Clinically significant depression affects one in 10 Americans every year. For many people, depression can remit on its own when given time, but for others it can become chronic and difficult to treat. Some of the strongest research on what works for depression focuses on what are called "behavioral" treatments for depression.
Behavioral Activation
As noted in the book "Behavioral Activation" by Jonathan Kanter, this approach has one of the strongest research bases in its support for successful treatment of depression. It's common for people who are depressed to want to withdraw from activities. However, over time, they may begin to have fewer sources of enjoyment in their lives. Additionally, they may begin to lose social support from friends and loved ones---support that can be crucial in helping to bring people out of depression.
Behavioral activation works just like it sounds: It focuses on helping people who are depressed to schedule pleasurable or meaningful activities every day. This may sound simple, but it's often not easy to do. The job of a therapist is to help clients keep this structure and to encourage them to follow through on these plans to be more active and engaged with life. Through repeatedly engaging in activities, people with depression stop going through the motions and eventually find that they genuinely enjoy themselves again.
Exercise
Exercise is often an important component of behavioral activation, but research cited by the Mayo Clinic also supports the use of exercise as a viable depression treatment in its own right. This includes running, weightlifting and sports, as well as an evening walk or gardening. Physiological effects include increases in pleasurable neurochemicals, such as endorphins, and improved immune functioning. Emotional benefits include having an enjoyable distraction from worries and developing confidence. There may also be social benefits in that individuals have more opportunities to interact with others.
Mindfulness-Based Cognitive Therapy
Mindfulness-based cognitive therapy (MBCT), is an eight-week group treatment. In MBCT, participants learn to observe thoughts, emotions and body sensation without struggling or reacting to them. This is different from a traditional cognitive approach, which teaches people to try to change or challenge thoughts. Instead, people in MBCT are encouraged to drop their struggle and simply be in the moment.
Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT), includes mindfulness and acceptance-based strategies. Clients learn that their attempts to not be depressed, paradoxically, actually increase their distress in the long term. They learn to let go of the struggle and to see thoughts as thoughts, emotions as emotions and sensations as sensations---as opposed to something they must eliminate in order to get rid their depression. Through this, clients learn that they can have these experiences and move their lives in directions that are important to them. In doing so, they begin to build a life that's about much more than simply not being depressed.
References
- "Behavioral Activation"; Jonathan W. Kanter, Andrew M. Busch and Laura C. Rusch; 2009
- Mindfulness-Based Cognitive Therapy: About MBCT
- "Acceptance and Commitment Therapy for Depression"; Robert D. Zettle; 2007
- Mayo Clinic: Exercise Eases Symptoms
- Portland Psychotherapy Clinic: Acceptance and Commitment Therapy
