I feel that writing about working with depression is something that needs to be approached with the greatest care and respect. It is to touch on one of the most persistent, ubiquitous conditions to afflict the human condition. Depression is encountered across all the world’s major cultures. The WHO estimate around 5% of the global population to suffer its effects, with women experiencing higher rates than men. Symptoms vary widely, with its potential to affect our physical, psychological, social, and spiritual being. The common, resulting experience might reasonably be captured as a reduced ability to engage with an active, meaningful life.
Here is how we might best approach working with depression together in therapy.
Space to really be heard
The most important place to start is with you – your story, your experience, what’s happened in your life. Each and every person’s experience of depression is their own, incomparable to the next. The particular ways in which its symptoms show up (and, how often) is yours. The depth of its effects on your quality of life will be yours. And, how restrictive it may prove is unique to you. It is likely you already have some personal language and symbols that you describe your experience with, too. There are no assumptions to be made from one person to the next, even if we call it by the same general name.
There are many different ‘theories’ looking to explain where depression comes from. It’s really important to hear what you know already, and how you feel about any of these different views. Most people that come to therapy with the experience of depression already have good knowledge of many. This may particularly be the case if you have tried or are engaged with medications for your symptoms. So, it’s important to make space for your valid knowledge around this, so that you never feel patronised, talked down to.
Expanding your depth and breadth of knowledge, understanding, and expertise
A pluralistic approach to working with depression doesn’t have a fixed theory or agenda about what its cause might be. Instead, we take an open approach to working with you, from the place you arrive at. We explore possibilities, helping you dive into areas of your experience that perhaps haven’t been given full attention before. I will listen out for this in your story, and we can then agree therapeutic tasks that feel right for you.
An example might be for me to suggest we work with feelings. This can assist you to more readily express and be aware of your emotional experience. As some will relate to, depression can imprint a monotonous emotional numbness. Another example might be to work with thought patterns. This can help you stand back a bit from those negative cascades of thinking. One more example might be to work with social, cultural, and political factors. Sometimes, it is the relentless grind of the ‘system,’ factors outside you, that merit focus for their negative impact.
The overall goal is to add depth and nuance to the totality of your understanding. And, to do so with kindness, consideration, and understanding. The deleterious effects of depression, the way it often limits what we can do, can create feelings of guilt and shame. I consider what a person can do when battling depression to merit quiet respect.
Expanding possibilities
Intertwined with expansion of knowledge, understanding, and expertise is gentle consideration of possibilities for change. This is to test out things that have proved helpful for others, that you perhaps haven’t yet tried. It might be, for example, inviting you to see your experience of depression from an alternative perspective. This can in turn invite a little breathing room from symptoms. Another strategy might be to engage with manageable, specific behavioural changes. Think of these as experiments, challenges, games… whatever language makes sense in your life. We can negotiate these, and monitor them, together.
There are many people that have benefitted from therapy for depression. It is frequently reported to increase their understanding of its symptoms, and help with their management. Some even free themselves from it entirely.
In closing
If there’s anything here you’d like to know more about, or would like to work together in a therapeutic way, you’re welcome to be in touch. For available resources and community in Denmark, I recommend you explore Depressions Foreningen. In the UK, as a good starting point there is the Mental Health Foundation. Further, for those in Denmark, I hope it’s helpful to remind you that your doctor is your first point of contact for state-led healthcare. I wish you solidarity and strength on your journey with the experience of depression.
