Depression is a word that carries different connotations for each of us. For many people the word itself can have a depressive effect because of its associations. In one form or another it is a condition that has touched the lives of most people, whether they have experienced it (or are experiencing it) first hand or whether they have been exposed to it within their families or among their colleagues or friendship groups.
Dealing with depression can involve medical treatment, psychological therapy or, more often, a combination of both. Medication can provide essential support for sufferers. In particular it can help those affected to function day to day while, hopefully, longer term healing is slowly taking place at a deeper level.
A recent research paper* considers how the effectiveness of antidepressant medication compares with psychological treatments, such as counselling and psychotherapy. The paper highlights how well at least one form of psychological therapy compares to purely medical treatments.
This can be a controversial area, at least partly because depression is such a catch-all term and no two people’s experience of depression will be the same. A common feeling for those who are depressed is that their own particular experience is unique – a feeling likely to be exacerbated by the sense of disconnectedness that comes with it. Invariably, depression will be experienced with a sense of feeling helpless, hopeless and worthless. It doesn’t necessarily stop there; the range of possible symptoms is very wide. The excellent MIND booklet** on depression lists over 20 of them. Also, depression can be brought on both by clearly identifiable causes (some of which are suggested below) or it can arise for reasons that are harder to pin down. Sometimes, sufferers will have no idea why they are feeling what they are feeling. Being diagnosed as depressed may bring some initial relief, if only because it seems that what is wrong has at last been identified. Hopefully this will mean that healing can finally start.
However, as a label, the diagnosis can also be unhelpful, partly because of some negative public attitudes (although I would hope this is changing). In a text entitled ‘When you can’t just snap out of it’***, Kirshen Rundle, a person-centred therapist, expresses the worry that a diagnosis of depression ‘pathologises the individual’. She highlights the danger that distressing events, such as divorce, bereavement and stress at work, can be falsely identified as mental health problems when in fact they are part of being human.
Those isolated in depression can feel that something is fundamentally wrong with them. Therefore, a label that pathologises them might simply be accepted without question and confirm to them that they are indeed ‘not right’. However, working in therapy to get underneath the depression may reveal an alternative, and more encouraging, reality.
*‘Extended problem solving treatment for depression’ – M Brambling & R King, Queensland, Australia, 2013
**‘Understanding Depression’ – MIND (www.mind.org.uk)
***This text is a contribution to ‘Client Issues in Counselling and Psychotherapy’ – J Tolan & P Wilkins