- [voiceover] when you picturesomeone treating depression, and maybe when you thinkabout therapy more generally, you might picture somethinglike the scene here. someone lying on a couchdiscussing their problems while a bearded serioustherapist, who happens to look a lot like freud, listens and takes notes and maybe occasionally gives the patient some kind of insight. but this is an overly simplistic picture
of psychological therapies,which can actually be really diverse. but before i talk aboutspecific ones, i want to note two things about allpsychological therapies. the first is thattherapists go through years of training to get where they are, so chances are theyhave helped individuals with depression in the past. the second thing is that thetherapist doesn't know you.
they aren't personally investedin you or your problems. both of these things makingtalking to a therapist very different from talkingwith a family member or a friend. the first type of therapyi want to talk about here is also the oldest, andthat's psychodynamic therapy. this is the type of therapythat looks most like that couch picture from before. it is based on the ideathat depression is caused
by a loss in a person's life, either a real one or a symbolic one. this loss could also beconscious or unconscious. the goal of this type of therapyis to give a person insight into their thoughts and behaviors. in doing so they canhelp them find the root of their depression, thesymbolic loss in their life that lead to theircurrent depressive state. they do this by talking, not necessarily
about their problems, but about anything that comes to their mind at that moment. the job of the therapist isto guide that discussion, to focus their attentionon certain details. this therapy is meant tobe continued long term, because as it turns outit can take a long time to shift through andidentify unconscious causes. but unfortunately this typeof therapy is generally not effective in treating depression.
another thing that i want to focus on is the term "psychotherapy,"because we have freudian psychotherapy, that's what we've been talking about here, but these days the term psychotherapy is generally used as an umbrella term formany different therapies, some of them really effective. although these may look different from traditional psychotherapy,
they all do use it as a base. one example of a modernform of psychotherapy is called "inter-personaltherapy," it's also known as ipt. the idea behind thistype of psychotherapy is that social networks andsocial support can kind of act as a buffer against depression. ipt focuses on helpingpeople be more aware of their social networks. specifically it's goal isto help people be more aware
of the ways that their actions might be preventing them from maintaining close social relationshipswith those around them. the goal is to help theindividual with depression improve these socialrelationships as a means to decrease their depressive symptoms. unlike traditional psychotherapy,this type of therapy is meant to be short term. it focuses on strategiesrather than discussing the past
and looking for insights. instead of lying on a couch and talking about their relationshipwith their mother, they might talk about ways toreconnect with their mother. it's much more action oriented. the next therapy thati want to talk about is behavioral therapy, andbehaviorism in general does away with hiddenconcepts like the unconscious. instead it focuses on people's behaviors.
as it relates to depression,the ideas is that depression stops a person'senergy and makes them withdraw from their social contexts. a combination of these twothings reduces a person's access to pleasurable activities,so all of the things that they once enjoyed doing. because they are no longergoing out and having fun, this reinforces their negative mood. the goal of behavioral therapy is to focus
on strategies instead ofthinking about the past. but rather than focusing onways to fix relationships like ipt, the goal ofbehavioral therapy is to get the person outof the house and back to the activities that they once enjoyed. by increasing social contactwith friends and family and by forcing the individualto engage in activities that they once found pleasurable, even if they don't findthem pleasurable now,
they will eventually feel better. through repetition theywill eventually begin to enjoy them again. this therapy, which is shortterm, let me write that down, this therapy is actually quite effective. it turns out that goingthrough the motions really does make peoplefeel better over time. but one problem withthis style of therapy is that people find it really hard.
people with depressionmight find taking part in these activities to be really stressful and really intimidating. another problem is that people don't start feeling better right away,it isn't spontaneous. in fact, it can be a few weeksbefore they see improvement, before they start enjoyingthese activities again. because of this, some individuals might have a hard time sticking with it.
if behavioral therapy is more focused on changing people'sbehaviors, cognitive therapy is about changing people's thoughts. the idea behind thistheory is that how we feel is largely a factor of howwe think about the world and how we interpret the world around us. over time people developautomatic negative thoughts and irrational assumptions. imagine a person going aroundthinking to themselves,
"i am worthless." think about how thinkingabout that statement and repeating it overand over might contribute to depression. think about how it mightaffect how this person acts, how they perceive the world. both of these things,both automatic thoughts and irrational assumptions,drive our behavior and shape our experiences,
even if we're not consciously aware of it. in practice, cognitivetherapy has two parts. the first is to challengethese automatic thoughts and irrational assumptions,and the next is to change them. more specifically, to show the individual that they have the ability to change them, to show them that thesethoughts are actually under their control. because it's action-oriented,this type of therapy
tends to be short term. there are some problemswith this style of therapy. the main one is that dependsa lot on the individual with depression. the therapist can act asa guide, but it is really the individual with depressionwho needs to make it work. that can be somewhatchallenging for individuals who believe that theirsymptoms are a part of them and who don't believethat they have the power
to do anything about them. but that said, cognitivetherapy can be really effective for individuals who areactive participants. the last kind of therapy i wantto talk about in this video is cognitive behavioral therapy. as you can probably tell by the name, this therapy is a combinationof cognitive therapies and behavioral therapies. it's based on the idea that there is
a reciprocal relationshipbetween our thoughts, our feelings, and our behaviors. notice that i have drawnall of these arrows as being two-sided. here we're saying someonehas a negative thought, "i am worthless," and thismight lead them to not study for a test since theybelieve it's hopeless anyway, and then they feel upset when they fail. or maybe they forget whenan assignment was due
and this leads them tothink, "i'm stupid," which then leads to a depressed mood, which then leads to themcanceling plans with their friends and causes them to think,"i am a terrible friend." this could go on forever, andthat's the main point here. cbt holds that all of thesethings are interconnected, and you can't really piece them apart. so if anything is reallygoing to help an individual with depression, it needs to address
both cognitions and behaviors. the goal of this therapyis to challenge people's negative schemas and change them while at the same timealso encouraging them to be mindful of theirbehaviors and go back to being activeparticipants in their life. of the therapies that i've mentioned here, ipt and cbt are generally considered to be the most effective.
sometimes just as effective as medication. but i want to point out that this isn't an either/or kind of deal. in general the best outcomes tends to come from a combination ofmedicine and therapy.
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