Depression is not a feeling

Depression is the second biggest health concern world wide according to the World Health Organisation (WHO). Heart disease being number one. Major life stressors and losses can trigger depression in all of us.

Being clinically depressed is not about “pulling yourself together”. It is about being ill.

People often fall into extreme phases of low mood after facing adversities in life injury, divorce, death of a close one, being made redundant, a missed promotion or financial loss. Most of them want to better deal with the psychological symptoms of helplessness, hopelessness or the inability to feel pleasure. 
Some of my clients have seen a GP or Psychiatrist who did or did not prescribe medication. The doctor recommended counselling to learn coping skills and to re-define meaning in life. Obviously medication does not provide those. 

I will work with you on the negativity that permeates your perception, interpretation and memory. Using Cognitive-Behaviour Therapy and Mindfulness*. 

Applying cognitive behavioural therapy means to review and to change how we think and what we do. My clients learn helpful thinking habits, assertiveness and stress management amongst others. We will also look at emotions, in particular if your anger has turned inwards. In addition we will address resilience, a sense of control and how to leverage your social support.

All of these measures aim at stress-reduction. Stress can stem from bigger adversities, attachment patterns in relationships and maladaptive coping styles as part of your personality (i.e. need for control, perfectionism, need to please) and lifestyle. 

*The treatment of choice for the prevention of recurrent depression in the UK National Health Service (NHS) and meanwhile successfully used for a broad spectrum of health benefits using awareness of what is going on in the mind and bringing the client back into the present moment.

Client’s reflection on depression

A client of mine kindly provided some feedback on his counselling process with me and what he thinks of medication:

How counselling helped you during the past months?
Looking back, it’s difficult to remember how I got myself into such a mess.
At the time, though, it was very real, destructive and dark.
My sessions … were like a lifeline.
One of the most important factors was feeling that I had a team around me.
That you shared my different battles and that I was not alone.
Your wholehearted approval (and surprise) when I mentioned that I had gone sailing while in the very depths of melancholy was especially memorable!
Various insights you offered – and a couple of the books you recommended – helped me to better understand my depression.
Some of the techniques and words of advice you shared helped me to create a toolkit to dig my way out of the hole I was in.
Where you would draw the line to medication and other measures?
As you will recall, I chose to go onto Prozac during all of this.
In retrospect, it’s hard to know what role, if any, it played in my recovery.
In fact during the first ten days, it made me worse.
However, there was a watershed point about 6 weeks after I started the Prozac when I began to quickly and steadily recover.
At the time, it felt as if I had absorbed a sufficient level of Prozac and my brain was now being flooded with happy chemicals.
However, I have no way of objectively quantifying what was the Prozac and what was my natural recovery mode kicking in.
If I were ever to go into serious depression again (God forbid), I would probably go back onto anti-depressants.
I would certainly immediately go into counseling.
I hope these comments are helpful.
(anonymous)