Depression, Panic Disorder Therapy Via the Internet


Cognitive behavior therapy (CBT) to treat depression or panic disorder could be as close, and convenient, as your computer screen. There is evidence that Internet-based cognitive behavior therapy is just as effective as CBT obtained in a group setting for panic disorder and depression.

Cognitive behavior therapy is an approach that focuses on patterns of thinking that are negative and maladaptive and the person’s beliefs that support them. According to the National Alliance of Mental Illness, CBT therapists are goal-directed, problem-focused, and strive to help individuals view their beliefs as hypotheses rather than facts and to test them. CBT has been shown to be as helpful as antidepressant medication for people with depression and to also be beneficial for panic disorders, anxiety disorders, personality disorders, eating disorders, and mood disorders.

In a new doctoral thesis presented at Karolinska Institutet in Sweden, psychologist and doctoral student Jan Bergstrom presents the results of a randomized clinical trial of 104 patients who had panic disorder, in which the effectiveness of Internet-based CBT was compared with group CBT. Bergstrom reports that both types of CBT worked very well and that there was no significant difference between the two groups of patients either right after treatment ended or at the six-month follow-up.

When an analysis of Internet-based CBT for depressed patients was conducted, results showed that patients with more severe depression and/or with a history of more frequent depressive episodes did not benefit as much from the Internet intervention. The analysis also indicated that Internet-based CBT is most beneficial if it is administered as early as possible.


In Sweden, as in many other countries, including the United States, there is a shortage of psychologists and psychotherapists who are trained in the use of CBT methods. Introduction of an Internet-based CBT option could allow patients without physical access to such therapeutic help to participate in an Internet-based self-help program and regular contact with a therapist via email.

The National Institutes of Mental Health report that approximately 14.8 million American adults suffer from major depressive disorder, and that about 6 million adults ages 18 and older have panic disorder. Approximately two-thirds of people with depression either do not seek treatment or are misdiagnosed. Internet therapy could make treatment more accessible, affordable, and less visible, given that some people attach a social stigma to mental health therapy.

Previous studies have explored the effectiveness of Internet-based CBT in many venues, including a recent controlled trial of social anxiety disorder, one in which Internet CBT was used to reduce the risk of falls in long-term care facilities, another that used the approach for eating disorders, and a recently published study in which Internet-CBT was used for irritable bowel syndrome.

Internet-based cognitive behavior therapy appears to be an effective and convenient way to treat depression and panic disorders. Bergstrom notes that it “is also more cost-effective than group therapy. The results therefore support the introduction of Internet treatment into regular psychiatry.”

Karolinska Institutet
National Alliance of Mental Illness
National Institute of Mental Health