Understanding Depression
How is Depression Treated?
Mental health professionals may differ on the approaches they take in comprehending and addressing depression. While it is beyond the scope of this page to review all of the different theories and approaches to dealing with depression, it might be helpful to have some idea of what one might expect if they seek professional help to attend to depression.
It is quite likely that the mental health professional will begin by exploring if the depression is occurring in an identifiable context. For example, has the person been depressed since the break-up of a valued romantic relationship, since coming to college, or ever since the weather turned cold and dreary. Sometimes, the origin is in a person’s past. The death or severe illness of a loved one years before, a difficult life period of abuse or neglect in childhood, a traumatic experience that seems to linger or periodically resurge in a person's awareness---- all of these might be relevant to the way a person is experiencing the present or at least helpful in understanding the scenery of a person’s pain. Often, however, there is nothing the person can point to that would prompt them to feel as depressed as they do, and this "undefined" depression might inform how a mental health professional will proceed.
Some professionals may take a more past-based approach, reviewing the person's personal and social history in order to identify and resolve some pain that has been unattended to. This approach, called a psychodynamic approach, is rooted in more traditional forms of psychological intervention and it assumes difficulties are beneath a person's awareness. The idea behind this approach is that this awareness, when brought to the surface, will bring with it some relief via a new understanding and revision of the way a person interprets his or her life (including the depression).
Other professionals may take a more interpersonal approach, relying on a supportive and empathic counseling relationship to help the person feel safe enough to get through the various forms of pain contained in the depression. The client, via the relationship with the mental health professional, begins to remember how to be connected with people in a positive way that can then be applied to personal relationships outside the counseling context. The assumption in this approach is that connection, between human beings, creates a healing context , and that in healthy supportive relationships, recovery from psychological hurt simply occurs naturally in the way that a flower will naturally grow in a well tended garden.
While these approaches have some significant merit, most mental health professionals recognize that integrating these perspectives into what is known as Cognitive-Behavioral Therapy is usually most appropriate. Research into different approaches usually indicates that a cognitive-behavioral approach is most effective, although the skills and personal styles of the mental health professional likely plays a very important role in how helpful any approach is.
So, what exactly is the cognitive-behavioral approach? Underneath the jargon is a rather simple but stimulating idea: how we think impacts how we feel and, in turn, how we behave. So, if we can have an impact on what we're thinking, we can have an impact on the behavioral consequences of those thoughts: namely, becoming depressed. It may sound ridiculously simple; but the very nature of depression is such that a person's normal ability to balance positive with negative thoughts is impaired. A trained mental-health professional has skills to detect even the most subtle forms of this emphasis on negative thoughts. Pointing these out to the client and help the client to point them out to him or her self becomes the first task. Then, gradually, counseling involves a supported effort toward identifying true and applicable alternative thoughts. Eventually, the normal balance between negative and positive thoughts return and yield a view of the world and reactions to that world that is not so..... well, not so depressing.
What About Medication?
Various medications are used in the treatment of depression and, from this medical approach which recognizes depression as an illness, medication is the most appropriate intervention. However, research does tend to suggest that medication and cognitive-behavioral therapy is more effective than medication alone.
People have different attitudes toward medication, especially when it comes to addressing problems of an emotional or psychological nature. Many individuals are simply uncomfortable taking medication. Some fear it will lead to addiction. Others feel it indicates a failure to deal with the problem through their own inner strength. Yet, others are quite comfortable and eager to take anti-depressant medication because they view it as a tool, as valid as any inner-psychological resource that is available to alleviate distress. It is clear to mental health professionals that the chemistry of a person with depression is different than that of someone who is not struggling--- similarly, the chemistry of a person is different when depressed than when that same person is not depressed. The often used phrase "a chemical imbalance" is used in the popular media to describe depression or other psychological difficulties. Medication simply brings about a restoration, so to speak, of that balance needed to free the struggling person from the effects of depression.
Those who do have some concerns about addictions, side effects, and the mechanisms of medication should discuss these with a medical professional---preferably a psychiatrist. Rather than simply ignore a tool that may bring about significant relief from suffering and impairment, having an open dialogue with a professional knowledgeable about medication can lead to an informed decision. One helpful rule of thumb for individuals very reluctant to try medication is the level of distress a person is feeling. If one has a headache but is reluctant to take pain-medication, he or she usually has a threshold that dictates when it's time to take the medicine. Similarly, when your problems with depression reach the point that life is so disrupted that functioning is too great a challenge, it may be time to revisit any hesitations one might have about anti-depressant medication.