Treatment of Depression

I believe it is fair to say that depression, as an illness is not fully understood. Neurologically, there are characteristic problems arising in the neurons in the brain. The Neurons are the electrochemical transmitting and receiving organs that allow us to think, move, and function. When we receive a stimulus, the information is transmitted to the brain where it is evaluated on many levels. How we process this information inconjunction with our physiological makeup affects how efficiently the neural network functions. There may also be a biophysical component of depression in which our body chemistry is not balanced which also affects our neural functioning. How we think, feel and behave all have an impact on how we cope with life stresses, which come in the form of different types of stimulus. Because we are all so unique, how we are affected by life stresses are also highly individualized.

Treatment of depression is not rocket science, it is much more complicated than that. In severe cases of depression, medical intervention in the form of medication may be required. This however is only the first step. Medication deals primarily with the symptoms, not the causal agents of depression. The previous blogs deals with some of the causal agents of depression; loss, change, pregnancy, season, death, addiction and so on. In short, when we are faced with situations in life that challenge us we are exposed to stress. If we feel that we are not able to deal with these challenges we may feel overwhelmed and may begin cycles of feeling inferior, helpless, and alone. It is interesting to note that when a person is in depression they are often not able to identify their situation clearly, A case of not being able to see the forest for the trees. It is this state that I am able to help you. One of the greatest difficulties for the client is to find the motivation to get help. Counselling alone or in conjunction with medication can be successful in helping people come to terms with depression. An optimum treatment regime would target the three basic components of our being, Thinking, Behaviour, and Emoting.

As a starting foundation taking care of our physical needs is essential. Eating well, exercising and getting enough sleep must be part of the cure. By eating well this means having a well balanced diet of the food groups in appropriate portions. Exercise is also found to aid in the reduction of depressive symptoms. As we exercise, our bodies produce endorphins, which are self-generated chemical compounds that give us the sense of well-being, which is the long-term objective of treatment. Exercise also helps us to regulate how well our body clocks function, which is a component of how well and long we sleep. As you may see already we are a very complicated system.

Working with the thinking and emoting component of ourselves is often one of the more difficult. As we live we form our values and beliefs about our world. These serve to help us cope with the challenges of living. When we run into situations for which our values and beliefs no long provide help, we are left without support. This loss of control may instil fear, and anxiety, which in turn may interfere with our being able to function in our daily lives. Which is where consultation with a counsellor becomes important. As Carl Jung once said that our distressing symptoms often provide us the clues with which we may heal ourselves. My job as a counsellor is to provide empathy, objectivity and perspective, to the client. Depression takes us into ourselves and provides the opportunity to look at how we internalize our stress. The truth of course is that as a general rule we do not want to deal with the painful internal issues. As an example, when a loved one is ill or dies, we may be faced with the reality of our own mortality or infirmity. Many of us do not willingly want to know that life can be a fragile and ephemeral thing, and this can lead to internal conflict. Examination of our internal beliefs and values can lead to immense personal growth, which is often essential in the scope of living a meaningful life. The therapeutic process in counselling provides the confidential, safe, and non-judgemental environment in which to deal with the unique and difficult psychological issue of living.

Depression

What is it, how does it operate, have you got it, and what can you do about it.

These days it seems that depression is a common. It is likely that if you don’t have this disease yourself, you probably know someone who does.

What is it?

Depression is defined as “a low sad state in which life seems dark and its challenges overwhelming.” (Comer, 2007) We all have times in our lives when this happens. When we grieve for the loss of a loved one, when we loose our job, when our marriage is “falling apart.” This state is normal; it provides us a time for reflection and connection to ourselves. Carl Jung, one of the founding fathers of modern psychology went so far as to suggest that our psychological symptoms stem from our need to be whole in relation to ourselves, and that these symptoms contain the clues needed to heal us. As a therapist I believe that there is some truth in this concept. Being in a depressed state as I mentioned before is normal, where it becomes problematic is when this disease becomes extended, chronic, and interferes with normal daily functioning over time. (Comer, 2007)

Clinical depression is quite different from general depression in that it can cause “long lasting psychological pain that may intensify as time goes by. (Comer 2007) Symptoms of Clinical Depression fall into roughly five categories, emotional, motivational, behavioural, cognitive, and physical.

Emotional symptoms may include feeling miserable, sad, hollow or dejected. I have heard those with depression speak of being in a black fog or hole and being unable to get out of it. For some, the frustration of being in this state may also lead them to feel angry, frustrated or agitated. (Comer 2007) Adolescents and children may exhibit symptoms of irritably or crankiness. (APA 2004)

Motivation of those who are clinically depressed is severely limited. Just getting up to go to work may seem impossible. Insurance companies who recognize the loss of productive workers to this disease support this observation. This lack of motivation in the clinically depressed person is carried into all aspects of life. There is a loss of interest in even what may have been a passion in daily life. (APA 2004)

Behaviour symptoms of depression may be expressed through lessened activity levels, a greater requirement for sleep. This may be due to the negative emotions and lack of motivation. (DSM 2004) Our behaviour is tied very closely to our emotions and thinking processes and if these two are distorted, it is likely that the behaviour will reflect this.

Thinking or Cognitions are also closely tied to emotions and behaviour. Depressive symptoms in thinking may be a highly negative view of self, or pessimism, which may translate into a feeling of inadequacy, inferiority, or being undesirable. In severe cases thoughts of death or suicidal ideation may be expressed. (Comer 2007)(APA 2004)

Physical Symptoms of depression may include headaches, indigestion, constipation, dizzy spells and general pain. (Comer 2007)

Medically, depression has been defined that if five of the criteria for depression have been met, during a two-week period then clinical depression is diagnosed. The criteria include:

  • 1) thoughts of suicidal ideation or death,
  • 2) difficulty in thinking or decision making,
  • 3) feelings of worthlessness or guilt,
  • 4) fatigue or loss of energy every day,
  • 5) restlessness observed by others,
  • 6) insomnia or hypersomnia,
  • 7) weight loss or substantial weight change,
  • 8) loss of interest or pleasure in most activities,
  • 9) depressed mood.

(APA 2004) For a more comprehensive diagnosis, you may refer to the Diagnostic and Statistical Manual of Mental Disorders fourth edition written by the American Psychiatric Association.

Now Stop!!!!

If you recognize that you have the symptoms listed this is the first step in the treatment process. There is help so don’t despair. If you recognize that you have the more severe symptoms, such as thoughts of death and or suicidal ideation, go directly to the hospital or emergency clinic where you will under direct medical supervision. This may seem somewhat drastic, but it is necessary. Treatment may include both therapy and or medication depending on the severity the depression. For less severe cases or post emergency depressive conditions call me and we can set up an appointment to help you deal with this issue. It is not necessary that you go through life with the burden of depression upon your shoulders.

Next News Blogs, How Does Depression Function:

References

American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders 4th Ed. Arlington VA. American Psychiatric Publishing.

Comer, R.J. (2007) Abnormal Psychology, sixth edition. New York, N.Y.; Worth Publishers.

Welcome

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I would like to welcome all people of all ethnic origins of all walks of life, and of all ages to the WalkerCounselling.com web site. As this is the first post of this website I would like to begin by dispelling some myths about the counselling process. I do this in the hope that for those seeking help, this profession does not intimidate you.

It may seem obvious in retrospect, but if you are facing mental distress, counsellors are available to help reduce it. Yes we have extensive training both practical and theoretical, but the reality is that we are also people like you who have ourselves been “through the mill”. If we as counsellors are worth our salt, we will not tell you what you must do; rather we will work with you in your unique person and situation and see if we can provide ideas and tools so that you can master the difficulties in your life. There also appears to be an idea in the general public that if you see a counsellor, there is something “wrong” with you. Unlike auto mechanics we can’t just change a flat and presto you’re up and running the way you want. The fact is that it is often our own ways of thinking, feeling and behaving that we judge as good or bad.  It can be helpful to stand back and really question our self worth.   But how we see our world has a great deal to do with how well we can operate in it. My job as a counsellor is not to criticize how you are thinking, feeling, or behaving, but rather to help you to become aware of your own processes regarding these three basic parts of our psychological being. If you determine that you are not satisfied with your current values and beliefs, you are free to change them. It sounds easy doesn’t it? The reality is that it can be quite difficult. If we think of ourselves as a programmable system and we recognize that we have been programming ourselves for as long as we’ve been alive, then it becomes evident that changing our habitual programming is not nearly so easy as changing a tire. Again this is where I can help. By working with me you will be able examine your own psychological system from a much more objective perspective in which you will: firstly become more aware of your current situation, secondly, to choose if you wish to change and thirdly if you see fit, to make those changes over time.

One very important aspect of counselling is this: Few if any counsellors are a good fit for all people. The first and probably most important issue is to find a counsellor who fits your needs. Again unlike repairing a car, the “mechanic” counsellor needs to be able to relate well to you. If this does not occur, and you can’t seem to relate well you may need to find a counsellor who does.

Counselling is about exploring who you are in a trusting, and secure environment with a caring individual so that you can get on with your life in a more satisfying and meaningful way.

So, don’t be put off counselling or therapy, and don’t wait until the bottom falls out of your world. I am here to help with all my experience and training

Cheers