Counseling For Depression

Depression: According to the CDC, 1 in 20 Americans ages 12 – 59 were clinically depressed 2005-2006. NIMH says 14.8 million people in the US have some level of depression. Only 39% of people with serious depression seek counseling.

Do you know the main signs of depression? It is characterized by a change in mood that is present more than 2 weeks (and not associated with a recent death) these include: self attitude, changes in cognitive functioning, disturbance of sleep and eating patterns, decrease in hygiene & personal appearance, decreased energy, decreased interest in things you normally enjoy doing, missing work or school, anxiety, difficulty concentrating or remembering and sometimes suicidal thoughts. You need not have all these symptoms to be depressed.

Depression is a very treatable condition. There are many causes & types of depression. The most common types of depressions and what I work with are situational depression, dysthymic depression, major depression, postpartum depression ( for this problem a client must also have medical caregiver involvement), premenstrual dysphoric depression (PMDD), and seasonal affective disorder (SAD).

Situational Depression is usually a single episode or rare occurrence of mild depression associated with an identifiable temporary situation that is affecting you now. When the situation or stressor resolves, usually the depression resolves as well. Examples of common stressors can be things such as; loss of a short-term relationship, job loss, not getting hired or accepted for a job/school, moving alone to a new city/state, a significant shift in lifestyle, seeking a new career, adjusting to caring for a sick family member and seasonal affective disorder. This type of depression usually responds well to counseling, doesn’t typically require medication and a short number of counseling sessions is often sufficient.

Dysthymia is a mild type of depression that is recurrent and has been present at least 2 years without relief or only a few days of relief of symptoms. People sometimes say, “I’ve always been depressed” with this type of depression. It is treated well with therapy and usually medication. A major depressive episode can hit a dysthymic person too, which causes a double depression. When this occurs it demands careful treatment, close follow-up and frequently requires medication.

Major Depression is a more severe type of depression. It includes most of the above mentioned symptoms under signs paragraph and has been present for more than 2 weeks. It often accompanies more serious life events such as: a significant loss, unresolved childhood trauma, loss of a long-term relationship, domestic violence (a client must be out of the relationship to see me for therapy), sexual abuse as a child, unresolved childhood neglect, abandonment or growing up with substance abuse in the family.

This type of depression is usually recurrent and a type of depression that should not be ignored especially if you have thoughts of suicide too. Once you have resolved issues and learned coping skills it is less likely to recur but people with this type of depression have a higher incidence of recurrence.

Postpartum Depression (PPD) is thought to be a form of major depression. It differs from the typical “baby blues” that sometimes occurs after the birth of a baby where one’s moods are up and down> These symptoms begin 1-3 days after birth and is characterized by weeping, irritability, lack of sleep, mood changes and feelings of vulnerability, (some of these symptoms are due to hormonal changes).

Baby blues don’t usually last longer than 10 – 14 days and then resolves. PPD is different from the baby blues in that it is much more severe. It can begin any time between the birth and 6 months post birth. In addition to the symptoms listed above for baby blues, with PPD these symptoms are also present; ambivalence, disinterest, or lack of desire to care for your baby and sometimes a mother also has thoughts of harming her child. If you are having thoughts of harming your child this is dangerous and you must go to a hospital emergency room or contact your doctor immediately.

If you are having any of the other symptoms mentioned besides harming your baby, you still need to contact your doctor and see a mental health professional. This is serious disorder and should not be ignored. PPD needs both medical and mental health care. It is very treatable. Do not be ashamed about getting help you are not the first or only mother who has had this disorder, do not ignore the symptoms of PPD thinking they’ll just go away.

How therapy helps

Depression is a real illness and carries a high cost in terms of relationship problems, family suffering, lost work productivity and general enjoyment of life. Therapy helps a person pinpoint the life problems that have been contributing to depression. It helps a person understand what it is that may be solvable and can improve. A therapist helps you identify options and choices, gain coping skills and set realistic goals. Therapy helps you to better understand yourself and improve patterns of interacting with others. In addition it can help you incorporate enjoyable and fulfilling activities back into your life.

I strive to help a client develop a sense of safety and trust. As your therapist I will be a non-judgmental witness to your experiences, whatever those may be and to what extent you chose to reveal. Many depressed people have experienced inadequate or neglectful parenting, sometimes parenting by a substance abusing parent or a parent that was mistreating or abusive in childhood or you’ve been a victim of domestic violence. A therapist can be the first person you tell your story to and therefore the preamble to trusting another person with your story. Silent suffering only continues the pain, isolation, and often shame for not being (in your opinion) stronger and depression is the result of the burden of keeping the stories hidden.

I usually recommend other things to help support your therapy; reading handouts, books or completing exercises are examples. I also want to make sure there are no medical issues so I recommend you have a check-up with your doctor. I may suggest (and you should consult your doctor before beginning) that you start some form of exercise of your choosing. I sometimes suggest you consider a trial of medication.

I strive to approach your depression issues in a comprehensive manner according to the duration, type and intensity of the depression you have. You can be assured that you will be a part of developing the plan and are always free to discuss the need to change something about this plan.

Grief Recovery

Grief may be the result of a death either recent or in the past. It may be due to a divorce or romantic relationship. While grief is normal and natural is the most powerful of all emotions and is the most neglected and misunderstood experience by the griever as well as those around you.

Grief is the conflicting feelings caused by the end of or change in a familiar pattern of behavior. Conflicting in that some feelings of relief or freedom and as well as pain, fear. Grief can also be due to loss of control by illness, loss of career or retiring, loss of safety as well as other circumstances.

In therapy the first thing I assure people of is I am not going to tell you how you feel nor am I going to say, ”I know how you feel” and neither does anyone else; only you know those two things. I know you have endured painful changes in your circumstances and we’ll talk about what actions you can take to regain a sense of well-being.

While stages in recovery have been the common identifier in determining how to work with grief and where an individual is in their process of grief, everyone has a different experience. The common five stages of grief do not fit for everyone, in fact usually not. An example is that no one really has the experience of denial. At the moment an unexpected death of a loved one, it is common for a short time, to experiences numbness, which is different from denial. Most people come to therapy and say “my mother died or I have been diagnosed with an illness”, there is no denial there. I will work with you wherever you are and help you with the symptoms that you are experiencing.

Grief does have some similarities to depression but it is different in that you also have a loss of hope, dreams and expectations. I do not recommend medications for grief unless you have had 3 -7 or more days of little to no sleep and then it is only medication for a short time to help you get the sleep you need. Loss is painful but working through it to completion with adequate support is the only way to complete the process of recovery.

FERTILITY, INFERTILITY, DONORS, SURROGATES OR ADOPTION

Some of these words can imply difficult and often less than one had anticipated choices. Ultimately the goal is you and your partner decided you want to have a baby! When you and your partner decided to have a child, depending on what your relationship is, there are many decisions that may have come to bear that you didn’t consider. Perhaps you are having trouble getting pregnant; it may be deciding who is going to try to become pregnant and what method of conceiving you will try. It may be you must find a fertility clinic or that you’ve tried getting pregnant and now must find a fertility clinic. Next, you must choose the methods, as well as cost and it may be who is going to be involved or not involved when considering surrogates or donors. Finally, you may have decided on adoption, or felt that that is your last or only choice because nothing else has worked out. All these things that may be involved could be much more stressful than either of you expected or were prepared for. These things can overwhelm and divide relationships if you either have been trying for some time or if it’s is one of the processes of the options mentioned above.

Whatever your particular situation, couples striving to start a family no matter what your method is can be extremely stressful to even the most stable relationships. Therapy can help you sort through and process the emotions and help a couple to find more effective communication. Becoming a parent is exciting but to be a good parent you must still be a good couple and a happy individual.