Depression
Introduction to Depression Counselling
Depression is a part of many mental health conditions… here are some well known diagnoses that you might hear from health professionals all of which can include depressive symptoms and episodes..
Major Depression, Bipolar Disorder, Post-natal Depression, Dysthymia…Complex Post Traumatic Stress disorder…Borderline Personality Disorder…Substance misuse
People with so-called personality disorders, complex post traumatic stress and substance misuse often present with depressive symptoms and episodes as well…..
Suicidal ideation, loss of weight and insomnia can be part of these presentations…
Often anxiety goes hand-in-hand with depressive symptoms..
Often depressive symptoms can be treated with psychotherapy alone, sometimes combined with symptomatic relief of insomnia or anxiety using medication…sometimes in combination with antidepressants…occasionally hospitalisation is required…and treatments such as major tranquilisers, transcranial magnetic stimulation or electro-convulsive therapy.
How can we understand Depression
Depressive symptoms are one way in which difficulty managing our emotions can be experienced.
When any of our emotions are not intense enough we experience what is often described as depression… we can feel diminished interest or motivation in our everyday life …sometimes to the extent of feeling ‘numb’ or ’empty’, or not ‘alive’…..sometimes we and the world itself do not feel real… our ability to concentrate and make decisions and feel motivated is lost….
We have lost our usual sense of vitality and well-being…or in life-long cases this has always been less than it should be..
I see depressive symptoms as reflecting underlying patterns of thinking feeling and behaving which are often life-long and which may have served an adaptive role at one point in life such as in childhood.
How I assess patients with Depression
As an experienced psychotherapist who also has practiced meditation for over 30 years I have long been struck by the similarities between the processes of psychotherapy and meditative inquiry.
When I assess patients I am interested to see how they process different aspects of their sensory experience…are they familiar with self-reflection and introspection…how in touch are they with their bodily feelings, including breath and emotions. I am interested to build on strengths and abilities that will help that person in meditative inquiry and self-awareness. Some of my patients are already meditators, others become meditators and others who are not interested in meditation are able to use their psychotherapy in a similar way to meditative self-inquiry.
To begin with I want to see how the person’s depressive symptoms respond to the support of an understanding and safe therapeutic relationship…so if the depressive symptoms and well-being don’t improve significantly within a period of therapy the next step is taking care of sleep and managing excessive anxiety associated with the depression… this might just require sleeping medication or it might need antidepressants. Sometimes I will prescribe medication myself but it is often useful for your GP to take this role so we can focus on the psychotherapy…
My approach to Depression Counselling and Psychotherapy
As a psychotherapist and medical practitioner trained in systems family therapy and modern psychoanalytic psychotherapy I am concerned with a holistic approach to patients.
Often a person’s depression which is what is seen in the foreground makes sense once we can see the hidden background and broader context of the person’s life, behavioural emotional and thought patterns. Often this will lead to solutions…
Many of the approaches used in personal psychotherapy such as inquiry into epistemology (the philosophy of how we know what we know), effective communication, mindfulness, body awareness and emotions are extremely helpful in depression counselling.