Treatment for Depression
Along with anxiety, the next most common referral in GP surgeries is for depression.
The interesting thing about depression is that it is not a primary emotion. It is always a response to something else that is going on that remains unresolved.
Effective treatment for depression therefore requires that we address the underlying reasons relevant to each individual, rather than adopting a ‘one size fits all approach’.
The most common causes of depression I have observed in my clinical work are:
- Unresolved emotions from the past. For instance, many of my clients have mentioned an unresolved early bereavement in their past which well-meaning adults around them tried to quickly sweep under the carpet or dismiss as soon as possible. The idea was that if you don’ think about it, it won’t hurt you. Unfortunately the timing was premature and merely interrupted a normal grieving process. On other occasions, critical or incomplete parenting has led to unexpressed or invalidated feelings from the past that continue to seek completion in the present. Of course the tragedy is that these same client will judge themselves negatively and beat themselves up or feel guilty for feeling low and weak, precisely because they had incomplete or unhelpful training in how to handle emotional problems.
- Trauma – untreated trauma takes a huge toll on the system and can wear a person down. Depression can be an attempt to flatten and switch off these signals. Unfortunately, it will also switch off other positive feelings too, like a connection or enjoyment to past activities.
- Unmet emotional needs in the present – Similar to the above, if emotional needs are not being met, or certain stresses are ‘live’ in the present and not being addressed, the incessant anxiety can tip a person over into depression not just to attempt to flattern the signals but also because of an inner sense of hoplessness where a person feels ‘I don’t know what or how to deal with this problem’ – which is itself a depressing thought where one can get no peace from their concerns. Self-judgements, critical and negative self-talk will only add fuel to the fire and a person will continue to berate themselves for not being able to solve their problems.
Many people I have worked with who have selective eating disorder (a phobia of new foods) illustrate this point. They are extremely self-critical of their inability to overcome something like trying new foods, ignoring the fact that phobias can be about anything, and having a phobia about food is no less easier than having a phobia about spiders.
Treating depression effectively in such cases calls for a holistic and multi-skilled approach – being able to de-traumatise past events, assisting a client to speedily process unresolved emotions from the past, coaching them to cultivate better inner coaching and self-talk, helping them to be able to listen and focus on meeting their real unmet emotional needs, lowering their stress and anxiety levels, getting them in balance and integrated with their emotions and feelings, and able to communicate their needs/concerns.
Ultimately I believe that the body always has a drive towards health and will choose health when presented. In therapy we just have to remove the ‘spanners’ thrown into the works. Once that is done, the system will soon ‘auto-correct’ and find its balance.