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By Sally Tamarkin[1]


Therapy: Many of us have an image of it our minds -- whether it's Robin Williams tending to a wounded Matt Damon[2] , Betty Draper lying on a couch[3] or one of a great many[4] New Yorker cartoons[5] . But these popular depictions of therapy don't tell us what a session is like or whether psychotherapy is effective (though studies have found that it is effective[6] and that the benefits it brings are real and lasting[7] ). And although the numbers tell us that psychotherapy has become a common feature of many people's everyday lives -- in 2008, 40 million adults in the U.S. received mental health treatment[8] -- if you've never been, the actual experience of being in therapy can be somewhat mysterious, if not intimidating and downright off-putting.


For anyone who's considered therapy but didn't know where to start, or simply wants to understand what it's like once you're in the room, check out the guide below, which provides the need-to-know information for the most common kinds of psychotherapy.


What's Up, Doc? Mental Therapies And Their Uses


Psychodynamic Therapy

If you're picturing Tony Soprano opening up to Dr. Melfi[9] , you're onto something. Psychodynamic therapy[10] is all about talking. More specifically, the patient is guided to talk about his or her thoughts and feelings and free associate[11] (i.e. talk uninterrupted about whatever comes to mind), with the goal of bringing unconscious patterns of behavior to the fore so they can more easily be addressed and (if it would be beneficial to the patient's health) changed.


Useful For: Depression, anxiety, anything panic-related, anyone curious about/interested in exploring his or her own mind[12] [13]


Term Of Treatment: Can be a fixed term or open-ended; often lasts up to two years[14] [15]


What to Expect: Sessions take place once or twice per week and are unstructured. The patient is encouraged to guide the session by talking freely[16] about whatever is on his or her mind.


Find a Psychodynamic Therapist/Analyst[17]




Cognitive Behavioral Therapy

Based on the idea that we can make permanent changes in the way we behave by shifting our negative patterns of thinking, Cognitive Behavioral Therapy (CBT[18] for short) is short-term and goal-oriented. The therapist and patient work together to identify the behaviors the patient wants to change and then come up with an action plan to do so.


Useful For: Depression, anxiety, eating disorders, mood disorders, phobias[19]


Term Of Treatment Four to seven months, with meetings every one to three weeks


What To Expect: Sessions are structured and the relationship with the therapist can be more “business-like[20] ” than in other kinds of therapy. In other words, the patient and therapist will work together to identify and change problematic patterns of thinking and behaving. The patient is given "homework," which consists of keeping a record of his or her thoughts, feelings and behaviors between sessions.


Find a Cognitive-Behavior Therapist[21]




Family Therapy

Families are so much more than the sum of their parts, and can experience struggle and conflict singular enough to warrant a pop culture genre[22] . Luckily, family therapy[23] considers the family unit to be a system[24] with its own unique dynamics (rather than just a collection of individuals who happen to be related). It may address specific problems[25] like an addiction in the family or focus more generally on communication and members' relationships with each other.


Useful For: Families dealing with substance abuse, mental illness, eating disorders, abuse, financial worries and other problems[26]


Term Of Treatment: Short term[27] , but duration depends on the severity of the problems and how long it takes to resolve them. Most cases are completed within 20 sessions[28] .


What To Expect: Typically the family is treated together, but members may also see the therapist (or a different one) on their own.


Find a Family Therapist[29]




Group Therapy

The more the merrier, right? Group therapy[30] is useful for anyone who wants to explore the challenges and conflicts he or she is experiencing in relationships, work, life, etc., and do so in a supportive group setting with other people who are struggling with the same or similar things.


Useful For: People who are struggling with anything from depression and anxiety to loss or trauma[31] and want to work through these issues in the company of others. The group setting offers unique opportunities[32] to learn from others and get lots of feedback, and it tends to be cheaper than seeing a therapist one-on-one (making it a good option for those on a budget).


Term Of Treatment: Six to 20 weeks[33]


What To Expect: The therapist will put together a group of five to 10 people who share the same problem or conflict. The group meets for 75 to 90 minutes for a conversation guided by the therapist.


Find a Group Therapist[34]




Dialectical Behavior Therapy

Originally developed to treat individuals with suicidal thoughts[35] , DBT[36] has since been found to be an effective treatment[37] for people with Borderline Personality Disorder[38] (BPD) and BPD-like symptoms (which include unstable moods, extreme reactions[39] like panic, depression, suicidal thoughts and fear of abandonment). DBT was designed to help these individuals understand their thoughts and behaviors as out-of-the-ordinary and extreme, and then learn coping and interpersonal skills that allow them to find more measured, moderate ways of acting and reacting.


Useful For: Anyone who experiences the kinds of feelings associated with Borderline Personality Disorder (even if they aren't diagnosed as such), including high emotional reactivity, rapid mood changes, and ongoing feelings of emptiness, especially as the result of trauma or abuse, eating disorders, substance abuse, or obsessive-compulsive disorder[40] [41] [42] [43]


Term Of Treatment: Although DBT typically lasts less than one year, the duration of treatment depends on how long it takes[44] for the patient to experience improvement.


What To Expect: Weekly therapy sessions[45] are focused around problem-solving and learning or improving interpersonal skills. Patients will also attend weekly group therapy sessions in order to learn additional skills[46] , and will be given "homework" so they can monitor and evaluate their behavior over time.


Find a DBT Therapist[47]




Interpersonal Therapy

No matter how many reasons there are to appreciate other people[48] , relationships of all kinds can be tough. Typically used to treat those with depression, Interpersonal Therapy[49] focuses on the patient's relationships with other people and how depression has affected the patient's ability to relate to and communicate with partners, friends, family and others.


Useful For: Individuals who suffer from depression[50]


Term Of Treatment: Up to 20 weeks[51]


What To Expect: After an initial assessment phase in which the therapist and patient work together to identify the patient's "problem areas," treatment is task-oriented and focused on improving the patient's interpersonal skills[52]


Find an Interpersonal Psychotherapist[53]




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Also on HuffPost:




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  • Summer Weather


    Seasonal Affective Disorder (SAD) is most commonly associated with winter blues, and it afflicts about 5 percent of Americans.

    But for less than 1 percent of those people, this form of depression strikes in the summer. Warm weather depression arises when the body experiences a "delay adjusting to new seasons," says Alfred Lewy, MD, professor of psychiatry at Oregon Health and Science University, in Portland.

    Instead of waking and enjoying dawn, the body has a hard time adjusting, he says, which could be due to imbalances in brain chemistry and the hormone melatonin.

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    <a href="http://www.health.com/health/gallery/0,,20483493,00.html" target="_hplink">The Most Depressing States in the U.S.</a>

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  • Smoking


    Smoking has long been linked with depression, though it's a chicken-or-egg scenario: People who are depression-prone may be more likely to take up the habit. However, nicotine is known to affect neurotransmitter activity in the brain, resulting in higher levels of dopamine and serotonin (which is also the mechanism of action for antidepressant drugs). This may explain the addictive nature of the drug, and the mood swings that come with withdrawal, as well as why depression is associated with smoking cessation. Avoiding cigarettes -- and staying smoke free -- could help balance your brain chemicals.




  • Thyroid Disease


    When the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough thyroid hormone, it's known as hypothyroidism, and depression is one of its symptoms.

    This hormone is multifunctional, but one of its main tasks is to act as a neurotransmitter and regulate serotonin levels.

    If you experience new depression symptoms -- particularly along with cold sensitivity, constipation and fatigue -- a thyroid test couldn't hurt. Hypothyroidism is treatable with medication.




  • Poor Sleep Habits


    It's no surprise that sleep deprivation can lead to irritability, but it could also increase the risk of depression. A 2007 study found that when healthy participants were deprived of sleep, they had greater brain activity after viewing upsetting images than their well-rested counterparts, which is similar to the reaction that depressed patients have, noted one of the study authors. "If you don't sleep, you don't have time to replenish [brain cells], the brain stops functioning well, and one of the many factors that could lead to is depression," says Matthew Edlund, M.D., director of the Center for Circadian Medicine, in Sarasota, Fla., and author of "The Power of Rest."




  • Facebook Overload


    Spending too much time in chat rooms and on social-networking sites? A number of studies now suggest that this can be associated with depression, particularly in teens and preteens. <a href="http://news.health.com/2010/02/03/internet-addicts-more-prone-depression/" target="_hplink">Internet addicts</a> may struggle with real-life human interaction and a lack of companionship, and they may have an unrealistic view of the world. Some experts even call it "Facebook depression." In a 2010 study, researchers found that about 1.2 percent of people ages 16 to 51 spent an inordinate amount of time online, and that they had a higher rate of moderate to severe depression. However, the researchers noted that it is not clear if Internet overuse leads to depression or if depressed people are more likely to use the Internet.




  • End Of A TV Show Or Movie


    When something important comes to an end, like a TV show, movie, or a big home renovation, it can trigger depression in some people. In 2009, some "Avatar" fans reported feeling depressed and even suicidal because the movie's fictional world wasn't real. There was a similar reaction to the final installments of the Harry Potter movies. "People experience distress when they're watching primarily for companionship," said Emily Moyer-Gusé, Ph.D., assistant professor of communication at Ohio State University, in Columbus. With "Avatar," Moyer-Gusé suspects people were "swept up in a narrative forgetting about real life and [their] own problems."




  • Where You Live


    You can endlessly debate whether city or country life is better. But research has found that people living in urban settings do have a 39 percent higher risk of mood disorders than those in rural regions.

    A 2011 study in the journal Nature offers an explanation for this trend: City dwellers have more activity in the part of the brain that regulates stress. And higher levels of stress could lead to psychotic disorders.

    Depression rates also vary by country and state. Some <a href="http://www.health.com/health/gallery/0,,20483493,00.html" target="_hplink">states have higher rates</a> of depression and affluent <a href="http://news.health.com/2011/07/25/depression-affluent-nations/" target="_hplink">nations having higher rates</a> than low-income nations.

    Even altitude may play a role, with <a href="http://news.health.com/2010/09/21/is-high-altitude-linked-to-suicide-risk/" target="_hplink">suicide risk</a> going up with altitude.




  • Too Many Choices


    The sheer number of options available -- whether it's face cream, breakfast cereal or appliances -- can be overwhelming. That's not a problem for shoppers who pick the first thing that meets their needs, according to some psychologists. However, some people respond to choice overload by maximizing, or exhaustively reviewing their options in the search for the very best item. Research suggests that this coping style is linked to perfectionism and depression.




  • Lack Of Fish In The Diet


    Low intake of omega-3 fatty acids, found in salmon and vegetable oils, may be associated with a greater risk of depression. A 2004 Finnish study found an association between eating less fish and depression in women, but not in men. These fatty acids regulate neurotransmitters like serotonin, which could explain the link. Fish oil supplements may work too; at least one study found they helped depression in people with bipolar disorder.




  • Poor Sibling Relationships


    Although unhappy relationships with anyone can cause depression, a 2007 study in the American Journal of Psychiatry found that men who didn't get along with their siblings before age 20 were more likely to be depressed later in life than those who did. Although it's not clear what's so significant about sibling relationships (the same wasn't true for relationships with parents), researchers suggest that they could help children develop the ability to relate with peers and socialize. Regardless of the reason, too much squabbling is associated with a greater risk of developing depression before age 50.




  • Birth Control Pills


    Like any medication, the pill can have side effects. Oral contraceptives contain a synthetic version of progesterone, which studies suggest can lead to depression in some women. "The reason is still unknown," says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University, in New York. "It doesn't happen to everyone, but if women have a history of depression or are prone to depression, they have an increased chance of experiencing depression symptoms while taking birth control pills," Dr. Hutcherson says. "Some women just can't take the pill; that's when we start looking into alternative contraception, like a diaphragm, which doesn't contain hormones."




  • Rx Medications


    Depression is a side effect of many medications. For example, Accutane and its generic version (isotretinoin) are prescribed to clear up severe acne, but depression and suicidal thoughts are a potential risk for some people.

    Depression is a possible side effect for anxiety and insomnia drugs, including Valium and Xanax; Lopressor, prescribed to treat high blood pressure; cholesterol-lowering drugs including Lipitor; and Premarin for menopausal symptoms.

    Read the potential side effects when you take a new medication, and always check with your doctor to see if you might be at risk.

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