Depression (Major Depressive Disorder):
Major depression is the “common cold” of psychiatry (Seligman 1975). By 2020 the World Health Organization estimates that Depression will only be second to cardiovascular disease in terms of worldwide health burden (Murray and Lopez 1998). Major Depression affects approximately 14.8 million Americans (Kessler et al. 2005) and is the leading cause of disability in the United States for ages 15-44 (WHO 2004). When we are depressed it has a significant impact on our thinking and beliefs such that our thinking centers on themes of loss, self- devaluation, and hopelessness. We have negative views of ourselves (e.g. “I am a looser”), of the future (e.g. “nothing will change”), and of the world (e.g. “everything goes wrong”). We can also get depressed about depression (e.g. “This just shows how dysfunctional I am”).

CBT is indicated for the treatment of depression. Treatment duration is typically 15 to 25 sessions and is delivered once or twice weekly. We recommend committing to 10 sessions with close monitoring of response. Within 10 sessions one can usually determine if the depression is going to respond to CBT.

Research has shown that CBT can be slightly superior to antidepressant medication (a total of 17 studies). However, more recent research shows that CBT is as effective as antidepressant medication for depression but is superior to medication for preventing relapse (Beck 2005). CBT is indicated for postpartum depression, recurrent depression associated with bipolar disorder, depression that is associated with poor physical health (e.g. chronic pain) and mild, moderate and severe depression.

To read more about Depression and CBT click on the following links:

http://pn.psychiatryonline.org/cgi/content/full/42/9/14
(a news report about a large government trial of CBT for Depression that appeared in Psychiatric News).

http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml
(Links to the National Institute of Mental Health (NIMH) guidelines for Depression).

http://www.nami.org/Content/ContentGroups/Helpline1/Major_Depression.htm
(Links to National Alliance on Mental Illness (NAMI) guide for Depression).

Click here to listen to Dr. Bermudes discuss suicide prevention on the KFBK John McGinnis show, 9/30/2011.  Dr. Bermudes begins his portion of the program at the 8-minute mark in the show.

References
1. Beck AT. The current state of cognitive therapy: a 40-year retrospective. Arch Gen Psychiatry 2005;62:953-959.
2. Kessler RC, Chiu WT, Demier O, et al. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry 2005;62:617-627.
3. Murray CL, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Boston, 1998.
4. Seligman MEP. Helpless. WH Freeman & Co., San Francisco, 1975.
5. The World Health Organization. The world health report 2004: changing history, annex table 3: burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates for 2002. Geneva: WHO, 2004.