Depression & Mood Disorders

DEPRESSION & MOOD DISORDERS

“Every man has his secret sorrows which the world knows not; and oftentimes we call a man cold when he is only sad.”

— Henry Wadsworth Longfellow

Unfortunately, when people don’t know exactly what depression is/how it feels, they can be incredibly judgmental and unsympathetic. Many clients have expressed puzzlement, frustration, and/or anger toward their friends/family for not being more empathetic when the client is obviously struggling, sometimes to a catastrophic degree. One’s sadness/depression may seem all encompassing and the compassion, support, and understanding one desires may be sorely lacking. Perhaps you are responding to your own experience of depression in harmful ways; it could be that you are carrying around feelings of guilt or shame, minimizing your own pain/experience, or telling yourself to, “Snap out of it.” These responses are not helpful and may even lead to a worsening of symptoms.

  • Persistent feeling of sadness
  • Increased tearfulness
  • Social isolation
  • Loss of interest in formerly enjoyable activities
  • Difficulty concentrating
  • Changes in sleep habits
  • Changes in eating habits
  • Feelings of guilt, shame, worthlessness, and/or helplessness
  • Hopelessness
  • Restlessness
  • Irritability
  • Decreased energy
  • Physical pain
  • Suicidal ideation, planning, attempt(s)
Treatment: Cognitive-behavioral techniques (CBT) are primarily utilized in the treatment of depression, as they have been demonstrated to be effective at reducing symptoms. The key principle behind CBT is that your thought patterns affect your emotions, which in turn, can affect your behavior. In therapy, we will work to identify specific problems/issues in your daily life; help you become more aware of unproductive thought patterns and their impact on one’s life; identify negative thinking patterns in the hopes of reshaping them to alter how you feel; and help you learn new, more adaptive behaviors. Some techniques that are commonly employed include the following:
    1. Cognitive Restructuring/Reframing: challenging irrational, maladaptive thoughts and replacing them with more realistic cognitive appraisals.
    2. Behavioral Activation (BA): based on the well researched understanding that depression often keeps us from doing the things that bring enjoyment and meaning to our lives, which causes us to feel worse; BA reverses this trend through re-engagement in those activities that bring enjoyment.
    3. Journaling/Thought Records: journaling about emotions, thoughts, and behaviors in the pursuit of increasing self awareness and prompting future behavior change.
    4. Relaxation and Stress Reduction: progressive muscle relaxation/body scans, guided imagery, breathing exercises, physical exercise, mindfulness practice
“Rebuilding of the self in and after depression requires love, insight, work, and most of all, time.”
— Andrew Solomon, The Noonday Demon: An Atlas of Depression