Depression itself, is a Natural Response
That statement is probably hard to digest if you are suffering with persistent, crippling depression.
But most, if not all, people eventually come to understand what it means to occasionally experience a relatively short period of depression. Going through life, there will be natural emotional peaks and valleys. In its natural state, a depressed mood is a useful signal from your nervous system that something in your world isn’t serving you well. When you’re able to listen to and trust your perceptions depression can help you realize that you need to make some changes. When recognized as a natural signal, and you have the resources, it can even motivate you to make those changes.
However, a depressed mood can sometimes become persistent and/or severe. When this happens, it can run your life and make you feel powerless to make any changes. It can interfere with your ability to engage fully with your world and relationships. If any of these thing occur, it’s time to take steps to intervene.
It is also important to note that depression can be associated with other medical conditions. Such medical conditions can change the treatment approach. This is why, in my counseling intake forms, and in your initial session with me, I will ask you about your current and past medical and psychological diagnoses and treatments. This can seem like a waste of time but is actually essential for correct treatment.
Types of Interventions
Interventions fall into two main categories: psychotherapeutic and medicinal.
“Medicinal” may mean psychiatric medications prescribed either by a Psychiatrist (MD), medical or naturopathic doctors (MD, DO, ND) or Psychiatric Mental Health Nurse Practitioners (PMHNP). It can also mean herbal or homeopathic remedies, supplements or dietary changes prescribed by a Naturopath (ND).
“Psychotherapeutic” can mean any type of mental health counseling or therapy. The counseling treats your psychological health and involves addressing patterns of Cognition (thought), Affect (emotions & feelings) & Behavior (ways you act in the world). It engages you in the process of looking at what isn’t working for you in your life. It then, very gently, begins to help construct manageable ways to heal or change those painful experiences, environments or relationships. It may also mean working deeply with past emotional wounds and/or making lifestyle changes. For many people, making micro or macro changes in their lives alleviates their depression.
At Self-Awareness Counseling, we will take a 360° look at what’s happening in your life. We will examine your relationships and environment, as well as explore your inner cognitive, emotional & behavioral responses to them. We will work from the “outside-in” to find the small lifestyle changes that may make profound differences in the way you experience the people and tasks in your life. We will also work from the “inside-out” by increasing your mindfulness & self-awareness toolkit. With these tools, you can learn to listen to your Self in a new way in order to truly meet your own needs from moment to moment. We can also increase your Self-trust by using the Internal Family Systems (IFS) methodology. This approach identifies when wounded parts of you are still operating subconsciously, as if old painful situations are still in play. It then helps them step into the present and into healing.
Sometimes the change a client makes in psychotherapy doesn’t alleviate enough of the depression or takes too long. There are also situations where it is impossible for a person to change the key factors in their life contributing to the depression. In these cases, medicinal interventions may be a good additional option. There is robust data showing that often, when depression is severe enough to require medication, outcomes improve when meds are paired with psychotherapy. If medication helps a person feel a little better, they often gain enough motivation and clarity to use counselling to make the bigger, lasting changes. This can enable them to maintain a balanced mood, sometimes without continuing to use the medication.
In my counseling practice, I may start to talk to clients about the possibility of adding medicinal interventions under some circumstances. For instance, if the depression is interfering too severely with their ability to make any significant life changes, or if the changes they are making aren’t significantly relieving the depression. Sometimes clients are, quite reasonably, worried about taking medications. Our counseling work can help with decision-making about the variety of medicinal as well as psychological interventions available and next steps in treating their depression.
Signs & Symptoms of Depression vary widely among individuals.
Extended periods of depression may be experienced in a variety of ways by different individuals and for diverse reasons. The Mayo Clinic provides a good overview of the signs and symptoms of depression (click here).
For example, some people may suffer with deep feelings of hopelessness, loneliness, heaviness, sadness, self-criticism and defeat. Others may be more inclined toward a lack of feeling. This can range from apathy (a lack of interest or caring about anything or anyone) to a certain numbness and disconnection from the world or their bodies. Still others may develop an increasingly short fuse and be quick to anger and frustration. Some people may experience an intensity of anxiety and panic along side the cycling thoughts of hopelessness and despair.
Individuals with depressive disorders also experience divergent physiological changes affecting sleep, appetite & behavior. While some people can’t sleep, others sleep too much and don’t want to get out of bed. The same dichotomy is true of appetite (no desire for food or compulsive eating) and other compulsive behaviors. For example, some people compulsively throw themselves into an activity such as, working, exercising, having sex, staying out all night partying, and burning the candle at both ends, all in order to push the depressed feelings away. Others fall into more and more passive and socially isolated behaviors like binging on tv and/or food, drinking or getting high alone. Depression is often at the root of addictive or compulsive behaviors.
Depression, like Anxiety, is a Nervous System Response
One way to make sense of the variety of divergent ways people experience depression is to understand that a depressed mood is one of the signals that a nervous system sends to you when it’s worn out from processing physical or psychological hardship. The nervous system is a complex, whole-body response system.
A person’s nervous system might be hitting a low for many reasons. To name just a few, a person may have experienced:
- chronic anxiety
- chronic pain or illness
- chronic repression of anger
- complex grief or loss
- deep and long-standing shame
- persistent bullying, invalidation or rejection
- physical, sexual or psychological abuse
- multiple interpersonal and/or environmental problems and losses
The signals the nervous system sends, of feeling worn out or defeated, have both a physical component and an emotional component. In other words, we have feelings about enduring too much emotional/physical pain and loss. Pain and loss can also include too many thoughts of pain and loss. Examples include: frequent inner review of past hurtful or shameful situations, prolonged fixation on a loss, self-criticism or other harmful inner-dialogue, and the full range of anxious feelings.
Our nervous system is designed to “talk” to us when things aren’t going well so it uses emotional signals to flag us down and get our attention. In other words, when someone is experiencing a depressed mood the body is signaling, very loudly, that things are NOT OK!
There is substantial evidence that some childhood environmental factors and some inherited biological factors will make certain people more susceptible to depression and anxiety when life’s hardships occur. This is why it’s very important not to judge yourself negatively or compare yourself to others who seem to be able to keep a “positive” attitude when life gets hard. It is also important to remember that we never know what others are truly experiencing, and often it’s quite contrary to what they show on the outside. Furthermore, the workings of the mind and body are still far too great a mystery to understand all the factors that make it harder for some emotionally. The important thing to remember is that comparing yourself to others can be misleading and unhelpful. You only have your life. Telling yourself you “shouldn’t” feel what you feel will only get in the way of shifting it. If depression is preventing you from living fully and authentically, it is time to find an intervention and start the work of turning it around.
For More Information:
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