DBT Therapy for Depression | Dialectical Behavior Therapy Skills

Depression is a prevalent mental illness. The Centers for Disease Control estimates that it will affect around 4.8% of the population over the age of 18, and it led to 49,316 suicides in 2023. Even if depression doesn’t get to the level of suicidal ideation, it can still adversely affect almost every facet of day-to-day life, such as relationships, work, or even simple self-care.

Fortunately, there are effective treatment options available for mental health disorders. With DBT therapy for depression, you can develop skills that can help you manage depressive moods and learn how to live with your symptoms.

Understanding DBT Therapy for Depression

Dialectical behavior therapy (DBT) is a derivative of cognitive behavioral therapy developed by Marsha Linehan in the late ’80s. Originally, it was designed for borderline personality disorder, but it’s now used to treat depression and many other behavioral and mental health concerns.

The therapy focuses on four main skill areas including: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These dialectical behavior therapy skills help you become more aware of your thoughts and actions, manage your moods, and deal with stress without falling back on unhealthy habits.

Depression can leave you ruminating, pulling away from people, and struggling to manage your emotions. DBT targets these issues, teaching you skills to break the cycle. DBT is focused on balancing acceptance and change. You learn to sit with your feelings as they are, while also working on healthier habits. 

DBT Skills Training for Focused on Depressive Symptoms

Practicing DBT skills helps you notice your thoughts, deal with emotional storms, and respond to mood swings in healthier ways. These techniques are practical and are meant to be used in day-to-day life to cut down on rumination, manage difficult thoughts, and keep your emotional balance.

Mindfulness Skills 

Mindfulness is the foundation of DBT therapy for depression. By anchoring yourself in the present, you’re less likely to fall into depressive patterns. 

You might start with basic mindfulness exercises such as focusing on your breath or tuning in to the sounds around you. The idea is to be aware, not judge.

Instead of labeling your emotions, you just acknowledge their existence. The more you practice, the easier it gets to pause and respond thoughtfully, rather than just reacting automatically.

Distress Tolerance Skills

Distress tolerance skills will help with getting through difficult emotional periods without making things worse. These DBT skills focus on surviving intense feelings, not immediately addressing them. Radical acceptance means facing reality as it is, even if it’s difficult.

Emotion Regulation Skills

Emotion regulation helps you get a handle on your feelings and respond in ways that don’t make things worse. Instead of being at the mercy of your moods, you learn to manage them.

First, you work on emotional awareness, which is naming what you feel and understanding what triggered it. When your emotions don’t fit the facts, the opposite action can help. For example, if you’re tempted to stay in bed all day, maybe you push yourself to get outside or text a friend.

Interpersonal Effectiveness and Building Resilience

The last skill in DBT therapy for depression is interpersonal effectiveness. Depression is more manageable when you can communicate your feelings, protect your boundaries, and deal with stress without being overwhelmed. These skills support stronger relationships and a steadier, more resilient life.

Improving Relationships with DBT

Depression can make you isolate yourself from the people who care about you. DBT therapy for depression gives you ways to reconnect, such as expressing your needs clearly and actually listening. 

Interpersonal effectiveness skills are focused on balancing what you want with what others need. You learn to ask for help without feeling guilty, and to say no without wrecking the relationship. That means less conflict and more positive moments with the people around you.

Assertiveness and Boundary Setting

Depression can make it difficult to stand up for yourself. You might go along with things just to avoid conflict.

DBT teaches assertiveness with the DEAR MAN skill (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate). This gives you a framework for speaking up clearly and respectfully.

Setting boundaries protects your energy and self-respect, which is key to resilience.

Developing Coping Mechanisms

Depression can trap you in a cycle of negative thoughts. DBT therapy for depression focuses on coping skills that build resilience and help you self-soothe. Mindfulness and distress tolerance are important in this regard as they help you handle urges without falling into old, harmful patterns.

You learn to pause and breathe when emotions get intense. The more you use these skills, the better you get at handling setbacks. As your coping mechanisms get stronger, you’ll likely find more emotional stability.

DBT Treatment Process for Mental Health

DBT therapy for depression uses a structured approach that combines one-on-one sessions, group learning, and real-time support. Each part has its role in helping you build and use skills that can make life with depression more manageable.

Individual Therapy Sessions

In individual therapy, you and your DBT therapist address your personal challenges. These sessions are usually weekly and follow a plan, but there’s room to focus on what’s most pressing.

A common tool is the diary card, where you write down emotions, urges, and behaviors. Going over this together helps you identify patterns and target the most difficult issues.

Your therapist balances acceptance with change. They’ll validate your experience, but also direct you toward new strategies for cutting down on harmful habits.

Group Skills Training

Group skills training is more akin to a class than a support group. It is where you learn and practice DBT skills alongside others. These groups usually meet weekly and are led by someone trained in DBT.

You’ll cover the four modules outlined above. There’s a lot of hands-on practice, such as role-playing, worksheets, and group discussions. It’s a chance to see how the skills function in real-world situations.

Special Considerations in DBT for Depression

If you use DBT therapy for depression, it will be important to keep co-occurring conditions, safety issues, and the need to tailor skills for specific challenges in mind. These factors shape how you use the skills and how much they’ll help in everyday life.

DBT for Borderline Personality Disorder with Depression

If you’re dealing with both borderline personality disorder and depression, DBT is often the go-to. BPD brings intense emotions, relationship difficulties, and poor impulse control. Depression contributes to hopelessness and low energy, making daily life feel difficult.

DBT aims to address both at once. The emotion regulation piece offers ways to spot triggers and cut down on mood swings. Interpersonal effectiveness helps with boundary-setting and keeping relationship drama from feeding your depression.

Addressing Self-Harm and Suicidal Ideation

Self-harm and suicidal thoughts are realities for many people with depression, especially when emotions can become overwhelming. DBT addresses the driving factors of these risks by teaching safer coping strategies and offering structured support.

The distress tolerance module is important in this regard. Skills such as distraction, self-soothing, and TIPP (Temperature, Intense exercise, Paced breathing, Progressive muscle relaxation) can help patients with distress without resorting to self-harm.

Therapists will often use chain analysis to help you trace the steps leading up to self-harm. It’s about identifying patterns so you can try something different next time. Some programs even offer phone coaching for those moments when things feel overwhelming.

Adapting DBT for Anxiety and Emotional Dysregulation

Depressive disorders do not occur alone. A review of literature indicated that more than half of people who seek treatment for depression or anxiety will have a comorbid depressive or anxiety disorder.

Mindfulness skills ground you in the present, instead of letting anxious thoughts take over. The check the facts strategy is handy for testing whether your fears actually match what’s happening.

When anxiety pushes you to avoid things, DBT encourages you to do the opposite action, like reaching out to a friend instead of isolating. It can be uncomfortable, but it can ease both depression and anxiety over time.

Develops Skills to Manage Depression Symptoms

Depression is a disease that can be debilitating, but it doesn’t have to control your life, and with the right treatment, it doesn’t have to. But at Luxe Recovery, we offer DBT therapy for depression that can help you or a loved one manage your symptoms.