Depression and anxiety and suicidal thoughts: Dialectical Behavior Therapy (DBT)

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Dialectical Behavior Therapy (DBT) refers to an evidence-based, comprehensive treatment that helps in dealing with the symptoms of borderline personality disorder. DBT was created by Marsha Linehan. It includes a combination of skills, techniques, and treatments that can be applied as a stand-alone or therapy option. Dialectical Behavior Therapy is based on the idea that unwanted behaviors are used to manage emotional states and that each behavior in turn causes new ones. It offers methods on how one can suppress their actions to help themselves develop more adaptive coping mechanisms and improve emotion regulation skills. In this overview, we will give you an introduction to DBT, with an overview of how it is typically administered in therapy sessions.

Dialectical Behavior Therapy (DBT) is considered to be a modern DBT. It was developed over the course of many years, but the roots of DBT can be found in cognitive therapy, much like other contemporary DBTs such as Acceptance and Commitment Therapy (ACT). The DSM-5 defines it as “an empirically validated treatment for borderline personality disorder (BPD). It combines individual psychotherapy with skills training and was derived from dialectical behavior therapy (DBT), developed by Marsha M. Linehan in 1987 (Rosenfeld et al., 2019). DBT is based on a “double-edged” approach which allows for the use of acceptance and change strategies.

The theory behind Dialectical Behavior Therapy (DBT) is that all behaviors can be used as a survival strategy to regulate emotions and to prevent anxiety, therefore it is important for the patient to integrate their new skills into the elements of the self where they reside (Warlick et al., 2021). For instance, because anger often pushes people to commit acts of violence, the patient learns that they should be able to accept their feelings while not allowing themselves to act upon them. It is important that patients are able to recognize when they are engaging in self-defeating behaviors and adapt when needed in order for them not only to survive but also improve their quality of life.

There are various causes of Depression and anxiety, such as stressful life memories, hormonal changes, and genetic predispositions. There is much more to it than that though. Some say that depression is caused by a chemical imbalance in the brain, while others believe that bad experiences during childhood can cause your brain to develop an anxiety disorder later on in life. Either way, there are many different treatments for both Depression and anxiety (Ramaiya et al., 2019).

When you are Depressed, you feel like you have no way out of your situation. It could be caused by a stressful life memory, or a chemical imbalance in the brain. Either way it is there, but it is not as permanent as one might think. There are many different treatments for depression, such as medications and therapy. If you want to discuss them with your doctor and figure out which one is right for you, then go ahead and do so. If you have experienced Anxiety at some point in your life then maybe you can relate to how hard it was to get over it.

Managing Depression and anxiety can be very hard. However, with the help of a therapist, it is easy to manage and treat depression and anxiety. Dialectical Behavior Therapy, or DBT, is an evidence-based treatment for emotion regulation and behavioral control. This therapy has been shown to reduce symptoms of depression and anxiety in people with borderline personality disorder (Poon et al., 2022).

Exposure to social rejection can trigger feelings of depression and anxiety. Therapy helps patients limit the triggers they encounter on a daily basis and allows them to gain mastery over thought patterns that create these feelings. For people struggling with depression, the therapy includes exercises such as mindfulness meditation, dialectics (loving yourself despite a painful situation), acceptance-based behavioral therapies (ABC), and active listening skills. Through Dialectical Behavior Therapy (DBT), people learn how to better regulate their emotions and manage their behavior.

According to the National Institute of Health (NIH), this therapy is used to treat people with borderline personality disorder. It has been shown in a number of studies that people who participate in dialectical behavior therapy (DBT) are more likely to have a lower rate of recurrence of borderline personality disorder symptoms following treatment. These studies highlight the importance of DBT in treating mental health conditions such as depression and anxiety disorders.

Suicidal thoughts may be caused by various factors, but there are a few that seem to be more common than others. The most likely cause of suicidal thoughts is depression and anxiety, which can lead to feelings of hopelessness and helplessness. Other signs include unusual anger or frustration, poor self-esteem, difficulty making decisions, or intense loneliness. Sometimes people will have suicidal thoughts without having any major depression or anxiety symptoms yet still having some sort of underlying trigger such as a family member who committed suicide. Thankfully these days there is an abundance of resources that allow you to get help addressing the cause(s) of your suicidal thoughts rather than just treating the symptoms.

Depression and anxiety and suicidal thoughts are common in teens and young adults, however, for some it can be their first time experiencing them. Suicide rates in these age groups rose rapidly between 2006 and 2016, according to a new report from the Centers for Disease Control and Prevention. A major factor in these numbers is the finding that suicide rates are higher among men who have ever used illicit drugs. The report found that the overall rate of suicide among adults ages 18 to 65 rose 10% from 2016 to 2017. The reasons behind this may be complex, with some pointing to the opioid crisis, economic downturns and the aging population as possible causes. But several years ago, there were two reports that indicated a connection between mental health conditions and suicide.

DBT is a type of therapy that offers skills to manage intense emotions, regulate actions and reactions and improve relationships.  These skills include mindfulness, distress tolerance and emotional regulation. The programs teach clients how to understand their feelings and those of others. Dialectical Behavior Therapy concentrates on the present moment without judgment or emotional reaction to it. This allows for cognitive flexibility in order for the client to experience the world in a different way so that clients can access new thoughts, beliefs and behaviors. DBT helps clients learn a skill called dialectics which lets them accept both sides of an argument or emotion as well as realize that there are multiple ways to see something or view life situations (DeCou et al., 2019).

In general, Dialectical Behavior Therapy (DBT) is vital in addressing Depression and anxiety and suicidal thoughts. DBT is a type of therapy that combines mindfulness, acceptance and commitment therapy, and dialectical behavior therapy. DBT has been shown to be effective when dealing with mood disorders, violent and self-injurious behaviors, borderline personality disorder (BPD), eating disorders, and suicidal ideation. DBT falls at the intersection of mindfulness practice (mindfulness group skills) and positive psychology because it brings in positive reinforcement through the compassion focus-based practices. Dialectical Behavior Therapy is used for people with high levels of depression or anxiety as well as those who are struggling with suicidal thoughts or feelings.

Reference

DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior therapy, 50(1), 60-72.

Poon, J., Galione, J. N., Grocott, L. R., Horowitz, K. J., Kudinova, A. Y., & Kim, K. L. (2022). Dialectical behavior therapy for adolescents (DBT‐A): Outcomes among sexual minorities at high risk for suicide. Suicide and Life‐Threatening Behavior.

Ramaiya, M. K., McLean, C., Regmi, U., Fiorillo, D., Robins, C. J., & Kohrt, B. A. (2018). A dialectical behavior therapy skills intervention for women with suicidal behaviors in rural Nepal: A single‐case experimental design series. Journal of clinical psychology, 74(7), 1071-1091.

Rosenfeld, B., Galietta, M., Foellmi, M., Coupland, S., Turner, Z., Stern, S., … & Ivanoff, A. (2019). Dialectical behavior therapy (DBT) for the treatment of stalking offenders: A randomized controlled study. Law and Human Behavior, 43(4), 319.

Warlick, C. A., Farmer, N. M., Frey, B. B., Vigil, K., Armstrong, A., Krieshok, T. S., & Nelson, J. (2021). Cost borne by the counselor: Comparing burnout between dialectical behavior therapy (DBT) counselors and non‐DBT counselors. Journal of Counseling & Development, 99(3), 302-314.