Specific Counseling Strategies

After getting to know my client, and our coming to agreement together that at least one of the issues being dealt with is depression, I ask some questions to try to ascertain the type of depression, how severe it is, what areas of a person's life are affected by it, and what areas may be contributing to it. I may give a short written test to help with this process. I also want to know if the individual has contemplated suicide, since staying alive is the first order of business in improving one's quality of life.

No matter how severe the depression is or what is causing it, one of my first tasks is to impart hope. Depression robs a person of hope, and one of the first steps on the road to recovery is to begin to believe, at least intellectually, that there are options available to make things better, that a meaningful, productive life is attainable, and that there are many others who have previously felt the same way (or worse) who have gone on to find relief and a new lease on life. Sometimes we need to settle for my telling someone, "I have hope even if you don't right now; let me have hope on your behalf for awhile till you begin to experience it yourself."

Depression is multifaceted, and different people experience it in different ways. Some of the information that you may hear or read on the subject takes only one approach to this complex issue. For example, some articles written on depression stress only the "disease" model, going on to state that depression is purely and simply a chemical imbalance, for which the necessary and sufficient remedy is medication designed to correct that chemical imbalance. Others stress that depression is rooted in faulty thinking patterns which need to be relearned, such as self-blame and "negative filters." Another school of thought says that depression grows out of impaired relationships (which we have all experienced to some degree), and will be most acute in those who have experienced the most significant bonding problems. Still others believe depression must be understood as a spiritual problem requiring a spiritual response.

I believe there is truth in all of these, and I work at developing a path of recovery that takes each person's individuality into account. Some may be dealing mainly with physiological issues, for which lifestyle changes as well as medication can give substantial help (e.g., exercise, diet, sleep patterns, and/or exposure to light). For others, there may have been deep emotional wounding in past relationships, perhaps in one's family of origin, that still needs healing. I endeavor to help a person understand and come to terms with these issues (see "Healing Past Hurts"), perhaps working through a grieving process that was never completed. I also recognize that the key for some people may be improving present relationships, or at the very least how they approach and think about those relationships.

For many, self-talk and thinking patterns truly have become a major part of the problem, and I have found that teaching people who are depressed how to change these patterns can work wonders. This is called "cognitive," "cognitive-behavioral" or "cognitive restructuring" therapy and its effectiveness has been demonstrated by much research. Finally, for some, depression may very well have its roots in one's spiritual life. If so, even though the depression has gone on to affect the mind and body as well, dealing with the spiritual issues may be key to long term peace of mind. Therefore, I am sensitive to the need for addressing this area and am always open to a person's desire to do so.

Most often, my counseling with my clients involves dealing with two or more of the above areas at the same time, with the aim of developing a long term solution as well as the relief of present symptoms.

[Back to "Overcoming Depression: Background"]