DBT for Depression: How It Works and Who It Helps

DBT (Dialectical Behavior Therapy) helps treat depression with four core skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills help people manage difficult emotions and reduce depressive symptoms. This therapy was originally developed to treat borderline personality disorder, and now it is supported by growing clinical evidence showing a significant reduction in depression symptoms.

At Renewed Mental Health Group, Dialectical behavior therapy is offered alongside psychiatric medication management. This allows therapy and medical care to work together as part of a coordinated treatment plan.

What Is DBT Therapy for Depression?

Dialectical behavior therapy for depression is a structured treatment that combines individual therapy with skills training to help people manage the intense emotions that often contribute to depressive symptoms.

This theory was developed by Dr. Marsha Linehan in the late 1980s to treat chronic suicidality and borderline personality disorder. Since then, it has been adapted for major depressive disorder, anxiety, and trauma because many of these conditions involve difficulties with emotion regulation. The American Psychological Association describes it as a stage-based therapy that combines behaviour therapy, cognitive behavior therapy, and mindfulness.

Dialectical Behavior Therapy involves the following treatment techniques:

• Mindfulness: Staying present instead of getting pulled into rumination.
• Distress tolerance: Getting through a crisis or a bad day without making it worse.
• Emotion regulation: understanding and shifting emotional responses, rather than being controlled by them.
• Interpersonal effectiveness: Communicating needs and maintaining relationships, even when depression makes withdrawal feel easier.

The “dialectical” part refers to holding two things as true at once: accepting where you are right now, while also actively working to change it. For someone with depression, that balance matters. It doesn’t ask you to pretend things are fine, and it doesn’t leave you stuck in the difficulty either.

Is DBT Good for Depression? 

Yes. Clinical research supports this therapy as an effective treatment approach for depression. A study titled ‘Effect of Dialectical Behaviour Therapy on Depression & Anxiety Among Elderly Individuals,’indexed on PMC, found that a 12-week intervention of this therapy can significantly reduce symptoms of both depression and anxiety. It was originally developed to treat borderline personality disorder (BPD).

It has since been adapted for other mental health conditions, including major depressive disorder, as researchers continue to study how the therapy can help people manage emotional distress and improve daily functioning.

Additional clinical trials have examined Dialectical Behavior Therapy skills training that focuses on mindfulness and emotion regulation to address depression and anxiety that often occur together. This reflects the growing use of this therapy beyond personality disorders and its application in treating depressive symptoms.

Researchers have also studied Radically Open Dialectical behavior therapy (RO-DBT). This is an adaptation designed for people with chronic depression, particularly those with overcontrolled coping patterns. A multicenter randomized trial found that RO-DBT produced greater reductions in depressive symptoms compared with treatment as usual. This highlights its potential as an option for people whose depression has not improved with standard approaches.

Does DBT Work Alongside Antidepressant Medication?

Yes. Dialectical behavior therapy is often used alongside antidepressant medication rather than as a replacement. Research has shown that therapy, antidepressant medication, and a combination of both can all be effective, depending on a person’s needs. In many cases, combining therapy with medication provides the most comprehensive support. Your psychiatric provider and therapist work together to coordinate your care, ensuring that treatment is aligned with your goals and symptoms.

What If Depression Hasn’t Responded to Standard Treatment?

If you’ve already tried therapy, medication, or both and still feel stuck, it does not mean you’ve run out of options. Sometimes, finding the right treatment involves adjusting the approach rather than starting over.

Dialectical Behavior Therapy offers a structured, skills-based framework that can be especially helpful if depression is accompanied by intense emotions, persistent self-criticism, relationship challenges, or difficulty coping with stress. Talk with your provider about whether adding this therapy to your treatment plan may be a good fit for your situation.

Who Benefits Most From DBT for Depression?

Dialectical Behavior Therapy is beneficial for people whose depression is accompanied by intense emotions, difficulty coping with distress, or patterns of behavior that make recovery more challenging. It is often recommended when emotional regulation, healthy coping skills, and relationship challengesare important parts of treatment.

You may benefit, if you experience:

• Chronic or recurring depression that continues despite previous treatment.
• Intense emotions that feel overwhelming or difficult to manage.
• Frequent mood swings or rapid changes in emotional state.
• A current or past history of self-harm.
• Depression that occurs alongside anxiety or other mental health concerns.
• Depression that has not improved with medication, therapy, or a combination of both.
• Ongoing relationship conflict or difficulty maintaining healthy relationships.
• Suicidal thoughts that require structured, evidence-based therapeutic support.
• Strong emotional reactions that occur quickly and take time to settle.

If several of these experiences sound familiar, Dialectical behavior therapy is worth discussing with a mental health professional. An evaluation can help determine whether Dialectical Behavior Therapy is the right fit for your needs and whether it should be combined with medication or other evidence-based treatments.

Can DBT Treat Depression and Anxiety at the Same Time?

Yes. Dialectical Behavior Therapy can be effective for people who experience both depression and anxiety. These conditions often occur together, and the dialectical behavior therapy addresses the emotional and behavioral patterns that contribute to both. Techniques such as emotion regulation, distress tolerance, and mindfulness can help reduce overwhelming emotions and improve day-to-day coping. The studies on DBT have found that it can significantly reduce symptoms of both depression and anxiety when they occur together. If you experience both depression and anxiety, a single integrated treatment plan may be more effective than addressing each condition separately.

Is CBT or DBT More Effective for Depression?

Cognitive Behavioral Therapy (CBT) is one of the most widely used treatments for depression. It focuses on identifying and changing negative thought patterns and unhelpful behaviors that contribute to low mood. Dialectical Behavior Therapy builds on many CBT principles while placing greater emphasis on emotion regulation, distress tolerance, mindfulness, and healthy relationships. The following differences may help determine which therapy is a better fit.

Most people do not have to choose between both. The two therapies share many core principles and techniques. Our clinicians do not use a random plan. They evaluate your symptoms, treatment history, and goals to recommend the therapy that best supports your recovery.

What Happens During a Dialectical Behavior Therapy Session?

Dialectical Behavior Therapy sessions follow a structured format that helps make treatment feel consistent even during difficult periods. Every session is personalized to your needs. Most individual sessions include the following:

• Reviewing your diary card: A diary card is a simple daily tracking tool that you complete between sessions, either on paper or through an app. It records your mood, emotions, urges, behaviors, and the therapy skills you practiced. Reviewing it with your therapist helps identify patterns, track progress, and focus on situations that need the most attention.
• Discussing the week’s biggest challenges: You and your therapist explore a specific situation that feels emotionally overwhelming or difficult to manage. By looking at how you responded, you can better understand the patterns that contributed to the experience.
• Learning and practicing DBT skills: Instead of only talking about problems, you’ll actively practice practical skills from one or more of the four dialectical behavior therapy techniques. Your therapist will help you apply these skills to real-life situations.
• Planning skills practice between sessions: Before the session ends, you’ll choose practical ways to use the skills you’ve learned in everyday life. Regular practice outside of therapy is an important part of building lasting change.
• Preparing for the week ahead: You and your therapist will discuss upcoming situations that may be stressful or emotionally challenging and create a plan for responding to them using the skills you’ve been practicing.

What Does DBT Treatment Look Like at Renewed Mental Health Group?

Dialectical behavior therapy treatment at Renewed Mental Health Group combines individual therapy, skills groups, and psychiatric medication management into one coordinated care plan, available both in-person and through telehealth. You can meet with our clinicians in person at our Long Beach, Anaheim, or Ontario offices, or connect virtually if you’re based elsewhere in Southern California, including Irvine and the surrounding Orange County area. Our plan includes:

• Individual therapy sessions with a clinician trained in dialectical behavior therapy skills.
• Dialectical behavior therapy skills groups, where you learn and practice the four core modules alongside others working through similar challenges.
• Psychiatric medication management, when medication is part of the right plan for you, is coordinated with your therapy.
• In-person and telepsychiatry options, so care fits your schedule and location.

We accept a wide range of insurance plans, including Aetna, Cigna, Anthem Blue Cross, Optum, UnitedHealthcare, Medi-Cal, Medicare, and more. Our team can verify your specific benefits before your first appointment.

If you’re struggling with depression and want to explore whether DBT is the right fit, book an appointment with Renewed Mental Health Group or call (714) 361-0898 to speak with our team.