Many individuals who seek my help in therapy are often already aware they are feeling depressed, but just as often a new client will describe a more unclear confusion about why life seems so much less meaningful or satisfying than before. Helping clients to recognize that they are suffering from a depressive episode which is beyond their full conscious control can help increase self-empathy for their struggles, and start them on a journey of recovery.
Feeling depressed on occasion is, I think, an inevitable part of the ebb and flow of human experience, but if you’re mildly depressed more than 50% of the time, or if you are so low you are having real difficulty making it through the day, then it seems evident the psyche is in distress and asking for greater attention.
I adjust my approach to depression to meet the unique needs of each individual I work with, and the first step is to get a better understanding of what kind of depressive episode you are experiencing.
A situational depression can occur in reaction to specific events, such as the loss of a significant person in your life, or a mid-life crisis, when our typical patterns of seeking fulfillment and pleasure in life are no longer working, and we need to find new ways of approaching our lives moving forward. This can even include changes in career, relationships, or other dynamics in our lives. There is often wisdom in the depression that together through our therapeutic exploration we can begin to discover.
Often a depression can be a maneuver by the psyche to blanket over a painful increase in anxiety, and/or other difficult feelings below the surface, which may be old traumatic wounds from childhood trying to resurface. It may be fruitful to give voice to the depression itself, as well as underlying parts of the self that feel overwhelmed by toxic shame, hurt-rage, repressed sexuality, and/or bereavement.
In addition to our active dialogue in sessions, I encourage many of my clients to draw pictures of their feelings, perhaps in the form of emotional self-portraits, as a way of validating difficult emotions, and to make them more tangible so we can work with them more actively. You can even try drawing with your non-dominant hand to get away from the pressure of trying to make a pretty picture, instead letting the feelings express themselves in all their messy, chaotic, muddy or jagged characteristics. Journal writing or movement in the body can also be important ways of expressing big feelings that need to be more fully honored.
When you are contending with depression, developing a regular exercise routine is probably the single most effective practical intervention. Of course, when you’re feeling really low, getting yourself to begin exercise can feel excruciating. Sometimes, starting with just a 10-minute walk around the block can be a big achievement, and then we build from there. I can also refer you to a highly experienced psychiatrist for medication evaluation. Today’s anti-depressants vary in effectiveness, but they can legitimately make a big difference for some individuals. In certain cases, the process of finding the best medication for you can require some trial and error, in which case I can help you bear the frustration of going through that interim period.
Whether you are feeling a little blue, or are having dark suicidal fantasies, I am eager to work with you to make sense of your depression and help you find new purpose and pleasure in your life.