Eli5: How does cognitive behavioral therapy works against depression



Depression is caused by chemical disbalance in the brain, how come cognitive behavioral therapy can work for depression? How does this work? Does this mean our thoughts affect our chemicals in our brain?

In: Biology

The biological model for depression is just a theory and not a well proven one at that. Psychiatrists wouldn’t know the scientific method if it slapped its beautiful science titties in their faces. Ok maybe I’m biased lol

So the biological basis of depression generally goes that because anti depressants called serotonin reuptake inhibitors work, depression must be a lack of serotonin. That’s a bad way to start a theory.

Most depressions are environmental eg, grief, lost a job, end of relationships etc. And never require intervention, they only last 6 months ish and are appropriate.

Clinical depressions is when it lasts longer that 6 months or is inappropriate eg, no environmental cause. There’s also post partum depression but that’s a whole other kettle of fish because that’s lots of different hormones and environmental changes.

what do you mean by effective? Is CBT effective? I’d say its not. Not very anyway. Efficacy rates are varied and depend on the individual. It can be useful at creating coping skills and resilience to symptoms, not curing them.

For more info, this isn’t behind a paywall:

Your thoughts *can* affect the chemicals in your brain. Ever read something that made you really really angry? Ever hear a funny joke and then you’re in a better mood? Ever see a naked picture of a very attractive person? Your thoughts put you in a particular mood. Your brain is producing chemicals in response to the subjects you choose to think about.

The chemical imbalance theory is not well proven. But there can be observable changes in the brains of depressed people vs those who are mentally healthy. CBT is based on the principal that our feelings are a result of our thoughts. Its efficacy is generally comparable to that of antidepressants for mild – moderate depression. It works by having the patient modify thought patterns and behaviours, with the hope that blocking a vicious cycle of negative thoughts and reinforcing behaviour will help the person return to baseline emotional health.

As for your question about our thoughts affecting the chemicals in our brains, basically… Yeah they do. I’m no neuroscientist, but as a basic example, when we are anxious we release stress hormones into our bodies.

Even though the lack of seretonin theory is no longer widely accepted, it’s known that neuroplasticity is a large factor in recovery from depression, CBT can be used to basically train your brain. It’s not a cure all but it’s an evidence based approach that most of the time will be helpful to some degree.

“Every time the logical brain overrides the emotional brain, the logical brain “muscle” becomes stronger and stronger. In other words, through CBT training the brain actually reinforces the neural pathways, so it becomes easier and easier to deal with future stressful situations”

You can read about all of this on pubmed.gov and I also happen to be in CBT for depression and anxiety

Interesting reading about brain imaging: https://pubmed.ncbi.nlm.nih.gov/19622682/

OK let me try to do a true eli5 explanation

– depression might or might not be caused by a chemical imbalance (no one is actually sure) but we shouldn’t let that distract us because, there will surely be some physical explanation of it.
– cognitive behavioural therapy is a therapy which aims to change your beliefs, and it is effective against depression
– the reason this works is, exactly as you say, because our thoughts and actions affect the chemicals in our brains
– some people would say our thoughts and our brain’s biology are really the same thing, at different levels of zoom. From space, the earth looks one way, but from your front porch the ground looks completely different. If you zoom in again with a microscope to look at the ground in more detail, you’ll see more again. Some people think the mind is like that too. Beliefs are a very zoomed out way of looking at minds, and when we think in terms of beliefs, we can easily look at the whole person. When we talk in terms of cells, chemicals and synapses, we’ve zoomed in, and although the words we use to describe things are now completely different, we’re describing the same piece of ground as when we were talking about beliefs.

Thoughts can produce chemicals as much as chemicals can produce thoughts.

If you thought there was a tiger behind you, I bet that thought would produce a lot of chemicals, right? Specifically, it would produce some adrenaline.

CBT works by creating habits that interrupt thoughts that produce more sad chemicals.

One theory is that depression is a feedback loop of chemicals and thoughts. Sad thought lead to **sad self talk** which leads to sad beliefs which lead to sad chemicals which lead to more sad thoughts.

CBT helps us build a habit of recognizing and predicting the **sad self talk** step and interrupt this feedback loop by replacing sad self talk with something else — or to challenge our sad self talk. This breaks the cycle.

Evidence seems to show that this works pretty well.

It doesn’t really. It’s just a band-aid and based on “woo-science.” Sure it helps some people, but it does nothing to target the origin of your thoughts, which is what philosophy does. Reading philosophy (especially ethics and epistemology stuff) has done me far greater than any bullshit CBT garbage. You actually dive deep into your value system and understand yourself and the way you think better, by studying philosophy.

Thoughts affect feelings. Feelings effect mood. Mood effects thoughts and feelings. They are all inter- connected and interact and effect one another. Using CBT you can actively work on changing your thoughts/beliefs which can positively influence your feelings and moods.