interpersonal changes in life.
Behavioral Activation Treatment (BAT) is probably the most scientifically designed treatment of depression. It is easy to learn, although the implementation requires considerable fidelity to the model and the protocol.
Here are some key facts about BAT
- It is not just about increasing activation. The purpose of the therapy is to reduce avoidance associated with depression.
- BAT is a third wave context and value focussed therapy. This means that the treatment is focussed on helping the client work towards what is important and value laden to them.
- Learning to reward oneself is an important skill the depressed client needs to relearn.
- It is helpful in severe depression and is as effective as medication as well as cognitive therapy.
- Although BAT does not try to change negative thinking it is associated with changes in thought processes.
Would you like to learn more about using BAT to assist your clients that are struggling with depression? Visit our workshops section and sign up for an upcoming training!
Gelenberg, A. J., Freeman, M. P., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., . . . Fawcett, J. A. (2010). Practice guideline for the treatment of patients with major depressive disorder third edition. Am J Psychiatry, 167(10), 1.
NICE. (2018). Depression in adults: recognition and management. (CG90). London, UK: National Institute of Clinical Excellence
Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., . . . Uher, R. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments. Can J Psychiatry, 61(9), 524-539. doi:10.1177/0706743716659418