Online Cognitive Behavioral Therapy for Depression in New York

Depression Therapy

Life comes with its ups and downs, and it’s fairly common to feel occasionally down. However, if feeling a sense of despair has become rooted in your day to day existence, making normal functioning difficult, it might be a wise and healthy next step to talk with someone about depression.

If you’re feeling down you are not alone, you don’t need to suffer in silence and there is light at the end of the tunnel. If you’re feeling depressed, online cognitive behavioral therapy for depression can restore your zest for life or ‘joie de voir’ (exuberant enjoyment of life). However, prior to explaining cognitive behavioral therapy helps in treating depression, it’s helpful to first understand the most common types of depression people are experiencing.

Types of Depression
Symptoms of Depression
Cognitive Behavioral Therapy (CBT) Explained
Who Can Benefit from CBT for Depression
What CBT Sessions for Depression Look Like

Common Types of Depression

Major Depression. Generally defined by having 5 or more of the below (link) listed symptoms on most days for at least 2 weeks (1 of the symptoms must be a depressed mood or loss of interest in activities). For some this disorder is recurrent with people experiencing episodes monthly, others once a year or numerous times throughout their lives. Major depression episodes can interfere with your ability to work, study, sleep and eat.

Persistent Depressive Disorder (PDD). Generally, not as severe a major depression, but can be just as disabling with the same symptoms experienced (link) and continuing for at least 2 years. People sometimes experience momentary periods of not feeling down, but this relief of symptoms generally lasts for no longer than 2 months. Many people with PDD are able to function daily, but feel joyless or low much of the time.

Bipolar Disorder (manic-depressive disease). Causes extreme fluctuations in mood and changes in thinking, behavior, energy, and sleep. With bipolar disorder, you don’t just feel down, your depressive state may prompt suicidal thoughts that swing over to feelings of endless energy and euphoria. These extreme mood fluctuations can occur weekly or show up sporadically–perhaps twice a year.

Seasonal Affective Disorder (SAD). As days become shorter (in the Autumn and Winter) the body’s natural daily rhythms, our eyes’ sensitivity to light, or how chemical messengers like serotonin and melatonin function, can be altered driving mood changes. Experiencing sleepiness, weight gain, and depression during the Winter months but feeling perfectly fine in Spring, may be SAD.

Depression Types Unique to Women While women are at higher risk for depression in general, they’re also at risk for 2 different depression types influenced by reproductive hormones.

Perinatal Depression. Pregnancy brings significant hormonal shifts that commonly affect a woman’s moods. This disorder includes major and minor depressive episodes occurring while pregnant or in the initial 12 months post delivering a baby (postpartum depression).

PMDD. a severe form of PMS (premenstrual syndrome). Symptoms usually start soon after ovulation and end once menstruation starts.

Signs & Symptoms of Depression

If you are concerned you might be depressed, consider whether any of the following symptoms resonate with you:

Feeling helpless and hopeless throughout your day
Waning or no interests in former enjoyments including sex
Feeling exhausted, fatigued, or tired for no apparent reason
Trouble sleeping, oversleeping, early-morning awakening
Swings in diet, either much more food or far less food
Inability to concentrate or focus on simple things
Negative thoughts racing through your mind
Short-temper, easily irritable & aggressiveness
Being reckless in behavior and general disposition
Consuming more alcohol than usual
Excessive use of prescription or illegal drugs
Feelings of worthless, self-loathing, thoughts of death
Unexplained physical aches and pains
Persistent physical symptoms nonresponsive to treatment (digestive disorders, headaches, etc)

If experiencing several of these symptoms to an extent that they have affected your life, we may be helpful in getting you “unstuck”. We know feeling depressed affects your mood, ability to think, feel, and function. It closes off connectedness, blunts sensations of pleasure, stifles creativity, and often shuts down hope. Having said this, there’s plenty of evidence concluding people who receive online cognitive behavioral therapy for depression can find significant relief and get better. As the name implies, cognitive behavioral therapy uses both cognitive strategies to modify thought patterns and behavioral strategies to modify unhelpful or harmful behaviors.

Cognitive Behavioral Therapy For Depression Explained

In a nutshell, cognitive behavioral therapy for depression aims to help you recognize particular negative thought patterns along with your behavioral responses to challenging and stressful situations. Cognitive behavioral therapy helps correct false self-beliefs that are commonly the origins of certain moods and behaviors. The fundamental principle of cognitive behavioral therapy is thoughts precede moods and they’re both interrelated with your environment, physical response, and subsequent behavior.(1) As such, modifying a thought conjured in a given situation will result in a changing of mood, behavior, and physical response.

Generally cognitive behavioral therapy is shorter-term, usually takes as little as 6 sessions or up to 20 sessions and allows you to explore:

How your actions affect your thoughts and feelings.
Your self-perceptions, others and the world.

Cognitive behavioral therapy intends to improve your state of mind today, rather than probing into the past. In therapy sessions you’re guided on developing healthy and balanced ways of managing stressors, with the goal of eliminating your upsetting responses.

During sessions, you and the therapist will probe and identify environments, situations, and circumstances within your life that may be contributing to or triggering your depression. This exchange will surface any distorted perceptions and or unhealthy patterns of thinking.

Typically keeping journaling is encouraged to note situations you encounter along with your reactions to them. How it works is once you have a stream of negative thought(s), write down exactly what’s bothering you in that moment and think of ways to improve that moment. Since hopelessness typically accompanies depression, writing down what you can do to better that moment can be helpful in easing depressive feelings.

For example, if you’re coping with loneliness, write down considerations like signing up for online dating or a social club or group connected to any interest you’ve ever had. This is helpful in identifying and deconstructing your thought patterns and reactions and; then placing them into different categories of negative thought, including:

Overgeneralization – drawing overly broad conclusions of a single situation or event.
All–or-nothing thinking – viewing the world as black-and-white and not allowing for shades of grey
Automatically negative thoughts – negative self-talk that pops into your head immediately in response to a stimulus (trigger).
Rejecting the positive – disqualifying or marginalizing positive experiences for no valid reason.
Unrealistically maximizing or minimizing the importance of events – hyping things up or diminishing them down in ways disengaged from reality.
Feeling personally targeted – assuming things happening around you are because of your actions in some way or believing other’s unrelated actions are directed at you.
Dwelling on a single negative issue – consistently focusing on something until you’ve reached a point to where you now view it through a darkened lens.

Thus an essential aspect of cognitive behavioral therapy for depression is journaling as it prompts you to:

Self-reflect and evaluate to learn how to modify your responses to more healthy ways.
Practice grounded, accurate, non-distorted and balanced self-talk.
Develop skills to accurately and comprehensively assess emotional behavior, triggering situations and then manifest appropriate reactions.

Who Can Benefit from Cognitive Behavioral Therapy for Depression?

If you’re experiencing mild-to-moderate major depression, cognitive behavioral therapy as a standalone treatment can offer great relief. It’s ideal for those seeking to take an active role in their own care and healing. While the therapist assists in identifying and deconstructing feelings and thoughts, sessions often end with some type of homework for the client whereby they apply learned coping skills to daily life.

Cognitive behavioral therapy is effective both for adolescents and adults and is often sought to combat relapse for those who’ve previously battled depression. The coping skills cognitive behavioral therapy delivers can be used to manage lingering depressive symptoms for weeks, months and even years going forward. Cognitive behavioral therapy is most effective for people who:

Are motivated and aspire for change.

Can be introspective and readily self-reflect.

See themselves as able to influence if not control events in their immediate space.

What Do Cognitive Behavioral Therapy for Depression Sessions Look Like?

In Cognitive behavioral therapy, you and your therapist collaborate to uncover, identify, and agree on unhealthy patterns of behavior needing change. During a cognitive behavioral therapy session, the therapist will help you work through 3 basic steps.

First, the client understands and accepts that some of their perceptions and understandings of reality may not be valid yet are serving as the foundation of negative thoughts.(2)
Next, the client learns to recognize the manifestation of negative thoughts at their onset and considers alternative thoughts more grounded and aligned with reality.(2)
The aim is for the client to recognize the evidence supporting the alternative thoughts should prevail over the distorted thinking and “reframe” the situation and how they cope through it(1).

You can view the steps as a recalibration of the part of the brain keeping positive thoughts suppressed. Hence essentially, your core negative thoughts that disrupt and hinder your joy, focus and motivation are identified and you’re re-educated to be more grounded and realistic in your thinking.

Negative thinking for example can hinder depression recovery, and the reason is simple and clear: If you harbor negative thoughts, you’re more prone to stay depressed. But what’s less simple and clear is the way people with depression cope with positive emotions. Research has shown people with depression are not lacking positive emotions, they’re just choosing to not allow themselves to feel their positive emotions.

This cognitive behavior is referred to as “dampening,” and is observed with the suppression of positive emotions for negative thoughts like, “This good feeling won’t last” and or “I don’t deserve to be this happy”. Dampening is essentially defensive pessimism where a person with depression is protecting themselves against disappointment and getting their high hopes dashed.

Your therapist helps you identify unhealthy behaviors (like dampening) and structure a positive behavior modification plan. Cognitive behavioral therapy doesn’t simply end with our online session though. An important component of the program and treating your illness is practicing exercises in stressful situations in your daily life.

An Example of a Cognitive Behavioral Therapy for Depression Exercises

You will use coping skills founded on the principles of cognitive behavioral therapy to maneuver through life’s challenges away from our online sessions. To that end you will receive homework exercises designed to sharpen your coping skills and here’s an example. Remember, the basic idea behind cognitive behavioral therapy is very simple: Change the way you think and you can change the way you feel.

Cognitive Behavioral Therapy for Depression Next Steps

If you’re considering taking the step towards getting a handle on depression, we’re ready to walk that journey with you. We have a team of therapists that specialize in cognitive behavioral therapy, which is about learning to control your brain and depression rather than your brain and depression controlling you.
Receiving cognitive behavioral therapy online has become increasingly more popular, and is supported with an abundance of evidence proving its effectiveness (see studies below). Our practice offers online (telehealth) services, enabling anyone feeling depressed to receive confidential guidance from experienced, licensed, master’s-level therapists using HIPAA-compliant software, online right from the privacy of your own home or office.

Many people find online therapy enables them to engage more authentically, immediately, and thereby accelerates the entire wellness process. It’s worth noting research has concluded receiving cognitive behavioral therapy online for depression to be equally (and in some cases more) effective as traditional in-person therapy sessions (see studies below).

For the client, being in the familiar surroundings of your home or office creates a sense of safety and security to conversations that can be heart wrenching and trying. Being immediately comfortable with your chosen environment decreases stress and increases your ability to openly share, listen, and understand.

Sharing intimate details and talking about your innermost self can be difficult and the physical distance from the therapist with online therapy actually helps minimize apprehensions and hesitancy in opening up.

For people with difficult schedules also benefit from the flexibility that online live counseling sessions allow. Sessions can be held anywhere as long as you have internet access. With no drive time required and the ability to access your sessions from various locations, online cognitive behavioral therapy for depression is ideal for busy people.

Greenberger D, Padesky CA. Mind over mood: a cognitive therapy treatment manual for clients. New York: Guilford Press, 1995.
Beck AT. Cognitive therapy and the emotional disorders. New York: International Universities Press, 1976.
Effects of Constructive Worry, Imagery Distraction, and Gratitude Interventions on Sleep Quality: A Pilot Trial Nancy Digdon,Amy Koble ; Applied Psychology: Health and Well-Being

“The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two.”

Comparing in-person to videoconference-based cognitive behavioral therapy for mood and anxiety disorders: Randomized controlled trial. Journal of Medical Internet Research, 15(11), e258. Stubbings, D. R., Rees, C. S., Roberts, L. D., & Kane, R. T. (2013). https://doi.org/10.2196/jmir.2564

“This pilot study demonstrates that group Cognitive Behavioral Therapy could be delivered in a technology-supported environment (on-line video conferencing) and can meet the same professional practice standards and outcomes as face-to-face delivery of the intervention program”.

Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study – Source Khatri N, Marziali E, Tchernikov I, Sheppard N. Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study. Clin Interv Aging. 2014;9:765-770
https://doi.org/10.2147/CIA.S57832
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Question Does computer-assisted cognitive behavior therapy (CCBT) plus treatment as usual (TAU), compared with TAU alone, improve treatment outcome for depression in primary care patients? In this randomized clinical trial, CCBT was found to have significantly greater effects on depressive symptoms than TAU in primary care patients with depression.

Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care

A Randomized Clinical Trial

Jesse H. Wright, MD, PhD1; Jesse Owen, PhD2; Tracy D. Eells, PhD1; et al

Becky Antle, PhD3; Laura B. Bishop, MD4; Renee Girdler, MD5,6; Lesley M. Harris, PhD3; R. Brent Wright, MD5; Michael J. Wells, MD5,7; Rangaraj Gopalraj, MD5,6; Michael E. Pendleton, MD5,7; Shehzad Ali, PhD8,9,10

Author Affiliations Article Information
JAMA Netw Open. 2022;5(2):e2146716. doi:10.1001/jamanetworkopen.2021.46716

“Participants were highly satisfied and experienced clinically meaningful improvements in behavioral health outcomes”
Using Telehealth to Implement Cognitive-Behavioral Therapy
” – Source Loren Dent, Ph.D., Aimee Peters, L.C.S.W., Patrick L. Kerr, Ph.D., Heidi Mochari-Greenberger, Ph.D., M.P.H., Reena L. Pande, M.D., M.Sc.
Published Online: 15 Feb 201 8 https://doi.org/10.1176/appi.ps.201700477