For much of the last century, textbooks warned against using hypnosis with depressed patients. The fear was that it might deepen withdrawal or increase the risk of suicide. That view has changed, and in recent years depression has become one of the more interesting areas of hypnosis research.
What the evidence shows
Combined with CBT. The psychologist Assen Alladin developed “cognitive hypnotherapy,” which adds hypnosis to standard cognitive behavioural therapy. In a trial comparing the two, both groups improved, and the group receiving the hypnosis-enhanced version showed greater reductions in depression, anxiety and hopelessness.
Compared with CBT. A German team at the University of Tübingen ran a randomised trial in which 160 adults with mild to moderate major depression received twenty sessions over about six months of either CBT or hypnotherapy. Assessors did not know which treatment each person had received. The trial was designed to test whether hypnotherapy was “non-inferior,” and the published results reported that it was: hypnotherapy performed about as well as the established treatment.
Reviews. Meta-analyses of hypnosis for depressive symptoms have found meaningful benefits, while noting that the number of high-quality trials is still small.
This is encouraging, but it is early. Hypnotherapy is not yet listed in mainstream guidelines as a standard treatment for depression. CBT, other talking therapies and antidepressant medication remain the first-line options.
Why it might help
Depression tends to involve several things that hypnosis can address:
- Rumination. Going over the same negative thoughts. Hypnosis trains attention to move elsewhere.
- Hopelessness. A fixed expectation that nothing will improve. Hypnosis builds positive expectancy.
- Loss of pleasure. Vividly imagining enjoyable activity can help reconnect with it.
- Poor sleep. Often improved by relaxation and suggestion.
- Anxiety. Present in most people with depression.
- Inactivity. Mental rehearsal of small steps makes them easier to take.
The psychologist Michael Yapko, who has written extensively on the subject, argues that depression is partly maintained by rigid patterns of thinking, and that hypnosis is well suited to loosening them.
What it looks like in practice
Hypnotherapy for depression is active and focused on the present and future. It typically includes:
- Relaxation and relief from anxiety
- Building expectancy that change is possible
- Imagery of a realistic, better future
- Rehearsal of specific activities for the coming week
- Interrupting rumination
- Strengthening a sense of competence
- Self-hypnosis practice at home
It should not involve searching the past for a hidden cause.
Important cautions
- See your doctor first. Depression needs proper assessment, and some physical conditions and medications cause low mood.
- Use a qualified clinician. Someone trained in treating depression, not only in hypnosis. A general hypnotherapy diploma is not sufficient.
- Do not stop medication without medical advice.
- Severe depression, bipolar disorder and psychosis need specialist care. Hypnosis is not appropriate as a stand-alone treatment.
- Avoid regression and memory work. People who are depressed are especially prone to recalling the past in a negative light.
- Recordings are not treatment. A relaxation recording may help you sleep. It is not therapy for depression.
If you are struggling now
If you are having thoughts of harming yourself, please reach out today. In the UK, call Samaritans on 116 123 at any time, or contact NHS 111. In an emergency call 999. Elsewhere, contact your local emergency number or crisis line.
What you can do alongside treatment
Small things with good evidence behind them:
- Keep moving. Regular activity helps mood.
- Keep a routine, especially for sleep.
- Stay in contact with people.
- Plan one small, achievable thing each day.
- Practise a short relaxation or self-hypnosis exercise.
The bottom line
Hypnosis is no longer off-limits for depression, and early trials suggest it can stand alongside established therapy. It belongs in the hands of clinicians trained to treat depression, as part of proper care.
Next in the series: Hypnosis for Migraines and Headaches
This article is for general information and is not medical advice. If you think you may be depressed, speak to your doctor.