Depression and Therapy
What is Depression?
The diagnosis of Depression involves experiencing symptoms that may include: depressed mood, diminished interest or pleasure in most activities, significant weight loss or change in appetite, sleep problems, physical agitation or slowing, fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt, a decrease in concentration or focus, and recurrent thoughts of death and/or suicide. The above symptoms are more than what might be considered normal or healthy feelings of loss or sadness that result from situational events or life circumstances. For example, it would be healthy (and expected) that an individual would be upset and sad when trying to cope with the loss of a loved one or when experiencing a separation or divorce. For most of us, this kind of grief or sadness will subside with the passage of time and with support from others. Importantly, individual’s dealing with Depression will experience significant distress or impairment in their social, occupational, or other important areas of functioning (APA, 2000). In other words, Depression often makes it extremely difficult for a person to cope with living.
Treatment of Depression
While a wealth of research has accumulated that demonstrates the effectiveness of therapy in treating Depression, the symptoms of the disorder often make it difficult for individuals to seek help. For example, it is often the case that someone dealing with depression will have a negative view of: 1) themselves (i.e. “I am worthless”), 2) the world/environment (i.e. “the world is cruel and unfair”), and 3) the future (i.e. “the future is hopeless”). These are the three components known in the field of clinical psychology as the cognitive triad of depression (Beck, 1995). These cognitive beliefs may cause a person to feel that their problems are their own fault or theirs alone to deal with, that they would be ‘burdening’ others by talking about their feelings, that people would not really want to help them or may have ulterior motives for doing so, or that nothing is likely to change, so it may be hopeless to try.
The Cave
I remember once hearing someone talk about deep Depression using the following analogy: Imagine that someone is hiking in the woods and finds themselves separated from their group of friends. They become lost as the sun begins to set, the air chills, and the wind starts to howl. The sounds of the forest become intensified by heightened senses that react to every twig snap and rustling bush symbolizing a potentially unseen danger. They call out, but do not hear any replies. Frightened and alone, the person eventually finds refuge in a cave. The further they go inside the cave, the more they feel the relative warmth, protection, and safety it provides. However, the longer they linger, the more isolated they become from the outside world and the more difficult it is to face it again. They separate themselves from the dangers, but also the potential for hope and a life worth living. From inside their cave and through the passage of time, they become less likely to distinguish between the various sounds of the outside world; sounds that might imply either friend or foe, they cannot know which. This is how it often is with deep Depression – that even when one’s friends and family may be trying to mobilize the one they love, it becomes hard to hear them calling or to risk hope for change.
Getting Help
Seeking out help is the first step toward change. No one should have to deal with their feelings alone. Speaking with a therapist provides a forum to be heard, validated, and understood without judgment. Client and therapist work collaboratively to discover where problems may have developed and to make sense of them in light of an individual’s background and current life circumstances. A plan is then formulated to get ‘un-stuck’ and to open up opportunities for mental health and personal growth.
References
- American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision). Washington, DC.
- Beck, J. (1995). Cognitive Therapy: Basics and Beyond (1st ed.). Guilford Press, New York: NY.