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CBT or counseling for depression?

40 replies

Mumofboy93 · 15/09/2022 21:38

I've self referred to the NHS mental health team in my area and have been offered counselling or CBT for depression and some anxiety. Any experiences of either? How do I choose which?

OP posts:
JudyGemstone · 16/09/2022 09:30

I’m sure the medication is helpful, it is for many people. Counselling/CBT definitely isn’t for everyone.

It still doesn’t mean the cause is a chemical imbalance. A paracetamol might help with a headache but it doesn’t mean the headache was caused by a lack of paracetamol.

GetOffTheRoof · 16/09/2022 11:49

Wolfiefan · 16/09/2022 09:26

Sorry but without the medication I can’t function. I also use CBT techniques. But counselling wouldn’t cure me.

The medication can be life saving, I agree, but don't bin off counselling to other people any more than you would bin off someone saying they need their medication.

www.ucl.ac.uk/news/2022/jul/analysis-depression-probably-not-caused-chemical-imbalance-brain-new-study

www.nature.com/articles/s41380-022-01661-0

www.health.harvard.edu/mind-and-mood/what-causes-depression

www.mind.org.uk/information-support/types-of-mental-health-problems/depression/causes/

www.google.com/amp/s/www.psychologytoday.com/gb/blog/insight-therapy/202207/depression-is-not-caused-chemical-imbalance-in-the-brain%3famp

www.theguardian.com/commentisfree/2022/aug/03/the-chemical-imbalance-theory-of-depression-is-dead-but-that-doesnt-mean-antidepressants-dont-work

www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again

The latest studies are confirming what has been said for years - they don't know the causes of long term depression. But it's probably not a chemical imbalance as there's no evidence of that.

And my SAD was caused by depression and is a long term effect of what it's done to me.

Mumofboy93 · 16/09/2022 16:15

Thanks for all the responses, I guess it shows everyone finds different things helpful!

I think I'm leaning towards CBT at the moment as doing something and finding techniques sounds slightly more appealing than talking over the past. But still thinking on it.

I guess even if the NHS offering isn't the best, I'd at least get an idea if it's worth pursuing further...

OP posts:
GetOffTheRoof · 16/09/2022 16:31

FWIW @Mumofboy93 , the NHS might offer one or the other right now but it's not all you'll ever get. I had CBT offered again straight after my last round of counselling. The therapist referred me for it. I refused it as I've done it 3 times and found it not suitable for me.

And if they offer you the online CBT, I'd avoid it... It's a dreadful and very depressing programme - it's in desperate need of being brought up to date!

ShowTime80 · 16/09/2022 16:53

I would think twice on that OP. Opting out if the counselling because the idea of talking about the past is hard completely defeats the whole purpose of it. Looking to CBT because you think it will save you any discomfort to you means that the underlying problem won't go away. Unfortunately life doesn't work like that. You have to

ShowTime80 · 16/09/2022 16:56

Sorry posted too soon... let yourself be vulnerable if you want to recover.

Guiltypleasures001 · 16/09/2022 17:06

Psychotherapy with an integrative practitioner, someone who's trained in a variety of skills and models. CBT has its place, but if the person only does that one model, then they are not qualified to delve deeper.

Mumofboy93 · 16/09/2022 22:50

@ShowTime80 I'm not possibly opting out to avoid talking about my past. I just don't see that I have a past that's worth talking about, I've had a great life and am truly thankful for that. I don't know what it is that is making me feel depressed and don't know what I'd spent 50 minutes talking about... CBT sounds more in the present and structured which was why I said it sounded more appealing. I think the future and life situation now is potentially what troubles me more

OP posts:
ClumpingBambooIsALie · 16/09/2022 23:11

I would generally say that, all else being equal, the therapy that's most likely to be helpful is the one that the person feels most optimistic/positive about, or drawn towards.

A fair chunk of what can be helpful about therapy is the feeling that it's possible for things to change, and for the therapy to be something that can help you with that — and, assuming it's with an actual human therapist, the fact that you're teaming up with another person with your well-being as a common aim (i.e. the therapeutic alliance). Going into the therapy with the belief that, if you fully participate in it, this is something that has the possibility of helping you improve things, is tremendously powerful in itself.

So if, with the info you have available to you, you think that right now, CBT is more likely to suit you than counselling, then I would go with the CBT.

And if it turns out not to be what you hoped or expected, or it doesn't work well for you, there's no shame in that and you can try something else. Or it could be that the problem is not CBT itself, just that the therapist is a bad match for you. This is looking ahead a bit, though — lots of people do find it really helpful.

ShowTime80 · 17/09/2022 08:55

I don't know what it is that is making me feel depressed and don't know what I'd spent 50 minutes talking about... CBT sounds more in the present and structured which was why I said it sounded more appealing. I think the future and life situation now is potentially what troubles me more

Well that's what you would explore in the therapy. Who said you can't discuss the future and current life situation in therapy? It's the job if the therapist to help you find links and make sense of your emotions and feelings and then find practical solutions.

I don't understand why this CBT is being separated like this. A good therapist will talk and also suggest different strategies including CBT if appropriate, once they've assessed your needs.

ClumpingBambooIsALie · 17/09/2022 11:12

I don't understand why this CBT is being separated like this. A good therapist will talk and also suggest different strategies including CBT if appropriate, once they've assessed your needs.

Unfortunately that's the way IAPT works. IAPT CBT is delivered by people who are trained mostly in CBT techniques and is very heavily manualised, and while they will obviously listen to what the problems are, the expectation is you'll be doing CBT. The counselling is delivered by people trained in counselling and will be quite different.

ShowTime80 · 17/09/2022 13:21

Unfortunately that's the way IAPT works. IAPT CBT is delivered by people who are trained mostly in CBT techniques and is very heavily manualised, and while they will obviously listen to what the problems are, the expectation is you'll be doing CBT. The counselling is delivered by people trained in counselling and will be quite different.

Yes I get that part. I'm saying that a therapist will be able to suggest CBT exercises anyway. So you might as well go down the therapy route to get the best of both worlds. Whereas a CBT mental health worker is not a qualified therapist. The NHS are pushing CBT as it's so much cheaper but it's often just a sticking plaster.

ClumpingBambooIsALie · 17/09/2022 13:31

As I understand it the OP has been offered either counselling or CBT by the same service. She's not been offered therapy with someone trained in multiple modalities. So if she chooses the counselling there's no reason to believe that the counsellor will be trained in or willing to offer CBT exercises. Theoretically it's possible the counsellor will happen to have had CBT training, but not necessarily.

Mischance · 17/09/2022 13:37

CBT is about helping you to look at how you respond to the triggers that bring on your depression and looking at ways that you might change that. It is intended to be empowering - to give you tools to fight back when the black cloud descends rather than letting it drag you down.

Counselling is about talking through the things that make you depressed and giving you a chance to open up about them and see if there re ways to rethink what is going on. It is less proactive.

I was assessed for CBT for PTSD - I was regarded as in need of help and put on the list - 7 months at the last count! I will either be dead or better by then!

magaluf1999 · 17/09/2022 13:38

Ive had both. Mine was depression and anxiety.

Its very personal and subjective.

I found counselling useful to help me make sense of some stuff. To allow me to talk to someone who wasnt judging and was listening. It helped me out of a couple of tough spots and back onto an even keel and shift some guilt that was weighing me down.

But for me that even keel wasnt that even. I think ive suffered with low grade anxiety my whole life and ive been quite up and down with low mood a recurring theme. I then tried cbt which for me has helped me break this cycle by changing the way i think. I have never felt mentally better. My course was intensive. Once a week for six months or so. I really connected with the therapist and during the sessions we actually laughed a lot as well as tears. Its been the best think i ever did.

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