Depression Counselling Neil Wood-Gaiger BSc (Hons) Psych; Ad Dip CP; Dip Hyp CS; MBPsS; MCS (Acc); MHS Hypnotherapist ~ Psychotherapist ~ Councillor

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What is Depression?

The word depression clearly has different understandings for different people, individuals may often refer to "feeling depressed" when feeling sad or low in their everyday lives. These moods are usually transitory and pass, however for some these feelings do not pass and have a severe impact interfering with their ever day lives, lasting weeks or months and even if they do go away, the feelings regularly return. Depression also comes in many different forms including

• Unipolar depression characterised by feelings of permanent depression were there are never experiences any highs
• Bipolar disorder where the sufferer experiences extreme highs and lows
• Major depression where the individual appears generally apathetic about life
• Mild depression although the sufferer is able to maintain a semblance of life, they find everyday tasks difficult and unfulfilling
• Atypical depression where the depressed feelings tend to come and go in periods, were they tend to feel that external events control all their moods
• Dysthymia in which individuals although presenting as being generally melancholic are not aware of their condition, seeing it as just how they are
• Psychotic depression this is often signified by negative hallucinatory sights and sounds
• Seasonal affective disorder’ (SAD) where an individual experiences mood swings according to the time of year, the moods generally being worse by the winter months
• Postnatal depression, which may include mood swings and a lack of interest in themselves and the baby.

Although differing in symptoms and severity, all of these types of depression could be described as exhibiting an enduring and pervasive sense of negative well-being, that effects individuals across a wide range of circumstances.

It has been estimated that worldwide some 300 million people some form of depression at least for some part of their lives.
(Source: P Gilbert, Overcoming Depression, 1997).

Depression is also not as some might suggest a modern condition, being observed my Hypocrites as melancholia some 2,400 years ago. Furthermore, there is evidence, although we can’t ask them that most if not all mammals, particularly those experiencing prolonged stress, can suffer depression suggesting that depression is a natural response to external stressors.

In the recent past depression has become associated with chemical imbalances in the brain and indeed there is much evidence to support the link between depression and imbalances in the neurotransmitters, the chemicals involved in transmitting signals between neurons, in the brain. The result of this link is that depression has been commonly treated with synthetic chemicals, such as serotonin, that mimic the actions of these neurotransmitters. However as with all causal relationships, other than saying that there is a link, the direction of the link is unclear. It is just as probable that these chemical imbalances are caused by the negative patterns of thought as the imbalances causing the negative moods. In any event it is recognised that genetic or biological causes of these imbalances are probably rare and that in most cases the depression was originally triggered by an external event or situation.

How is depression diagnosed?

Depression is usually diagnosed through the use of depression tests that rate a patients ‘feelings’ with clinical depression being diagnosed if a certain number of feelings, that are signs of depression, are present over a certain period of time. According to the medical model a person can be only diagnosed as suffering from clinical depression if five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning and that at least one of the symptoms is either a depressed mood or loss of interest or pleasure.

These symptoms are:

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

(Tyrrell, 2011)

The above symptoms will also have to:

1. Cause significant distress or impairment in social, occupational, or other important areas of functioning.
2. Not be due to the direct physiological effects of a substance abuse, medication or another medical condition and
3. Not be better accounted for by bereavement.

For clinical diagnosis to be made the symptoms need to persist for longer than 2 months or be characterised by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Diagnosing clinical depression (or any other medical condition) is outside the ethical remit of any counsellor or psychologist, being the work of Doctors and Psychiatrists.

However, the medical model of depression does pose some interesting dilemmas. It states that depression can be diagnosed only if the symptoms cannot be better attributed to bereavement. So, since grieving is a natural response, we can see that depression could also simply be an out-of-place natural response, furthermore, if bereavement can cause depression like symptoms , why not other kinds of loss such as loss of employment, loss of financial security, loss of independence, etc, etc. It would seem highly probable then, that at least for many people, depression may well be related to real life issues, that are beyond the control or coping strategies of the individual and that depression may well be a natural psychic defence, shutting down and protecting the individual from the stressor, rather than facing the situation. Treating a chemical imbalance that has been caused by environmental situations with drugs, without treating the emotional feelings towards whatever environmental conditions that underlie the depression would seem illogical.

Although a counsellor should NEVER suggest that a client should come off their medications, counselling would seem to have an important role alongside the medical treatment of depression, with of course the consent of the client’s doctor. Indeed it is becoming increasingly common for counselling to be offered to patients with depression within doctor’s surgeries, or for doctors to advise their patients with depression to seek counselling, so that the underlying traumas can be addressed.

Depression Counselling

The following steps will help someone overcome depression and aid recovery;

1. Seeking help. You may have been persuaded to go to therapy by your doctor or family pressure. For any therapy to be effective you will need to seek therapy for yourself, if you 0have not self-referred then initial work will need to focus around your own motivations for wanting therapy for depression.
2. Steep by steep. It is important to allow you to progress your own speed, dealing with particularly difficult issues as and when you are ready to deal with them.
3. Break the problems down into smaller ones. Many issues, particularly around your childhood may seem monumental, braking these down into particular, single incidences may help you to deal with each smaller incidence in turn.
4. Introduce new positive activities. In thinking life is pointless you may possibly have given up doing the things you used to enjoy doing, encouraging you to start to do these again, or to take up new activities, possibly with your partner, should help to start to give you a positive outlook on life.
5. Become more attentive and aware of your thinking. Starting to recognise the typical thoughts that go through your head when you are depressed.
6. Identifying typical thinking styles. Learning to understand how your typically responses to situations, such as all-or-nothing thinking, discount your positive aspects of life.
7. Writing down thoughts. Keeping a diary of your thoughts will help you recognise the patterns of thought.
8. Identifying key themes in your depression, such as a need for approval, shame, unhappy relationships, unrealistic ideals etc., A diary and observations will help you identify these and give the opportunity to spot and challenge these when they arise.
9. Learn to challenge your thinking. By identifying the cause and effect of negative thinking your rational/conscious mind can be used to challenging your negative thinking.
10. Change negative thoughts. All of the above steeps will help you recognise and understand your negative thoughts and to recognise any recurrences of these thoughts so that you can develop strategies for changing them into thoughts that are more beneficial to your well-being.

The above steps would help depression suffers, overcome their depression, perhaps where drug therapy alone has failed. Learning to recognise their negative thought patterns and giving them understanding as to how these arose, will in a good many cases give them an insight into their depression, enabling them to utilise their conscious rational minds in spotting negative thinking as it arises and giving them strategies for both coping with the stressors that caused the negative thoughts and the negative thoughts themselves. For most people, given the right opportunity, will overcome their depression and move forwards to a more positive future and for those whose depression returns, early self-recognition of their symptoms will limit the impact of their depression and aid a speedier recovery.

To book your FREE initial consultation call Neil anytime on 07968 465933 or email any questions to neil@woodgaiger.co.uk   Back to Home Page

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