Sometimes people feel depressed and they can easily count the ways in which life is not going their way. They know why they are depressed and can articulate what led to their recent drop in mood. That doesn’t necessarily mean that they can pull themselves out of the depression, but at least they are beginning to put words to feelings, which is a good start.
Other people come into therapy and truly have no idea. They might suspect a possible chemical imbalance that may have led to a change in mood, sudden crying spells, a sense of hopelessness, low self-worth, and difficulty going out and performing day to day activities. Perhaps medication is needed to jump start the neurotransmitters once again to produce serotonin to restore mood balance. Even if medication is indicated, in most cases, therapy can help one begin a process to deepen awareness and slowly lead one out of the doldrums.
Even though the symptoms of depression are similar for all people (since they all meet the diagnostic criteria for this category), everyone has a very different and unique story. It is in the telling of the story that recovery can begin. Feelings that the person did not have time or courage to experience suddenly resurface. Reexperiencing the feelings and understanding the events that led to these feelings can be very beneficial. Also, often times certain negative and faulty beliefs are internalized as a result of life events- these beliefs then lead to a host of negative feelings. It is helpful to have a clinician guide you to reexamine some of these strongly held beliefs and begin to challenge them. For example, some people very early on internalize the belief “others will reject me” or “I am unloveable” and they continue to operate as though it is true across all situations. Of course you’re going to be depressed if you walk around thinking that all the time! Sometimes these beliefs are so strong that the person always looks for the evidence to prove their beliefs true, and they overlook incidents where the belief is actually false. Does this sound familiar?
Another interesting phenomenon, which I find prevalent in depressed patients is their tendency to blame themselves for everything. When they begin to explore the nature of their self-blame they often find that in fact they were initially angry at someone else but were unable to tolerate being angry at this person. Instead, they opt to take the anger and turn it against themselves. I can’t tell you how often I see this. Usually, the person finds anger so threatening that it is easier to hide it from others and even from themselves. It then comes out in an unexpected way, as an unhealthy or self-destructive behavior. In these cases, it is important to discuss the role that anger has played in your life, and your relationship to it. Hopefully, you can have a new appreciation for anger and realize that anger has energy (unlike depression) and purpose when it is used constructively rather than destructively. Try to understand why you might be angry, and see if there is something constructive that you can do about the anger…
Beyond the erroneous beliefs, and the internalized anger which often accompany depression, remember that depression can deepen,humble, and transform you. It takes you to the darkest places within yourself, and forces you to confront yourself, your worst fears and anxieties. If you let it guide you, you will find glints of light that will slowly lead you to a brighter place with a renewed sense of self and an increased sense of mastery. What I find most fascinating is that the way out of a depression is different for each person, and there is always a sense that the psyche is guiding them wisely to their own unique discoveries and opening doorways into new psychological territories.
Between Therapy Sessions 