Depression:Can Psychotherapy Help? (2)

 

Minstrel Man
by Langston Hughes

Because my mouth
Is wide with laughter
And my throat
Is deep with song,
You did not think
I suffer after
I’ve held my pain
So long.

Because my mouth
Is wide with laughter
You do not hear
My inner cry:
Because my feet
Are gay with dancing,
You do not know
I die.

 

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Image: Nik Shuliahin. Unsplash.

Can psychotherapy help those who experience the hellish afflictions of depressive illness? The answer to this question is that it is possible to treat some people through psychotherapy. Obviously, there is no universal panacea, no magic cure and this treatment is not for everyone.

However, there are several kinds of psychotherapy which have been shown through research to help depression. A GP or therapist will make an assessment to help the person decide which modality might suit them. Many have found different forms of psychotherapy helpful. 

There is a combination of factors in relation to the origins and causes of clinical  depression; it has both chemical and psychological origins. Therefore treatment often needs to address both of these, in terms of medical or psychiatric help and therapy. It is up to the individual to decide, along with professional advice, which treatment or treatment combination may be right for them.

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Medication for depression certainly has its place and has been proved to be effective. Indeed, it can be life-saving. Obviously different drugs suit different people, and some work generally better than others.

However, there is still plenty of room for further research:

New treatments are badly needed, the experts say. Most of the drugs in the study are known as SSRIs, which are thought to work by increasing levels of a chemical messenger called serotonin in the brain, but nobody knows for certain. “We don’t have any very precise treatments for depression at this point in time,” said Geddes.

Guardian

 

Dr Tim Cantopher, in his helpful book Depression:The Curse of the Strong, underlines the fact that depression does not happen to weak people. He refers to the increase of stress in our society, which he feels is the commonest cause of clinical depression:

This illness nearly always happens to one type of person. He or she is strong, reliable, diligent, with a strong conscience and a sense of responsibility, but is also sensitive, easily hurt by criticism and has a self-esteem which, while it may look robust on the outside, is in fact quite vulnerable and easily dented. This is the person to whom you would turn in times of need, and they would never let you down.

 

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Keeping quiet about one’s depression can make it worse; sometimes people share with friends or family and that may be helpful. At other times, being able to talk with a professional therapist may be the best way though one’s problems.

The therapist will help look for meaning, for what might lie, psychologically speaking, at the heart of the depression and emotional suffering. Insights may be gained into past experiences that may have been damaging, into negative ways of thinking and destructive behaviour patterns, all repeated in the present.

Long repressed thoughts, feelings and significant dreams can come into consciousness in the accepting and non-judgemental atmosphere of the therapy room.

Sometimes, a depressed person feels so isolated, so alone, in a very dark place. As a therapist, it seems often like a privilege to have someone try to communicate this pain of loneliness, of feeling locked inside, trapped in a dark hole, vessel. or tunnel.

Rather than attempt to ‘pull out’ the person, I wonder if there is any way I can be in there with her, even for a second? Of course I cannot know exactly what it feels like for her, but I have been in my own ‘dark spaces’ , so I know them inside myself.

Having someone even express the wish to be in that terrible place with her, may make the depressed person feel less afraid, less alone. Of course, this has to be handled sensitively and, crucially, with an awareness of timing.

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Issues like unresolved anger, grief, disillusionment, may be explored and worked through in a way that can provide understanding into the roots of the problems. Then perhaps new ways of managing such feelings may be discovered.

Gradually, such understanding may lead to re-evaluation and change, so that old patterns can be broken and new ways of being discovered.

People become trapped in their past, which is very depressing. Coming to terms with long-held feelings and disappointments can be a releasing experience, for these can inhibit personal growth and development. Adjusting to newly-found truths about oneself and one’s past may be difficult, but it often leads to increased energy for life and the wish to move on more hopefully and constructively.

Do you have thoughts about this post? Has psychotherapy helped you with depression? Feel free to share whatever you can in the comments. 

Snap out of it!! How Depression gets Misunderstood.

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‘It Hit Me’ Claudia Unsplash.

I felt a Funeral, in my Brain
I felt a Funeral, in my Brain,
And Mourners to and fro
Kept treading – treading – till it seemed
That Sense was breaking through –
And when they all were seated,
A Service, like a Drum –
Kept beating – beating – till I thought
My mind was going numb –

 

(Extract of poem by Emily Dickinson)

 

The whole of this poem above was recited during a brilliant Ted Talk on depression by the writer and Professor of Psychology, Andrew Solomon. Do watch this; it is both personal and professional and highly informative.

2015 PEN World Voices Festival of International Literature: On Africa © Beowulf Sheehan/PEN American Center

Andrew Solomon (Wikimedia Commons)

‘Anxiety is ‘being afraid all the time but not even knowing what you’re afraid of.’

‘The opposite of depression is not happiness, but vitality.’

(Solomons.)

What Some People Say……..

Often, people with depression say that others around them do not recognise their symptoms and feelings as indications of a ‘real’ illness. By ‘real,’ they often mean physical.

Physical illness might appear more tangible; there may be a rash, a temperature, a visible lesion or wound. People may develop physical symptoms (somatisation) if their depression is not recognised or if they cannot allow the depression to become known, even to themselves.

In his powerful, complex and highly analytical book, ‘Conversion Disorder’, Webster regards such bodily symptoms as a way of ‘not wanting to know.’ His role as analyst is to respond to this, somehow. Not by knowing, but by containing and processing:

‘I prefer to think of my vocation as a psychoanalyst as a quiet liturgy to the power of the symptom, to this intimate world where very little information can be given, even when there is so much to say. Inside this multitude, I see one of the greatest intimacies on offer- one I know daily in the demand turned upon me  by a patient who needs me to know something. Needs me to. With urgency. With great shame, I return this demand to them, even if I supply a placeholder, a stopgap, given to ease the anxiety that hurtles through their flesh….’

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Somatic symptoms can be just as painful  as any other illness. Again, such symptoms may be easily dismissed, seen as ‘imagined,’ rather than as real and genuinely distressing indicators of inner mental pain. If we find a sensitive doctor or therapist, such symptoms should be recognised as the body giving vital clues to psychological ills.

The ‘wounds’ of depression are visible in the depressed person’s weepiness, inactivity, frozen expression or general misery; however these may be downplayed or ignored by others around.

Thus there have developed the expressions snap out of it, pull yourself together, stop being so miserable, you have everything to be happy about.

Many people find depression in others difficult to cope with and they may react impatiently and unsympathetically. Perhaps witnessing depression in another person unconsciously stirs something hidden or repressed inside themselves.

Such unempathic comments will pile guilt on top of the depression. The depression may then be masked.

Masks….

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The term ‘smiling depressive ‘ may refer to someone who is reacting to what they perceive as society’s lack of understanding, or to their own shame; the smile is a cover- up. The depressed person may appear happy and functional in daily life, but the smile hides desperation.

The smiling depressive may feel that their symptoms are weak, that ‘no-one loves a moaner’ and that talking about it will upset others. They may feel that no-one will understand or be able to cope anyway.  So they smile and say ‘I’m fine.’

What are some of the terms popularly used to describe depression?

We hear them often, the expressions used to describe this excruciating illness:

Blues, black dog, black cloud, low, down in the dumps, slough of despond, the doldrums,

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Image:Creative Commons Zero – CCO.

How have sufferers described their Illness?

Clinical depression is a serious and debilitating illness. It is more than feeling sad. The depressed person cannot ‘pull themselves together.’ If they could, they surely would. Do not underestimate how despairing a depressed person might feel.

Those who suffer it have described themselves as ‘Floating helplessly in the middle of a vessel , groping for the sides,’ ‘In a dark tunnel, with no light at the end of it,’ ‘Trapped,’ ‘In a dead end,’ ‘Utterly hopeless,’ ‘Paralysed, static, unable to move or do anything,’ ‘Desperate, isolated and unable to ask for help,’ ‘As if I’m nobody, rubbish, stupid,’ ‘Not interested in anything .’

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Image:Creative Commons Zero – CCO.

Symptoms

There are several different kinds of depression and  it has many symptoms, which might last for any months or perhaps years. Often a depressed person may appear antisocial, cancelling social dates, unable to get up to go to work in the morning, or to get dressed, washed etc. Such is the feeling of utter inactivity, numbness, lack of energy and helplessness.

There may be irritability, low self-esteem, feelings of guilt and shame. Sometimes, people experience low libido, bodily aches and pains, loss of appetite (or perhaps the opposite), inability to think or concentrate, early waking. They might feel the need for more cigarettes, drugs or alcohol in an attempt to numb the pain.

Other symptoms can be sleep difficulties, ruminative and dark and suicidal thoughts, self harm, loss of interest and a lack of motivation. Often there is much anxiety and a sense of impending doom.

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Andrew Solomon said ‘we know depression through metaphor.’ This is an important statement.

Art is a way of expressing such feelings, through metaphor and symbol. Artists like Rothko, Pollock, Van Gogh and Munch all experienced mental illness and various kinds of depression.

These states of mind were expressed through painting and I will end this post with a look at a the work of some of the greatest artists who were able to graphically express their depression in paint:

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Van Gogh. Sorrowing Old Man.

 

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Munch. Melancholy.

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Pollock. Greyed Rainbow. . (Image:Mark Mauno, Flickr.)

Next week’s post is about How Therapy May Help Your Depression.

If you have had depression and feel able to share something of your experience, do please comment below.