Depression counselling and therapy

This page looks at how depression counselling and therapy can help in the treatment of depression.

An interesting thing about psychology is that every age has its own emotional disorders. When Freud was developing psychoanalysis at the end of the nineteenth century and start of the twentieth, hysteria was the illness of the day. Today depression is one of our main conditions; in fact it’s the world’s leading disability. Affecting more women than men, it can range from a mild dose of the blues to a serious disorder that may embrace self-harm and may generate suicidal thoughts and actions.

There are two main types of depression. Reactive depression stems from external factors like bullying, career problems, domestic violence, redundancy, illnesses such as cancer and a host of other causes. If and when the problem improves, the symptoms also tend to improve. Endogenous depression, on the other hand, is lodged deep in our psyche and is not so dependent on day-to-day events to trigger it. It’s that form of depression that I’m thinking of primarily here, although there is overlap.

What are the symptoms of depression?

Sometimes people come for therapy not specifically mentioning depression at all. It may feel more like a general dissatisfaction with life or a lack of fulfilment. Often depression is associated with other symptoms too, such as:

  • Having a flat, depressed and sad mood for much of the day
  • Feelings of hopelessness and helplessness
  • Difficulty in concentrating, making decisions and remembering details
  • Not finding enjoyment in anything.
  • Not feeling like talking or socializing
  • Lacking motivation
  • Insomnia (including early waking) or sleeping too much
  • Tiredness and loss of energy
  • A sense of worthlessness and guilt
  • Over-eating or loss of appetite
  • Irritability
  • Possible thoughts of suicide.

How do I know if I suffer from depression?

There are various online ‘tests’ for depression that you can do although self-diagnosis can be fraught with problems. It’s advisable to talk to a specialist. Your GP is often a good starting point. Symptoms may also be due to more than one cause or to a different cause.

People suffering from depression don’t all have the same symptoms. But if some of those in the list of symptoms persist for weeks or months, it might be an indication that you are depressed. They can be also combined with anxiety, struggling at work, indecisiveness, unexplained aches and pains, restlessness and losing interest in sex. Sometimes there may be a sense deep down that one is ‘bad’ and an accompanying tendency to be harsh on oneself.

What are the causes of depression?

There’s some evidence of a genetic component to depression. But factors linked to one’s formative years are frequently at work too. In her excellent book Psychoanalytic Diagnosis, Nancy McWilliams talks about these and what follows draws on some of her material.

Early loss

The experience of overwhelming and/or repeated loss in childhood is a common preliminary to depression. It may be obvious loss like the death of a parent or something less concrete like the loss of childhood itself when someone is made to give up natural emotional dependence on a parent before he or she is ready.

Turning against the self in childhood

A child losing a parent through an event like death or divorce may be too young to understand what has happened. They may believe that they themselves caused the parent to go away. That guilt may be heightened in families where a need to be upset about the loss is denied or criticized. Actual or emotional abandonment plus parental criticism can lay the foundations of depression.

The reason why children turn against themselves in this way is that, faced with a choice between accepting fear, desertion or uncertainty – which would mean powerlessness – and believing that the cause of their unhappiness is within themselves – which will preserve some control over circumstances – they will choose the latter. People often prefer any suffering to impotence.

Turning against the self also explains why depressed people are often very self-critical. They may have had a parent or other relative whose criticism of them they took in deeply or, as I say, a caregiver who, as children, they believed they drove away. Understandable feelings of anger about the loss are turned inward.
A final cause of depression can be having a depressed parent. A genetic factor might be implicated, but so might a child’s guilt for the normal demands they make on their incapacitated parent. Again, turning against themselves.

What can be done about depression?

There are various treatments for depression and analytic psychotherapy is one of them. It’s not a quick fix and there can be no guarantees but psychotherapy aims for long-lasting change through exploring and working with the (often unconscious) roots of the condition. Sometimes people can be helped by combining GP-prescribed medication with psychotherapy.

If you are in the Surrey area contact us for help with depression therapy and counselling›

Other pages which may be of interest

For more information about Anxiety counselling and therapy
For information on Anger and anger management therapy
See our blog post about stress: All stressed up and nowhere to go