Depression, also known as major depressive disorder, is characterized by a depressed mood, which can be experienced as feeling sad, empty, or hopeless, or a loss of interest or pleasure. In children and adolescents, the mood can largely include irritability. Additional symptoms may include:

• weight loss or gain,
• insomnia or hypersomnia,
• being physically agitated or slowed down,
• feeling fatigued or low energy,
• poor concentration or difficulty making decisions,
• thoughts of death or suicide, and
• feelings of worthlessness or guilt.

Every year, about 7% of the population experiences depression; the lifetime prevalence rate is about 17%. Females are approximately 1.5 to 3 times more likely to develop depression than males.

For all disorders, the CBT therapist starts by educating clients about their diagnosis and about CBT, helps clients set treatment goals, and teaches clients essential thinking and behavioral skills. CBT interventions for depression generally focus on helping clients become more engaged in activities that they value and have given up since becoming depressed. Treatment also involves helping clients evaluate negative beliefs about themselves, the world, and the future that lead to them feel depressed. CBT for depression can also be adapted depending on the client’s characteristics. For instance, in working with depressed children and adolescents, the therapist may involve parents or caregivers by teaching them new parenting skills that can help with the child’s depression. For older adults, CBT may focus more on helping clients maintain a socially active and fulfilling life, evaluate beliefs about aging, and learning how to cope with changes in health. Likewise, CBT can also help clients whose health problems, like HIV, lead to depression by helping them evaluate beliefs about having the illness and what it means about their life, as well as making sure they’re participating in meaningful activities.