DBT for Depression

Depression is a heavy weight to carry, especially for young people. It can steal their joy, disrupt relationships, and leave them hopeless. If your child or teen is struggling with depression, you're likely searching for effective treatment options. Dialectical behavior therapy (DBT) might be the answer you've been looking for.

Learn what DBT is, why it’s an essential tool for treating depression in adolescents, and the necessary techniques for helping your child begin their healing journey.

What is DBT?

Dialectical behavior therapy is an evidence-based psychotherapy for treating various mental health conditions, including depression in adolescents [*]. Whereas CBT focuses on identifying and altering negative thought patterns, DBT builds on these principles by acknowledging the validity of a person’s emotions while teaching skills to manage them effectively.

"Dialectical" refers to simultaneously holding seemingly opposite ideas in mind. In DBT, this translates to accepting a person's current struggles (validation) and working towards positive change.

How Can DBT Help with Depression?

DBT helps treat depression in teens and kids through a multi-pronged approach, equipping them with skills to manage intense emotions and build resilience. Depression often involves chronic sadness, hopelessness, and anger. DBT teaches skills like identifying emotional triggers, understanding what emotions are trying to communicate, and applying techniques like mindfulness and distress tolerance to regulate emotional intensity healthily and productively.

DBT also improves distress tolerance by teaching adolescents radical acceptance, where they learn to acknowledge their pain without judgment, and crisis survival skills for navigating overwhelming emotions.

Is DBT Effective for Treating Depression?

Research shows that DBT is effective for treating depression in children and teens. It reduces depressive symptoms in teenagers with major depressive disorder and addresses refractory depression with high success rates [*].

DBT for kids and teens also improves overall functioning, enhancing communication and social skills. Other depression-related symptoms DBT can improve include the following:

• Lack of interest in activities your child used to enjoy
• Persistent sadness
• Difficulty focusing on schoolwork or other activities
• Physical manifestations, such as chronic fatigue and sleepiness

DBT Techniques for Depression

DBT for teens and kids provides a powerful arsenal of skills to combat depression. Here is a close look at the four core DBT techniques for depression.

Mindfulness

Depression can distort our perception, making us hyper-focused on negative thoughts and situations. Mindfulness, a cornerstone of DBT, helps teens become more aware of their present-moment experiences (thoughts, feelings, and bodily sensations) without judgment [*].

Adolescents can treat their thoughts as “mental events” instead of absolute truths, detaching from negative rumination and self-criticism that fuels depression. Individuals can focus on the present and use mindfulness techniques like deep breathing and observing their environment to break free from dwelling habits.

Through mindfulness practices, individuals can be more aware of emotional triggers that may lead to depressive spirals.

Emotion Regulation

Depression often involves intense and overwhelming emotions that can be challenging to overcome. By practicing emotion regulation, individuals can learn to identify emotional triggers, understand emotional cues, and develop healthier coping skills.

Learning to anticipate emotions associated with specific triggers can help individuals prepare and recognize when they become too overwhelming.

Interpersonal Effectiveness

Understandably, depression can strain relationships, leading to isolation and loneliness. If your child suffers from depression, it’s essential to build bridges, not walls. Practicing interpersonal effectiveness skills can help individuals communicate assertively, expressing their needs and wants clearly.

They’ll also learn to set healthy boundaries and learn to say no to unreasonable requests, protecting themselves from emotional manipulation.

Interpersonal effectiveness also involves validating others’ feelings, leading to stronger social connections.

Distress Tolerance

When dealing with depression, everyday challenges can feel insurmountable. Fortunately, distress tolerance skills can help individuals accept their current situation and emotions without judgment, detaching from the situation and moving toward healthy coping mechanisms.

Individuals can also learn crisis survival skills like distraction techniques and self-soothing practices without resorting to self-harm or other destructive habits.

Finally, distress tolerance teaches teens to break down big problems into smaller, more manageable steps. Doing so fosters a sense of control and reduces the feeling of helplessness often associated with depression.

How Long Does DBT for Depression Take?

The exact duration of DBT for depression in teens can vary depending on individual needs and treatment response. However, most DBT programs last roughly six months or more. This timeframe allows for an in-depth exploration of various DBT techniques and their application to real-life situations.

For teens with more severe depression or co-occurring mental health conditions, DBT treatment may extend beyond a year.

Are There Risks Associated with DBT for Depression?

While DBT is a well-regarded treatment for depression, there are some potential drawbacks to consider. For instance, DBT requires a significant time commitment, with the national standard being weekly sessions.

In addition, DBT involves mastering new skills, which can be complex and overwhelming for some. DBT also often involves homework assignments provided by therapists, which can be challenging for some individuals to complete.

Overall, DBT is a powerful tool for helping individuals manage depression with minimal risks that can be curbed through effective communication and qualified therapists.

Can DBT Be Combined with Other Treatments?

Parents and caretakers can opt to combine DBT with other treatments for their child. A comprehensive approach can improve an individual’s overall coping skills while targeting specific aspects of depression. For instance, individuals might combine DBT with CBT or cognitive-behavioral therapy, which helps identify and change negative thought patterns associated with depression.

Therapists might also combine DBT with IPT or interpersonal therapy, which focuses on improving communication skills and resolving relationship problems potentially caused by depression.

It’s also common for DBT patients to take medications alongside their therapy. Antidepressants can help regulate neurotransmitters in the brain, improving mood and motivation.

When combining treatments, clear communication and collaboration between the therapist providing DBT and any other mental health professionals involved is crucial. Therapists must focus on tailoring treatment to the individual’s needs and monitor progress, providing regular updates to parents, teachers, and caregivers.

When is DBT Not Recommended for Depression?

While DBT is appropriate for treating depression, it may not be best for individuals with severe intellectual disabilities, low motivation, substance use issues, and severe psychosis. Patients might consider exploring therapies with a less demanding structure, such as motivational interviewing.

You might explore more straightforward or highly tailored approaches to treat specific symptoms.

The Bottom Line

Depression can long shadow an adolescent’s life and make them feel hopeless, but DBT provides an arsenal of tools for battling the symptoms involved. By practicing mindfulness, emotion regulation, and interpersonal effectiveness, among other techniques, individuals can navigate challenges and build healthier relationships.

While DBT might not be the perfect fit for everyone, exploring its potential benefits can be a crucial step in your teen's journey toward recovery. Explore our collection of DBT worksheets to help create a personalized plan for your child.

Sources:

1. B. O'Connell, Dowling M. “Dialectical behaviour therapy (DBT) in the treatment of borderline personality disorder.” Journal of psychiatric and mental health nursing, 2013.
2. Goldstein TR, Fersch-Podrat RK, Rivera M, et al. “Dialectical Behavior Therapy for Adolescents with Bipolar Disorder: Results from a Pilot Randomized Trial.” Journal of child and adolescent psychopharmacology, 2015.
3. Jennings J and Apsche J. “The evolution of a fundamentally mindfulness-based treatment methodology: from DBT and ACT to MDT and beyond.” International Journal of Behavioral Consultation and Therapy, 2014.