How does CBT help in combating depression in adolescents?

In this article, we will discuss the various interventions and strategies employed in CBT to treat adolescent depression and also learn about the effectiveness of CBT in fighting depression.

How does CBT help in combating depression in adolescents?

CBT is a systematic approach that has a variety of interventions crafted specially to restructure the distorted thought processes that cause irrational or negative emotions and behaviors within us. CBT helps adolescents learn to cope with these debilitating thoughts and replace them with positive and reinforcing thoughts.

Impact of Depression on Adolescents

Depression is considered one of the most fatal, disabling diseases that have led to decreased life span or premature mortality. It predominantly occurs between the ages of 15 and 21 years. With each day the number of children and adolescents grappling with this illness is increasing at a fast pace. Depression is dangerous because it has a lot of comorbidities. Adolescents can get afflicted with several other disorders or disruptive behaviors due to the negative impact of depression on their minds and body. Also, many chronic illnesses make a person lose hope and that can lead to depression as well.

Co-occurring Disorders or Maladaptive Behaviors With Depression

• Suicidal Behavior

Due to constant disparaging thoughts revolving in their minds and the perpetual hopelessness a person can lose the will to live. Adolescents are particularly vulnerable as they are going through puberty and undergoing a lot of changes and stress. The pressure can become intolerable and therefore depressed adolescents are prone to suicidal behavior.

• Substance Abuse

To help cope with the illness young adults often resort to alcohol or drugs to mitigate the negative feelings present within them. The high provided by the drugs or alcohol distracts them for a short while and they crave this short span of relief more as time passes by. This results in serious implications and can lead to addictions.

• Poor academic performance

It is quite natural that a poor mental state affects the academic performance and extracurricular activities of the students. They are disengaged from their lives and have very few mental resources to expend on studies or sports.

• Poor social life

Just like their academics, their social life is negatively impacted as well. As they are less likely to engage in social activities and lead an inactive lifestyle they have very little scope to form social bonds with their peers.

• Diabetes

Diabetes is one of the most fatal diseases in the world. Many patients suffer a lot due to diabetes which sometimes results in them feeling hopeless and sad. Over time this can lead to depression. 

• Obesity

Obesity comes with a lot of complications. Various health-related issues as well as the psychological impact it has on the person can make the person depressed.

• Eating Disorders
• Depression is often associated with eating disorders such as bulimia nervosa, anorexia nervosa, binge eating, etc. 
• Cancer

Cancer is a very serious ailment that completely overhauls a person’s physical and mental state. When confronted with their mortality people often become desolate and are prone to developing depression. 

• Stroke

Stroke has a tendency of disabling people and this has severe implications on their mental health. Suddenly losing control over their body or speech can be a harrowing experience and a person can feel distraught by the circumstances. 

• Heart diseases

Heart ailments can make the person feel vulnerable and restrict a lot of their activities making them feel restricted. Research suggests that people who suffer heart attacks are more likely to develop depression,

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Symptoms of Depression

• Feeling Sad and Anxious
• The person would feel uncontrollably sad and anxious about everything going on in their life. It will be a constant feeling which can be debilitating in the long run. 
• Feeling insignificant
• Thoughts such as ‘I am helpless’, ‘worthless’, ‘not good enough’ can perpetually revolve around in their minds. They might also feel guilty about their actions and behaviors which will further exacerbate their condition. 
• Feeling desolate

They might become cynical and negative due to a loss of hope and optimism. Their thoughts would be very grim and less hopeful. 

• Loss of Patience

They might develop a short temper due to decreased patience and be irritable about everything. 

• Disengaged from social life.

A person feels unmotivated and uninterested to engage in social activities and even avoiding hobbies that they previously enjoyed. 

• Fatigue

Extreme fatigue and tiredness are very common symptoms of depression.  

• Lack of concentration

It also affects the attention span or concentration of the person making it difficult to even carry out simple daily routine tasks. 

• Changes in the sleep cycle.

The person might experience insomnia or start sleeping for the whole day.  Sometimes sleep is used as a way to escape from reality for a short while. 

• Loss of appetite or increased appetite

Either the person might feel like overeating or just give up on eating. It would lead to dramatic changes in weight. Some gain weight due to binge eating and some lose weight due to loss of appetite. Both behaviors are hazardous to health. 

• Body pain or aches

Unexplainable pain in the body such as stomach ache or headache. 

5 rules of Cognitive Behavioral Therapy 

Cognitive-behavioral therapy (CBT) usually utilizes a short-term treatment lasting for about six to 20 sessions in the case of young adults and children as compared to adults who require more sessions. When children or adolescents are treated, the treatment method also includes counseling and psychoeducation of their parents. CBT focuses on cognitions and their impact on thoughts, emotions, and behaviors. All three components, that is, thoughts, emotions, and behaviors are interlinked and keep repeating in a vicious cycle. CBT counters the maladaptive consequences arising from this cycle by breaking the cycle at different levels. 

The CBT has a certain set of goals and rules based on which the treatment is carried out. Following are the important aspects of Cognitive Behavioral Therapy. that are followed in the treatment of depression in adolescents.

• The CBT is a collaborative approach and requires the client’s participation in the development of goals. In the case of children and adolescents, parents are also involved and asked to offer their input in the treatment plans.
• It is based on trust and mutual understanding. The client will entrust their issues to the expertise provided by the therapist. But the therapist will also respect the client’s views and opinions as they are the expert on their own issues.
• The therapist’s goal is to help the client become capable to deal with their own issues and focus on their developmental skills
• The clients are encouraged to actively participate in the sessions and as CBT is an activity-oriented therapy they are also instructed to do homework and worksheets.
• The CBT treatment is governed by goals and requires systematic planning and execution to achieve these goals with the help of the client.

Cognitive Behavioral Therapy Interventions

Individual CBT

In this type of treatment method, the focus is entirely on the client being treated and their needs. As it is a one on one process the therapist is able to provide their undivided attention and expertise to the client and focus on helping them become adept at handling any issues arising from irrational thoughts and cognitions.

Group CBT

Group cognitive-behavioral therapy is proved to be very effective in dealing with depressed adolescents. In this type of treatment, a group is collectively addressed and treated. The group is usually homogeneous, that is, everyone in the group being treated is undergoing the same disorder. As the people in the group therapy are often dealing with similar behavioral issues the members develop camaraderie and a sense of belonging. They don’t feel alone as they feel they have someone else who can understand what they are feeling and are experiencing. This helps positively in the treatment of depression. 

CBT with Parents

For effective results, it is necessary to psychoeducate the parents along with the children. This ensures that they are aware of the gravity of situations and are better equipped to deal with any issues. Parents also suffer from psychological distress after witnessing their sufferings and hardships. Therefore they are also included in the treatment method and provided counseling alongside the children. The parents are taught techniques and coping skills to help them maneuver this disorder and handle any complications that arise at home. 

CBT with Medication

Depression is an ailment that requires pharmacotherapy along with psychotherapy. Treatment of depression works best with medications to tamp down the symptoms and therapy to eradicate the causes. Adolescents are prescribed antidepressants and other medications by the psychiatrist. As they can get addicted to the drugs it is imperative to properly supervise the dosage and consumption of these medications. 

Trauma-focused CBT

Sometimes traumatic events can also lead to the development of depression the stressful events. At such times trauma-focused cognitive behavioral therapy can be utilized in fighting depression. This treatment option was developed to help children and adolescents affected by trauma. It is effective in treating disorders that are affected due to traumatic events such as  PTSD but it can also effectively be utilized to treat other trauma-related disorders. It is a short-term treatment option that covers several factors related to the traumatic event and experiences. It deals with depression by resolving the behavioral, cognitive issues, and also symptoms of depression.   

CBT paired with Motivational Enhancement Therapy (MET)

Depression makes the person feel unmotivated and hopeless. Therefore to bring the motivation back, the CBT has come up with a different treatment approach. It is called Motivational Enhancement Therapy (MET).

The adolescents or clients are encouraged to modify their behaviors from within. It can be done individually or in a group setting. There are different benefits attached to doing it individually or in a group. Several exercises that boost the motivation of the client are incorporated in this approach and techniques such as discussions, coping strategies, interviewing are utilized to achieve maximum effects. 

Conclusion

The intervention strategies utilized in Cognitive Behavioral Therapy for Depression were discussed and the effectiveness of CBT in dealing with adolescent depression was explored.

What we recommend for Counselling

Professional counselling

If you are suffering from depression or any other mental disorders then ongoing professional counselling could be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

Frequently Asked Questions

Do adolescents get depressed?

Adolescents can get depressed as the onset of depression is generally from around 15 years of age. Sometimes it can occur even earlier. 

Is CBT effective in treating depression?

Yes, CBT is one of the most effective treatment methods in helping with depression.

Is depression a mental illness?

Clinical depression is a diagnosed illness that negatively affects a person’s life and can even prove fatal.

Can depression be treated?

Depression is treated by using a variety of treatment options such as psychotherapy, medications, meditations, art therapy, etc.

Does CBT work for children?

CBT can be adapted to suit the needs of the child and work with them to help them develop coping skills. 

References

Cognitive behavioral therapy. Effective Child Therapy. (n.d.). Retrieved November 28, 2021, from https://effectivechildtherapy.org/therapies/cognitive-behavioral-therapy/.

Co-occurring disorders and Depression. Mental Health America. (n.d.). Retrieved November 28, 2021, from https://www.mhanational.org/co-occurring-disorders-and-depression.

Idsoe, T., Keles, S., Olseth, A. R., & Ogden, T. (2019, May 22). Cognitive behavioral treatment for depressed adolescents: Results from a cluster randomized controlled trial of a group course. BMC Psychiatry. Retrieved November 28, 2021, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2134-3.

Oud, M., Winter, L. de, Vermeulen-Smit, E., Bodden, D., Nauta, M., Stone, L., Heuvel, M. van den, Taher, R. A., Graaf, I. de, Kendall, T., Engels, R., & Stikkelbroek, Y. (2019, January 16). Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis: European Psychiatry. Cambridge Core. Retrieved November 28, 2021, from https://www.cambridge.org/core/journals/european-psychiatry/article/effectiveness-of-cbt-for-children-and-adolescents-with-depression-a-systematic-review-and-metaregression-analysis/D1D82E21388A16EB077D02A24366F689.

WebMD. (n.d.). Depression symptoms & types. WebMD. Retrieved November 28, 2021, from https://www.webmd.com/depression/guide/depression-symptoms-and-types

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