Treatments
cognitive behavioral therapy, psychotherapy, and counseling
WHAT IS IT?
Cognitive behavioral therapy is a type of psychotherapy, or “talk therapy”. With CBT, the therapist or counselor helps a person become aware of ways they think that may be negative, inaccurate, or harmful. The person learns to question these thoughts, understand them, and change these destructive ways of thinking. CBT helps a person think about, and react differently, to situations. Research shows that it is helpful for both anxiety and depression.
A cognitive behavioral therapist may have you keep a diary, practice mindful meditation, do role plays, identify cognitive distortions (how you think), do controlled exposure to anxiety, reintroduce rewarding activities, and other techniques to help you change (restructure) your thoughts and find new ways to react to problematic situations. It can be done individually, in groups of people with similar difficulties, or through the internet. There is often “homework”, or assignments to do between sessions. It is a problem-oriented approach to helping people cope with their lives. It is sometimes done for a specific number of sessions.
Many other types of talk therapy and counseling can be helpful for treating depression and anxiety. These therapies can support individuals as they experience life challenges. While the many different types of therapy and counseling have not been studied specifically in midlife women, there is extensive experience delivering these treatments to women of all ages.
OUR BOTTOM LINE: DOES IT HELP?
YES. There is strong evidence that cognitive behavioral therapy helps with anxiety, depression and other emotional challenges. And, unlike medications, it has no risks.
MOOD, ANXIETY & DEPRESSION
While not studied specifically in menopausal women, CBT can improve mood issues, anxiety, and depression.
SLEEP
There is a specific type of Cognitive Behavioral Therapy for Sleep that is very helpful for sleep problems during menopause.
POTENTIAL RISKS & SIDE EFFECTS
There are no risks with CBT. But there may be emotional discomfort with exploring painful feelings and emotions.
QUALITY OF LIFE EXPECTATIONS
By helping with anxiety or depression CBT may improve your quality of life.
IF I WANT TO TRY THIS TREATMENT WHAT ARE MY NEXT STEPS?
If you think CBT may be helpful for you, find a therapist or counselor certified in CBT. You may get a referral from your health care provider, a friend, or another trusted source. If you have health insurance, ask about mental health coverage under your plan. Before your first visit spend some time thinking about the concerns you want to address. Then ask the therapist about their expertise in the areas of concern to you.
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Hall J, Kellett S, Berrios R, Bains MK, Scott S. Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression. Am J Geriatr Psychiatry. 2016 Nov;24(11):1063-1073. doi: 10.1016/j.jagp.2016.06.006. Epub 2016 Jun 17. PMID: 27687212.
Ijaz S, Davies P, Williams CJ, Kessler D, Lewis G, Wiles N. Psychological therapies for treatment-resistant depression in adults. Cochrane Database Syst Rev. 2018 May 14;5(5):CD010558. doi: 10.1002/14651858.CD010558.pub2. PMID: 29761488; PMCID: PMC6494651.Webb CA,
López-López JA, Davies SR, Caldwell DM, Churchill R, Peters TJ, Tallon D, Dawson S, Wu Q, Li J, Taylor A, Lewis G, Kessler DS, Wiles N, Welton NJ. The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychol Med. 2019 Sep;49(12):1937-1947. doi: 10.1017/S003329171900120X. Epub 2019 Jun 10. PMID: 31179960; PMCID: PMC6712954.
Rosso IM, Rauch SL. Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions. Harv Rev Psychiatry. 2017 May/Jun;25(3):114-122. doi: 10.1097/HRP.0000000000000139. PMID: 28475503; PMCID: PMC5421393.
Zhang A, Borhneimer LA, Weaver A, Franklin C, Hai AH, Guz S, Shen L. Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression. J Behav Med. 2019 Dec;42(6):1117-1141. doi: 10.1007/s10865-019-00046-z. Epub 2019 Apr 19. Erratum in: J Behav Med. 2020 Apr;43(2):339. PMID: 31004323.
https://www.nimh.nih.gov/health/topics/psychotherapies/
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
Last reviewed July, 2021
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