Counseling For Depression
Most of us have experienced sadness at one point or the other in our lives and we often use the phrase, “I am depressed” pretty loosely. However, the majority of these situations & instances don’t meet the criteria for a diagnosable depressive disorder. This article focuses on the common depressive disorders that often brings people in for counseling & psychotherapy. In my practice at The Tri-Valley Center for Relationship Therapy in the East Bay, some form of a depressive disorder is a very common presenting issue among my clients seeking individual, couples or sex therapy.
Depression is both physical & mental
The central features of depression are intense sadness & inability to find pleasure in activities that were enjoyable before the onset of the depressive state. In addition to the feelings of sadness & loss of pleasure, people with depression often have frequent & automatic thoughts that focus on their flaws. As a result, people begin to see things in a negative light and become hopeless.
The physical symptoms of depression include low energy, fatigue, along with aches & pains that are severe enough to impact one’s social & occupational functioning. Depression also impacts appetite, sleep & sexual function. For some people, depression leads to over eating whereas others lose their appetite & weight. Similarly, some people, when they are depressed tend to sleep a lot, whereas others might experience insomnia. Sexual function, including sexual desire & the ability to get aroused is severely impacted.
Types of Depressive Disorders
Major Depressive Disorder (MDD):
MDD consists of an episode (lasting at least 2 weeks) of severely depressed mood characterized by changes in sleep, appetite, concentration, feelings of hopelessness, loss of pleasure, profound sadness, feelings of worthlessness and at times, suicidal ideation. It is an episodic form of depression because symptoms are present for a length of time and then clear, only to recur.
Chronic/Persistent Depressive Disorder:
As the term suggests, this type of depression is chronic and people feel depressed at least half of the time for at least 2 years. Research indicates that 95% of people with chronic depressive disorder do develop major depressive disorder over a 10 year period.
Seasonal Affective Disorder (SAD):
This is a form of depression that is referred to as the "winter blues." The individual effected by the winter blues experiences depression during winters, with the symptoms clearing up during the summer. SAD is triggered by an imbalance of melatonin in the brain which is only released during dark periods (winter).
Premenstrual Dysphoric Disorder (PMDD):
A depressive disorder characterized by depressive or physical symptoms in the week leading up to the period.
Gender differences in Depressive Disorders
Women are twice as likely as men to experience depression, especially in cultures around the world, where traditional gender roles are more prevalent. Researchers such as Nolen-Hoeksema have found several other reasons for the gender differences in depression:
Twice as many girls as boys are victims of childhood sexual abuse, a precursor to depression.
Women are more likely to be exposed to stressors such as poverty & care-giving, increasing the predisposition to depression.
Traditional social roles promote self-critical attitudes among girls & women, which in turn increases the risk for depression.
In certain cultures women are not allowed to pursue pleasurable activities such as sports to combat depressive feelings because the activities are not “feminine” & thus frowned upon.
Chronic stress during childhood into adulthood changes the reactivity of the brain to everyday stress making women more susceptible to depression.
Societal pressures on women to seek approval in interpersonal relationships intensifies interpersonal stress, which in turn results in depression.
Traditional social roles emphasize emotion-focused coping among women such as spending a lot of time reflecting on the sad mood & wondering why the unhappy events occurred. Men on the other hand, use distraction or action focused coping such as playing sports to counteract the sad mood.
How can therapy & counseling help with depression
One of the approaches that I use with clients struggling with depression is interpersonal therapy. The underlying premise of this approach is that depression is related to interpersonal problems. Interpersonal therapy is brief (usually 16-20 sessions) and it involves discussing interpersonal problems, exploring negative feelings, uncovering & expressing negative feelings, problem solving & adapting new, satisfying modes of behavior.
Cognitive Behavioral Therapy:
This is another approach that is very effective in treating depression. I have successfully used it with clients struggling with major depressive disorder (MDD), premenstrual dysphoric disorder (PMDD) & chronic depression. CBT involves helping the client understand cognitive distortions or thinking errors being used, identify automatic thoughts that reinforce negative beliefs about self, challenge the automatic thoughts by looking for evidence that supports or does not support the thought, & learn strategies to make more positive & realistic assumptions. CBT has shown to be as effective as anti-depressants in the treatment of depression & PMDD.
Mindfulness Based Cognitive Therapy:
This is a variation of cognitive therapy with an emphasis on being in the moment. With the help of meditation, people are taught to have a detached relationship with their thoughts and viewing them as mental events as opposed to the idea that thoughts are true or accurate representations of reality.
This strategy is effective in treating depression by increasing the participation of the individual struggling with depression, in activities that are pleasurable & rewarding, which in turns reduces withdrawal, isolation, avoidance and disrupts the downward spiral of depression.
Written by: Nagma V. Clark, Ph.D., L.P.C.C. specializing in sex therapy, couples therapy & marriage counseling, premarital counseling, individual relationship therapy & LGBTQQI couples counseling at Tri-Valley Relationship Therapy, Inc. in the East Bay, in Dublin & Oakland.
If depressed mood is impacting your interpersonal, social, sexual or occupational functioning, individual counseling & therapy at Tri-Valley Relationship Therapy, Inc. in the East Bay can help. Dr. Clark utilizes the Cognitive Behavioral Therapy (CBT) & Interpersonal Therapy interventions targeted to manage & alleviate depression.
Call 925-400-3541 or email firstname.lastname@example.org to schedule a free 15 minute phone consult or fill out the contact form and you will be contacted within 12-24 hours.