CBT/ Behavioral Activation for Major Depressive Disorder (MDD)

Cognitive-behavioral therapy (CBT) is a research-backed treatment for both children and adults with depression.

CBT involves learning how thoughts, behaviors, and emotions are linked:

Major Depressive Disorder is a mental health condition in which someone might experience daily low mood or loss of interest in previously enjoyed activities along with other symptoms such as low or high appetite, low energy, poor sleep quality, low self-esteem, or trouble concentrating.

One of the defining symptoms of Major Depressive Disorder is “diminished interest or pleasure” in activities (American Psychiatric Association, 2013). Generally, when feeling depressed, people will either stop engaging in activities altogether, or keep engaging but find them less enjoyable than previously. For example, someone who has played soccer for years may not try out for the team in a new season.

Behavioral Activation, a form of CBT, is an evidence-based therapy treatment designed with this symptom set in mind. Essentially, behavioral activation involves re-engaging in avoided activities and social interactions to provide positive reinforcement and an improved mood.

Behavioral Activation involves scheduling engagement in pleasurable and mastery activities with the hopes of improving mood in the moment. By creating change in mood at the micro level, it aims to reinforce macro change in overall mood (therefore, reducing depression).

Although people talk about depression as if it is a life-long condition, it generally should be situational (e.g., a reaction to a breakup or job loss). If depression is lasting for a long time, that could be a sign that there is another disorder present that is influencing mood.

Generally, I have found that in motivated people attending weekly treatment, their mood is lifted to the point of not being clinically depressed anymore after 4-6 weeks of CBT. We monitor their change in symptoms over time to make sure treatment is working.

As a a therapist, I love teaching people that they can be in control of their own mood. After lifting from the fog of depression, it is a good time to explore other potential disorders that could be leading to the depressed mood and needing their own therapy tools.

Children can engage in CBT/Behavioral Activation as well; their parents are involved by helping them schedule activities and rewarding them for completing their therapy "homework."