September 2015.
Depression and Treatment by Dr Elizabeth
McCardell, M. Couns., PhD
Depression is diagnosed as feeling sad or blue for two
or more weeks. It is characterised by two things: self blame and rumination
(thoughts that go round and round and round your head). Both paralyse decision
making skills, feelings of well being, and the ability to move on in one’s
life.
Depression, which is essentially a fear-based response
to events, relationships and psycho-physiological conditions, can lead to
dropping out of society, losing one’s job, ceasing to create, developing heart
disease, over-eating, under-eating, smoking, chronic resentment against self
and world, smoking and other addictive habits. Major depression is a growing
concern, world wide. The World Health Organization identifies it as the fourth
most significant cause of disability in the world.
So what is depression? There are many views on this,
many perspectives and it rather depends on how you see the world. Contributing
factors include biology: genetics (though no depressed gene has been located),
biochemical contributions (serotinin, a breakdown in the auto-immune response,
etc), health, exercise,
and diet. There are the psychological factors: your individual temperament,
coping style, attributional style (that is, how you view what happens to you in
different circumstances), your personal history, and so on. And the social
factors: the quality of your relationships, the culture in which you live, isolation,
and so on. Depression is contextual in the sense that it arises in response to
something. Interestingly, it seems to have a capacity to be spread (witness the
proliferation of deeply depressed adolescents through online sharing of gothic
thoughts and cutting). In other words, there are many contributors to whether a
person becomes depressed or not.
Childhood experiences, including the quality of support
you’ve experienced from your care givers, modeling and what you’ve learned from
your family as to how they cope with loss and adversity may contribute to the likelihood of having
depression, but not necessarily. What’s more important is how a person responds
ongoing processes, how they use information, how they form relationships, and
how they interpret the meaning of
things that happen to them. Socialization continues throughout life and our
coping skills are also being developed throughout life. This means we can learn
not to follow a pattern that we used in previous times to manage life’s
situations.
Treatment of depression ranges from medication,
electroconvulsive therapy, diet, exercise and psychotherapy. A single-pronged
approach is not likely to work, and doesn’t in many cases. Treating those
diagnosed with depression with anti-depressants such as serotonin-reuptake
inhibitors is often believed by patients to be sufficient, but, one,
anti-depressants don’t work for everybody (they just don’t work in the way
researchers thought they would) and the problems that exacerbated the condition in the first place are
still there.
Some interesting research is going on in Leiden, The
Netherlands, on the thesis that depression is an inflammatory problem and the
use of probiotics seems to have the effect of lessening the inflammation in the
body. Probiotics have been found to cut down the propensity for rumination.
Exercise fills the body-mind with good endorphine hormones
and feeling good clears the depression away. It’s hard getting oneself
motivated, however. The use of hypnotherapy at this level is very useful, as it
is on other levels as well.
Psychotherapies that concentrate on present issues are found
to be more effective than those that go back over old stuff. This is because
certain psychodynamic therapies work using rumination, and rumination, as I’ve
indicated, is a characteristic of depression. So a therapy (eg cognitive
behavioral, interpersonal and hypnotherapy) that refocuses on what takes a
person out of their problem story is more likely to be successful here in
changing things.
A metaphor might help. Imagine someone walking through the
bush for the first time. This is like thinking about something in a novel way.
If, for whatever reason, the person goes that exact same way the next day, and
the day after that and the day after that, the pathway gets worn down: old
patterns are repeated, negative thought patterns are reiterated, neural
circuits become circular, and it’s really difficult to leave the pathway
because it has created such a crevasse in the landscape that getting out is now
really hard. The walker has sort of forgotten how to walk innovatively.
Hypnotherapy can change that, using – possibly – this, or another tailor-made
visualization. The creation of a means out of depression needs to be as
individual as the person suffering depression. The reason for their depression
is as unique to them as their remedy. The remedy, I think, should be holistic,
but first and foremost, supported by a therapist who understands the
interconnection of all these processes.
