DBT for Depression
6.7% of adults in the US experience Depression each year.
DBT is an effective approach for treating depression and related issues such as emotion regulation.
Is DBT effective for depression?
DBT has been extensively studied for its potential to treat a variety of diagnoses. Recent studies have shown DBT to be effective in the treatment of common symptoms of depressive disorders. This is no surprise considering that DBT was originally developed with a focus on emotion regulation which is closely tied to one's ability to manage the fluctuations of mood symptomatic to depression. That said, at The DBT Center of Marin we offer Informed DBT which means that your therapist may integrate DBT with other modalities to optimally address your unique symptoms of depression. Such modalities are evidence-based, cognitive-behavioral interventions specifically for the treatment of depressive disorders.
What are Depressive Disorders?
Depressive disorders are characterized by the presence of sad, empty, or irritable mood, lack of interest in once pleasurable activities, difficulty concentrating, thinking, or remembering, and physical symptoms (headaches, chronic pain, or other physical problems) that don’t respond to treatment. Depressive disorders can also include thoughts of suicide or death. Depression is a mood disorder that can be mild or debilitating, and harm your quality of life.
How does DBT support this diagnosis?
Depressive disorders cause persistent irregularities in mood, resulting in interference with daily functioning, and unwanted behaviors and consequences. Through individual weekly psychotherapy and skills groups, DBT teaches tangible skills to regulate and tolerate mood, and modify ineffective behaviors to reduce crisis.
DBT recognizes that for some clients, not all treatment can occur while in session. This is why DBT clinicians use phone coaching as a hands-on crisis intervention tool, designed to help you learn to resolve crises more effectively. Through weekly individual sessions, phone coaching, and skills groups, DBT can help you achieve less frequent and intense symptoms of depression that get in the way of living life to the fullest.
Are You Depressed?
Recommended Reading
Which DBT modules are most relevant for depression?
Learn how to manage symptoms of depression through the 4 components of DBT: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
Mindfulness: Learn how to be truly present.
Mindfulness skills teach you how to be grounded to the present moment, and focus on your current situations. By being in the present, you are better able to identify and understand the different states of mind; which you are in, which contribute to your mood irregularities, and how to access healthier states of awareness. This knowledge is foundational for those hoping to develop increased control over the mind, which can be especially transformative for those struggling to work through painful symptoms of depression.
Mindfulness skills also train you to notice your thoughts and feelings non-judgmentally. Assigning judgment to your thoughts and feelings is commonplace, yet can lead to unnecessary emotional distress. For those with mild and severe symptoms of depression, reducing unnecessary emotional distress is a large focus of treatment, and results in reduced suffering and increased happiness.
Distress Tolerance: Learn to tolerate painful emotions, mood irregularities, and events that seem unbearable. Avoid behavior that can make things worse.
Distress tolerance includes a wide range of skills to help you navigate life with depressive symptoms. These techniques range from guided self-soothing skills, to easy to use methods that activate the parasympathetic nervous system, using your own body’s chemistry to reduce distress. Occasionally, symptoms of depression can trigger you to act in ways that make the situation worse. Distress Tolerance skills also include techniques to use in place of unhealthy or destructive behaviors that can make things worse. Those with mild and severe symptoms of depression often report the distress tolerance skills to be an empowering and essential part of treatment.
Emotion Regulation: Learn to manage, change, and accept different emotions, so that your emotions don’t control you.
Mild or severe symptoms of depression can be paralyzing, causing you to miss out on once pleasurable activities, feel hopeless and controlled by strong emotions, or act in ways you don’t like or even regret. DBT teaches Emotion Regulation skills and recognizes common factors that make regulating emotions hard – such as mood irregularity and even biology. These skills allow you to better understand the function of strong emotions. Ultimately, they empower you to stop unwanted emotions from starting in the first place, regulate or change such emotions once they start, and learn to accept and become comfortable with unavoidable emotions.
Interpersonal Effectiveness: Learn to communicate with others in respectful ways while maintaining healthy boundaries and upholding positive self-respect.
Interpersonal relationships and social interaction can make problems brought on by depressive symptoms even worse. Interpersonal effectiveness skills offer strategies to reduce contributing factors to mood irregularities brought on by your relationships with others. Interpersonal effectiveness skills provide clear instruction on asserting what you want and need from others, building trust, upholding self-respect, strengthening positive relationships, and ending destructive ones. Interpersonal Effectiveness skills also provide tools to head off problems and better resolve conflicts before they become overwhelming.
References to research that demonstrate the efficacy of the treatment for the diagnosis
1. Dialectical Behavior Therapy may effectively augment the effects of antidepressant medication in depressed adults. 75% percent of depressed adults treated with Dialectical Behavior Therapy and medication reported remission after 6 months. In the medication-only group, only 31% reported remission after 6 months.
Thomas R. Lynch, Jennifer Q. Morse, Tamar Mendelson, Clive J. Robins, Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study, The American Journal of Geriatric Psychiatry, Volume 11, Issue 1, 2003, Pages 33-45, ISSN 1064-7481,
2. Through a 16-week DBT skills group, participants saw a significant decrease in their depressive symptoms compared with the control group.
Harley R, Sprich S, Safren S, Jacobo M, Fava M. Adaptation of dialectical behavior therapy skills training group for treatment-resistant depression. J Nerv Ment Dis. 2008 Feb;196(2):136-43. doi: 10.1097/NMD.0b013e318162aa3f. PMID: 18277222.
Over a 6-month period, 173 suicidal adolescents received comprehensive DBT treatment (weekly sessions, skills group and phone coaching) or standard individual and group therapist. After treatment, a significant percentage of the DBT treatment group reported reduction in suicide attempts as well as self-harm behavior over the control group.
5. Neacsiu, AD, Eberle, JW, Kramer, R, Wiesmann, T, & Linehan, MM. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial.