DEPRESSION

Depression is one of the most common reasons for a patient to see a doctor or psychiatrist, and often following this for a client to see a counsellor or psychotherapist. Depression as a word describes a whole range of conditions. Depression as a term relating to psychology, is a 20th century word, prior to that, Melancholic or melancholia was the dominant term and used to describe any kind of sad state, including mourning.

Freud’s manuscript of ‘Mourning and Melancholia’ (1915) described the essence of melancholia by contrasting and differentiating it from the state of mourning, a natural process of recovery from the loss of a loved one. Ranging from a temporary state of low morale which nearly everyone will experience at some point in life following a disappointment or setback of some kind, to an overriding feeling of negativity and hopelessness with a high risk of suicide. In between these two states is a scale of varying intensity. About one in six people it is thought will suffer from a depressive disorder at some stage in their lifetime. Clinical depression is one of the leading causes of disability in the UK.

The severity of depression, like many other psychological states, can be measured in part in terms of the impact on daily life. If you have mild depression you are usually still able to function and engage in everyday life, work, and relationships. But life may seem dull and it may be very difficult to get motivated or enthusiastic.

Depression may also come and go. Some may be a different personality in the outside world, but depressive feelings may flood in when alone. If the contrast between the two becomes too great suicidal feelings can manifest. In such cases friends and familly may have no idea they are suffering from depression, indeed, they may be the life and soul of the party, and the person to which everyone else brings their problems.

Those with constant severe depression will likely not be able to function in life, i.e. they will not be working or able to engage in usual social activities or relationships with others. They may be silent and morose, cut off from everyday life, spend too much time in bed and barely fulfill basic needs.

Psychotherapy tends to be most effective in dealing with mild to moderate cases of depression. With more severe depressive disorders medical intervention and treatment are usually necessary. A GP is always a good place to start as they can refer serious cases to psychiatry and you may be offered CBT, however, a quick consult and pill prescription are not the answer to anything. In terms of causes has yet no exclusive gene has been found to be responsible. Like many psychological conditions, there is no one reason or cause of depression, a disadvantaged childhood, a poor social environment almost certainly poses a greater risk of later life depression in later life.

A depressive personality is often passive and dependent, in the face of adversity they tend to feel both helpless and hopeless. Instead of imagining that by their own efforts they can improve their condition, they believe themselves to be the victim of events. They may also feel personally responsible for whatever adversity they are experiencing. Most people respond to an adversity with an effective aggressive response, in other words they push back. In our depressive person this is repressed and turned inwards, showing itself only in self blame and self depreciation.

Counselling and psychotherapy focuses on developing and nurturing the fiery or aggressive aspect of your personality which has been repressed. There are number of reasons why this instinctual aspect of the psyche may have been repressed. For instance, parents may discourage any show of anger or aggression in their children, if a child is conditioned not to show anger or ambition, in later life when this quality is needed, a person may experience depression. This is just one example and not a description that necessarily fit for example, a bi-polar depressive disorder where feelings of elation and deep depression are cyclic, it tends to be more applicable to those with mild to moderate depression.

This is just a brief introduction on depression, there are a lot of good books which go into the conditionin much more depth. Regular counselling can help get to the root of the cause, and over time work towards a healthy balanced mental state. However, counselling and psychotherapy is rarely a quick fix, a lifetime of conditioning cannot be reversed in a few sessions. It takes commitment and effort from both client and therapist for positive change to manifest.

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