Cognitive Therapy for Depression Based in Mindfulness.

Mindfulness as a fundamental skill.

Depression is darkness of the soul, lack of will, hopelessness and sadness. There are many adjectives used to define it, but if we know anything about it, it is that its effects are devastating. Today I want to talk specifically about cognitive therapy for depression, using mindfulness as a foundation.

Clinical depression or “major depression” is a condition in which a persistent depressive mood or loss of interest occurs. Along with these symptoms, sleep difficulties, decreased appetite, reduced concentration, etc. also appear.

Regarding how many people suffer from depression, the statistics are worrisome. It is one of the most prevalent mental disorders. 17% of the population claimed to have suffered from depression in the past six months. The World Health Organization (WHO) reveals that in 2020 depression will be the second most widespread disease worldwide. Its treatment is becoming the main challenge in the field of mental health.

Depression treatment.

In the late 1980s, there were several ways to fight depression. Antidepressant medications have become the first-line treatment for clinical depression. Psychological treatments were also beginning to be successful. Behavioral therapy emphasized the need to increase the participation of depressed people in stimulating or pleasurable activities.

Cognitive therapy aimed to change the way thoughts contributed to the appearance and maintenance of depressive symptoms. Finally, interpersonal therapy claimed that learning to resolve interpersonal disputes and switch roles would help in combating depression.

With all the treatments available, surely the problem of depression should have been resolved. But unfortunately, that's not what happened.

The problem of relapses.

Unfortunately, while therapies for depression have proven effective, research has highlighted another problem. This problem was the recurrence of new episodes of depression in people who had already been through this situation. In this sense, some consider that depression is a chronic disease for life. The risk of recurrent episodes exceeds 80%. Patients will experience an average of four depressive episodes lasting more than 20 weeks.

Relapse and relapse following successful depression treatment are common and debilitating outcomes. That's the real problem we face. To face relapses, the use of cognitive therapy was insisted on. Thanks to this method, relapses became smaller, although they continued to exist. So, it was necessary to introduce a new element to solve this problem.

Cognitive therapy for mindfulness-based depression.

It was considered to include mindfulness as a possible component of the psychological treatment of depression. But what does “mindfulness” mean?

Mindfulness involves paying attention in a particular way: with a purpose, in the present moment, and without judging (Jon Kabat-Zinn). It is remarkable how liberating the action of perceiving our thoughts as simple thoughts and understanding that they do not define us can be.

The simple act of recognizing our thoughts as thoughts can free us from the distorted reality they often create. It allows us to have greater clarity as well as a greater sense of control over our lives.

The key is to get rid of repetitive negative thoughts.

Cognitive therapy for depression based on mindfulness posits as an essential ability to recognize and get rid of mental states characterized by patterns that perpetuate negative thoughts and of a ruminant nature.

If we don't pay attention to these patterns, there is likely to be a downward spiral of mood and the onset of relapse. The basic tool for effecting change in mental modes is the intentional use of attention and awareness in particular ways.

When choosing what we are going to take care of and how we are going to focus, we put in our hands the gear that facilitates the exchange of “mind gears”. When can we put this new skill into practice? In principle, this mental mode can be exercised in all situations.

Mindfulness as a fundamental skill.

Mindfulness is the fundamental skill that cognitive therapy teaches to combat depression based on mindfulness. This implies paying attention in a particular way, with a purpose, in the present moment and without making value judgments.

Becoming aware of thought patterns, emotions and bodily sensations is an essential first step. Mindfulness provides both the means to shift “mind gears” and an alternate mental gear to shift to.

The framework of cognitive therapy for mindfulness-based depression.

Cognitive therapy for mindfulness-based depression lasts 8 sessions. In this type of therapy, the process of learning to pay attention, with a purpose, in each moment, and without making value judgments predominates. Thus, learning to pay attention is the approach of the first sessions of therapy.

Patients become aware of the scant attention they often pay to their own daily lives. They learn to become aware of how quickly the mind changes from one topic to another. After realizing that the mind is wandering, they learn to bring it back and focus on a single element. This process is taught on the basis of body parts first and then on the basis of breathing.

Finally, patients learn to be aware of how the mind's wandering can allow negative thoughts and emotions to be present. Addressing mood swings as they occur or coping with them later implies a second phase of cognitive therapy for mindfulness-based depression.

As we have seen, mindfulness-based cognitive therapy for depression is an effective type of therapy for the treatment of depressive states. Thanks to it, patients learn to identify, give space, accept their negative thoughts, and ultimately let them go.

Bibliographic References:

Segal, Z.V., Williams, J.M. and Teasdale, J.D. (2006). Cognitive therapy of depression based on full awareness. A new approach to the prevention of relapses. Bilbao: Desclée de Brouwer.

García Campayo J, Demarzo M. Barcelona (2015). Mindfulness practical manual: Curiosidad y Aceptación. Siglantana, 2015.