Even though Dialectical Behavior Therapy (DBT) was developed to treat Borderline Personality Disorder (BPD), it has proven to be a viable treatment for many other psychiatric and mental health issues, as well. According to data analyzed by StuffThatWorks, Dialectical Behavior Therapy is the second most effective treatment for clinical depression, helping treat the condition to varying degrees in 82% of the patients who tried it.

According to a 2002 study by the American Journal of Geriatric Psychiatry, 71% of the depression patients in the study were found to be free of the condition at the end of the study period after being treated with Dialectical Behavior Therapy. 

Today, we will try to explore more about this therapy, including how it can be effective against depression.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy is a special form of Cognitive Behavioral Therapy (CBT). The purpose of DBT is to demonstrate to people how to be mindful of the present moment, develop healthy and safe coping mechanisms, form and maintain good relationships, and control their emotions. 

As mentioned earlier, DBT was initially intended as a treatment for borderline personality disorder (BPD). However, it has been increasingly used to treat other psychiatric conditions, particularly depression. DBT can help not only people who have issues with regulating their emotions but also those who use self-destructive ways to deal with their mental problems. It also helps people with drug abuse and eating disorders as well. DBT can even be used to treat post-traumatic stress disorder or PTSD.

Here are some of the techniques used by therapists to treat their patients through DBT. 

1. Being Mindful

One of the main teachings of DBT is to be mindful of the present moment and live fully only in that moment. This technique is applied to help patients focus on not only their surroundings, but also their internal world – their feelings, thoughts, and impulses. The next step in mindfulness in DBT is to accept the sensational input from your surroundings in a nonjudgmental way. The patient is advised to concentrate on their environment and their sensations, i.e., what they’re hearing, seeing, listening, touching, and smelling. This information must be processed in a healthy and positive way. This way, patients can develop healthy mechanisms to deal with the external world not only in normal circumstances but also when they are in emotional stress or pain. Mindfulness also helps to develop ways to keep calm and not act on impulses when confronted with a difficult scenario. Moreover, it breaks negative thought patterns that form in the patient’s brain automatically through overthinking. 

2. Tolerating Distress

Another key psycho-therapeutic technique of DBT is distress tolerance. This technique helps one to accept not only themselves but their reality and current situation. Whenever in distress, the patient should practice the following methods to healthily cope with the occurring crisis.

  • Use a distraction
  • Improve the situation 
  • Soothe themselves
  • Mentally jot down the consequences of not tolerating stress and the pros of tolerating it

This technique, much like mindfulness, provides the patient with the correct emotional mindset that they need to deal with intense scenarios. Furthermore, distress tolerance empowers one to deal with their emotions in such a way that will benefit them in the long run. 

3. Interpersonal Effectiveness

The next technique of DBT is interpersonal effectiveness. This technique makes a person more self-assured and assertive in their relationships. In short, it teaches you how to say “no” to someone’s demands while maintaining a healthy relationship with them. Interpersonal effectiveness teaches patients to become better speakers and listeners, improves their communication skills, and ameliorates their relationships overall. Patients learn how to deal with difficult people while building a rapport with them.

4. Emotional Regulation

This technique helps patients navigate and handle intense emotions effectively. Once a person regulates their negative emotions, they can enhance their ability to deal with difficult situations. 

Having covered the major techniques employed in DBT, let us now see how this therapy can be used to combat depression.

Treating Depression With DBT

While traditional methods such as psychological therapy and medication do wonders in helping depressed individuals, some cases require a different approach. For instance, DBT has been found extremely effective in treating elderly women veterans with depression. Another study, published by the US National Library of Medicine, established that DBT could reduce depression symptoms, suicidal thoughts, and self-harm.

DBT features a comprehensive set of ways to treat depression, some of which include:

  • Behavioral and cognitive therapy
  • Developing new and healthy coping mechanisms 
  • Acceptance-based thinking

When other methods fail to be entirely effective, DBT can prove to be an excellent treatment for depression.

Whatever the specific causes of depression may be in a patient, i.e., whether they live in a toxic place or self-loathe too much, environmental factors can seep into their depression and feed it. DBT is built on the philosophy of changing how one deals with such situations. This treatment is focused on equipping the patient with the best possible mental tools that they need to healthily address and counteract the negative aspects of life. Ideally, continuing down the path of DBT would allow the patient to ultimately free themself from this negativity. 

Research claims that even though the symptoms of depression are intrinsically resistant to change, a strong union between the counselor and patient can lead to the patient adopting healthy coping mechanisms and showing a substantial change in their behavior. As it is with all psychiatric conditions, this treatment may take time to prove effective, but it surely will if carried out correctly. Another study states that when a strong relationship between the therapist and the patient is established, DBT can:

  • Improve the patient’s ability to live in the moment
  • Help the patient manage stress effectively
  • Induce motivation and change in the patient
  • Restructure the patient’s mindset about external factors that worsen their depression
  • Help the patient develop new coping mechanisms and skills

Marsha M. Linehan (the creator of DBT) highlights the following eight strategies for treating depression with DBT.

  • Accepting and acknowledging the possibility of change in the patient’s life
  • Teaching, forming, and exercising practical problem-solving methods
  • Displaying irreverence to repeated relapses to malicious coping mechanisms
  • Being an exclusive consultant to the patients
  • Actively validating the patient through reinforced acceptance and empathy
  • Providing a growth-oriented, warm relationship to the patient
  • Educating the patient on the development of improved behavioral skills
  • Facilitate the patient with contingent strategies to reduce the chances of self-harm

Ideally, a DBT treatment session would include and practice all the aforementioned points. This protocol is considered the basis of treating depression with DBT. These strategies introduce healthy coping mechanisms and skills in addition to a positive mindset to patients. 

In Conclusion

Depression is one of the most dangerous mental disorders. There are many ways to treat depression, one of which is Dialectical Behavior Therapy. This type of therapy reinforces a positive outlook on life and fosters healthy coping mechanisms. DBT has shown exceptional results in treating depression and has become a haven for many unfortunate depression patients. 


Author: Jeremy Medvin

The given content is provided by Jeremy Medvin who is doing research on this subject. More research contributions credited to Sadia shahid MA Industrial Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Science and Technology, Islamabad; Fatima Nasir MA healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Science and Technology, Islamabad; Dr. Madiha Khalid Clinical Pharmacist, M. Phill. clinical pharmacy Pakistan, Jeremy Madvin, MBA International Business, University of Redlands, Redlands, Ca.