Monday, January 27, 2014

12 Steps to Defeat Depression: Cognitive Behavior Therapy, and Laughter

            Cognitive behavior therapy, also known as CBT, is what is referred to as a type of psychotherapeutic treatment aimed at helping patients first recognize the thoughts and feelings they have in response to any given situation, and then helping them understand those thoughts and feelings, and answer why they might be experiencing them. It’s commonly used to treat a range of disorders, including depression and anxiety.
            CBT is usually a short-term therapy focused on helping people focus on and correct a specific problem. You’re taught how to identify your destructive behavior or thought patterns and then learn alternative behaviors or responses.

            The idea behind CBT, which is supported by brain research, is that our feelings play an influential role in how we behave. As I covered in earlier blogs, feelings trigger neurochemical responses, which then trigger behavior. As this behavior becomes a “learned response,” the area in the brain responsible for remembering the response dumps chemicals into the system that once again causes a triggering of the response. It becomes a vicious cycle that’s difficult to break.

            Notice I said difficult, not impossible. *
            A CBT patient discovers that while they will never be able to completely control their environment, it is possible for them to control how they interpret those surroundings and respond to them. Like my elevator story I relayed several blogs ago, just thinking about getting in an elevator caused my fear level to rise, which caused the fight or flight chemicals to dump into my system, which, in turn, caused my heart rate and breathing to escalate to panic level. I fed this panic by mentally entertaining all of the awful things that could happen to me if I got stuck in an elevator. It was like a rolling snowball, gathering more and more snow until it became a behemoth I couldn’t control or stop.

            The CBT treatment process usually begins with the functional analysis stage, when the therapist helps the patient identify their problematic beliefs. The patient learns how their thoughts, feelings, and situations can contribute to destructive behaviors. This first process can be difficult, especially for those patients uncomfortable with contemplating their personal thoughts, feelings and physical sensations. In other words: the people who don’t like self-examination.

            But the self-discovery it can lead to can open up insights critical to the healing process.

            The second part of CBT concentrates on the behaviors that correspond to the perceptions, feelings or sensations. It is the behaviors that are the major culprits: you feel depressed, so you eat. You feel inadequate, so you don’t attempt activities in which you feel you’d fail, or you avoid social situations and opportunities that might provide advancement or personal enjoyment.

            Once you’ve identified the negative behaviors, the therapist teaches you new behaviors that you practice. And the more you practice, the more likely you are to be able to change your brain’s learned response to the original trigger! You take baby steps toward a larger goal, and your brain follows suit.

            CBT is focused on highly specific goals and has been used to successfully treat a variety of disorders, including depression, anxiety, phobias and addiction. In my most recent neuroscience course, our instructor said that a person suffering from depression should not be taking anti-depressant medication without also undergoing cognitive behavior therapy. He indicated that while the medications could take the edge off, it was the therapy that provided the real healing. He gave me the impression that he thought CBT alone could do the job, and should be the first line of treatment, especially when the negative side effects of anti-depressant medications are considered.

            If you want to give CBT a try, you must be ready and willing to spend time analyzing your thoughts and feelings. You must be open to better understanding yourself, which may initially cause you some hurt and disillusionment. Later, it will bring you a sense of relief and empowerment.

            However, you must understand that undergoing this therapy and becoming more aware of your feelings will not necessarily stop you from having them. It is your response to them—the behavior—you need to change.

            There are, however, techniques employed to help you overcome or subdue these feelings and thoughts. We’ve covered many of them in this blog. They include relaxation techniques, meditation, mindfulness, guided imagery and biofeedback. To those you can add journaling, role-playing and mental distractions.

            But, truly, the only thing that will help you change your feelings will be drawing closer to Jesus. The closer you get to Him, the better able you are to see things clearly—as they truly are—and the more likely you will be to respond to your situations with positive, life-affirming feelings and a sense of control and peace.

            The final advice I can give you is to fill your life with laughter. Hardly anything else does so much good for the body and spirit as a good laugh, a smile, a chuckle. As the Bible says, a merry heart is good medicine! And 21st Century medical research verifies that centuries-old wisdom. It strengthens your immunity, provides a physical and emotional release when you are stressed, and provides you with improved happiness.

            It lightens whatever load you’re carrying and causes your face—and heart—to smile. And medical research shows that just the act of moving your facial muscles into the motion of laughter, causes endorphins to be released into the system. Yes, those feel-good brain chemicals start running around the body, acting like a morphine drug! Laughter, even just the facial muscle movement mimicking it, really is good medicine!

            God’s marvelous word is relevant for our lives today. Science is just now validating its age-old truths!

            Well, this brings us to the end of our journey through defeating depression. I hope you’ve learned some effective coping skills and lifestyle changes that have encouraged and helped you. It has been an honor to go on this journey with you. My prayer is that all of you recover and stay healthy, happy and well and can face each new day with more joy and peace than you did the last!

             I pray that you find hope in your future, regardless of where pain and grief have led you.


NEXT WEEK: I begin to fully recover from depression and return to life, and then face the haunting questions: Where do we go from here; and, Do we try again and take a calculated risk in pregnancy—my life and the life of my unborn child…

Until next week,

Thanks for joining me!



* PTSD is one condition that does not seem to respond well to cognitive behavior therapy.