Therapy and Counselling for Depression

Psychotherapy for Depression in Surrey

Do you think you’re suffering from depression? Do you think your mood is getting in the way of living your life to the maximum? As a well-qualified, accredited and experienced psychotherapist and counsellor in Guildford, I have worked with many individuals throughout the area including Woking, Dorking, Farnham and further afield in helping them to explore the root cause of their depressive symptoms.

Based in Guildford, Surrey, I offer both individual and group psychotherapy sessions.

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.

The two main types of depression:

There are two main types of depression.  Endogenous depression stems from biological causes in a person.  It may best be helped by physical forms of treatment.  Reactive depression, as the name suggests, is a reaction against external factors.  The loss of a parent would be an example.  Reactive depression may respond well to psychotherapy and it’s this type of depression that I’m thinking of primarily here.

Treatment for depression

I’ve tried to give a quick survey of some of the different types of depression that affect people. Treatment for these will depend on the precise type and on whether a person is suffering from mild low mood or moderate depressive symptoms or severe depression symptoms.

Medication

Generally, though, a GP may prescribe antidepressants (such as an SSRI: Selective Serotonin Reuptake Inhibitor) or an older type of medication called an MAOI (Monoamine Oxidase Inhibitor. Often associated with the treatment of atypical depression). These medications can significantly alleviate debilitating symptoms.

Talking therapies

The so-called ‘talking therapies’ also have good track records in treating depression. It may, incidentally, be appropriate to take antidepressants while having therapy in order to be able to engage with the process in an active and motivating way.

Cognitive Behavioural Therapy (CBT) is usually a time-limited therapy lasting anywhere between six weeks and six months. It’s focused on precise goals agreed with the client and uses structured sessions and ‘homework.

Psychodynamic psychotherapy is very different. CBT aims to consciously alter an individual’s unhelpful thoughts, perceptions and behaviours in order to change how they feel and behave. Psychodynamic therapy aims to uncover why they are feeling and behaving as they are and works deeply with the unconscious mind to do that. (Think of your mind as an iceberg with seventh-eighths hidden below the waterline – that’s the size of the unconscious!)

Psychodynamic therapy also works with past causes of a person’s present struggles whereas CBT tends to stay in the present. Psychodynamic sessions are not structured as in CBT and the overall aim is not just symptom modification but also holistic change – growth in the whole individual. Going, as it does, to the roots of a condition like depression, psychodynamic therapy often takes longer than CBT – a year upwards – although changes may start to be noticed after only a few months.

Ultimately the choice of CBT or psychodynamic therapy depends on what a person wants. Which approach attracts you? Along with the ‘conscious you’ are you interested in exploring parts of yourself that are out of your conscious awareness? What are the financial and time considerations in your life? Do you want to stay in the present or also look at your past? These are the questions that only you can decide.

But if you’re in the grip of depression I would encourage you to be honest about it and be willing to ask for help. It’s out there and waiting. And you deserve it.

Symptoms of depression in women

Depression affects more women than men and it has often been thought that symptoms of depression in women differ from symptoms of depression in menBut this is not to the point where the condition exists in two distinct forms. That said, there are a couple of types of depression that are specific to women.

Perinatal depression

This condition embraces both minor and more severe depression symptoms occurring during pregnancy or the first year after giving birth (when it’s also known as postpartum depression). The effects on a woman and on her infant and family can be very bad indeed. She may experience severe mood swings, difficulty in bonding with the baby, thoughts of hurting herself or the child, social withdrawal and, in the case of postpartum psychosis, delusions, confusion or hallucinations.

Premenstrual dysphoric disorder (PMDD)

PMDD is a very severe form of premenstrual syndrome which can cause serious emotional and physical symptoms during the fortnight before a period begins. Among them may be feelings of upset, tearfulness, irritability, anger, self-criticism and tension plus a sense of being overwhelmed. Physical symptoms of depression can entail breast tenderness or swelling, muscle or joint pain, bloatedness and food cravings.

Symptoms of depression in men

In Britain men are 50% less likely to be diagnosed with depression than women. This could, however, partly reflect social pressures around men admitting ‘weakness’ or the need for help and it may also reflect their unfamiliarity with talking about emotional issues. A sobering thought is that men are four times more likely than women to complete suicide as a result of depression.

The symptoms of depression in men are probably broadly similar to the symptoms of depression in women and common types of depression (mild, major, persistent, bi-polar, recurrent, atypical etc) will also figure in males. But some symptoms appear to be more likely to manifest in men than in women. Not uncommonly one finds substance abuse, obsessive working, anger and agitation, reckless behaviour such as dangerous driving, controlling or abusive behaviour and a loss of interest in the family.

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.

How might you help me?

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.

Enquire about psychotherapy for depression – I aim to respond promptly to enquiries.

Other pages which may be of interest

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