How Does Dialectical Behavior Therapy (DBT) Help with Depression?

Depression is a serious, widespread, and growing health issue. About one in six adults experience major depressive disorder in their lives, with symptoms that may include: depression

  • Changes in sleep patterns and eating habits
  • A sense of worthlessness
  • Drastic energy fluctuations
  • Losing interest for activities that once excited them
  • Thoughts of suicide

Fortunately, there is a broad and ever increasing range of treatments available to get help with depression. I’d like to tell you about one in particular, Dialectical Behavior Therapy.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a form of cognitive behavioral treatment, which originated as a treatment modality for a very specific population: chronically suicidal individuals who were diagnosed with borderline personality disorder (BPD). DBT not only has become the “gold standard” treatment option in this particular realm, it is also now used to treat conditions such as:

  • Eating disorders
  • Substance abuse
  • Post-traumatic stress disorder
  • Depression (more on this soon)

The “dialectic” at play with DBT is the integration of change and acceptance—two concepts seemingly at odds. One way of looking at this paradox is to think of accepting yourself as you are currently, while you simultaneously do the work necessary to create change and attain your goals.

Characteristics of DBT 

Support-oriented: By assisting individuals in identifying their strengths, these strengths can be enhanced and built upon via DBT hence increasing a person’s self-esteem.

Cognitive-based: DBT helps individuals identify the thoughts (e.g. beliefs and assumptions) that can add complications to their lives.

Collaborative: DBT creates a deep working relationship between clients and staff.

DBT Skill Modules

  • Mindfulness allows us to deal with the dialectic discussed above, e.g. we embrace and exist in the present moment without judging it.
  • Distress Tolerance is what it sounds like: a path towards developing the skills needed to better deal with distressing events.
  • Emotional Regulation sets forth the goal of balancing and countering emotions with logic and appropriate action.
  • Interpersonal Effectiveness focuses on the crucial component of communication wherein we create and reach goals from such improved interactions.

How DBT Can Help With Depression

Even though it was not created to help with depression, Dialectical Behavior Therapy has shown itself to be quite effective. For example, in 2002, the American Journal of Geriatric Psychiatry published a study of older adults with major depressive disorder. It found that among those receiving DBT treatment, 71 percent were in remission by the end of the study. In contrast, 47 percent of those who didn’t receive DBT were in remission.

One major reason for such success is the DBT focus on validation. Just about everyone living with depression will experience long bouts of feeling worthless. Over time, this reality begins to permeate other aspects of their life—leading to an increased sense of sadness and an increased likelihood of invalidating oneself. DBT coping mechanisms enable patients to recognize these trends, identify negative patterns, and eventually break free.

A popular DBT that can help with depression is “diary cards.” As the name suggests, this involves literally writing on actual cards. The idea is to track invalidating thoughts and behaviors as they arise and document how we feel in the moment these thoughts and behaviors happen. In addition, patients are asked to write down which coping mechanisms were utilized and how they worked. Individuals carry these diary cards at all times and subsequently review and discuss them during therapy session and/or group sessions. At that point, the therapist offers feedback.

If you’d like to learn more about how therapy in general and how Dialectical Behavior Therapy in particular, can help with major depressive disorder, contact me today for a free consultation!