7 Types of Therapy That Can Help Depression
Finding a therapist
Depressed? Anxious? The good news is that talk therapy can really help, sometimes as much as medication. But if the only thing you know about therapy you learned from watching The Sopranos, finding the right therapist can feel overwhelming.
“There are probably more than 400 types of psychotherapy,” says Jeffrey Magnavita, PhD, a licensed psychologist and affiliate professor of clinical psychology at the University of Hartford.
The good news is that therapies fall into one (or more) “schools,” each with its own theories and techniques. Find out your options and choose the therapy that will work best for you.
This is the mother of all talk therapies. Sigmund Freud developed psychoanalysis, which probes the patient’s psyche and brings unconscious impulses and behavior patterns to the surface, more than a century ago.
The treatment centers on the dynamic between patient and analyst, and it can be rigorous—you may attend several sessions a week for years, if not decades.
The power of psychoanalysis is that it “creates a laboratory,” says Prudence Gourguechon, MD, the president of the American Psychoanalytic Association. “If you have a person who can't make decisions, for example, [the patient] actually starts demonstrating the same behavior right there in front of you.”
You might call psychodynamic therapy psychoanalysis lite. Patients rarely lie on The Couch, sessions are less frequent (usually only once a week), and the treatment is briefer (sometimes a year or less).
You may not dig as deep as in psychoanalysis, but treatment still focuses on the unconscious, personal development, and the relationship between therapist and patient.
“The psychodynamic therapies are all modifications of [psychoanalysis],” says Dr. Gourguechon. “They hold to the same basic premises, but the techniques are different and the goals are more limited.”
Negative thought patterns can cause—or contribute—to depression and anxiety, and cognitive therapy aims to turn that thinking around.
During treatment, you'll learn how to recognize harmful or irrational thoughts and replace them with more constructive ones.
Unlike psychoanalysis, cognitive therapy is geared toward solving immediate problems. It is brief (typically 16 weeks or less) and highly structured, with a specific lesson plan for each session. It also involves “homework”: The therapist may ask you to track your moods or practice new ways of thinking, for example.
As cognitive therapy targets negative thoughts, behavior therapy can help you overcome problems by changing your behavior.
For example, one common technique to treat anxiety disorders and phobias is "desensitization," in which a patient is gradually exposed to (or asked to imagine) anxiety-inducing situations as a way to become more comfortable with them.
Behavior therapy is often paired with cognitive therapy in
cognitive-behavioral therapy (CBT), an umbrella term that refers to many methods that incorporate both techniques.
Are interpersonal conflicts and a lack of social support causing your depression? If so, interpersonal therapy (IPT) might be right for you.
In IPT—which is brief and focused, like CBT—patients closely examine their relationships with family, friends, coworkers, and other key people, with the goal of resolving interpersonal conflict, improving communication, and building a more solid support network.
As part of the treatment, you may be asked to create an “inventory” of important relationships and role-play with the therapist.
In this type of treatment, you'll learn to distinguish healthy emotional responses from those that are misguided or harmful.
But unlike some types of therapy in which the patient-therapist relationship is strictly neutral, experiential therapy is characterized by the supportive, empathetic relationship that the therapist cultivates with the patient.
“If the person who’s being treated feels understood and feels a warmth from the therapist, these factors in and of themselves seem to be a large part of what makes people get better,” says Magnavita.
Don't rule it out. Like just about everything else, you can now get therapy on the Web, in real time. You can use instant messaging (IM) or set up one-to-one video services such as Skype, to interact with your therapist much as you would in person.
This may be particularly helpful if you lack transportation, live in a rural area, or are otherwise unable (or unwilling) to visit a therapist’s office.
What little research has been conducted on Internet-based therapy appears promising. In a 2009 study published in the Lancet, 38% of patients who received up to 10 sessions of CBT via IM recovered from their depression.