DEPRESSION AND PSYCHOTHERAPY
Problems with sleeping, loss of energy or appetite, decreased sex drive --- these can all be possible indicators of depression. Depression can at times leave people morose, self-deprecating, and with a despairing view of themselves or the world. Sometimes depression can affect appearance, producing stoop posture or a downcast gaze. And depression often runs in families. It's estimated that some two-thirds of people suffering from major depression consider suicide and a shocking ten to fifteen percent succeed.
Having worked with many people who struggle with a range of depressive symptoms, I find that psychotherapy can provide significant relief and help people re-engage with family, friends, work, and pleasurable activities. And for many people, in addition to therapy, medication can play a significant role in getting back on their feet.
I'd like to share with you two examples of people I've worked with who were suffering from depression. I've changed their names of course to protect their privacy.
Ellen came to see me because she'd had an abortion, and although she knew she'd made the right decision, she found that after the procedure she felt "very blue." She'd always considered herself fairly happy-go-lucky. But now Ellen wasn't able to feel much pleasure, and her lack of sleep was only compounding her discouragement. At 31 she'd already achieved signifcant success as an architect, but was finding that even her work was no longer engaging. Ellen was very clear during her initial consultation that she wanted to see me twice a week and she would not consider medication. She said she just needed to mourn her loss and feel her sadness. And for the next six months, that's exactly what she did. Ellen and I occasionally explored some of her earlier family experences that contributed to her despair. She also at times talked about her on-again and off-again relationship with her boyfriend and about disappointments at work. But Ellen primarily came in to grieve, to cry, and to talk about her depression. Over the course of our half year together, her mood started to lift. Ellen began reconnecting with her friends and finding more pleasure at work. As we were winding down our sessions, Ellen reflected on how surprised she was that she could dip so far down, but could then return to feeling much more like her old self.
Michael started therapy because, at age 29, he knew he didn't want to end up like his father who'd committed suicide the year before. Michael reported that his dad had always been distant and morose, and that Michael was aware of sharing these characteristics. In fact, Michael noted that for as long as he could remember, he'd always felt this way --- viewing the glass not as just half empty, but almost completely empty. After our first two sessions, during which Michael described these feelings at length, I recommended that he see a psychopharmacologist in order to consider medication. Michael knew that this was a good idea, and agreed that I could speak with his doctor, so that the three of us could be a team in helping him combat his depression. Michael's work these past two years has been slow but steady. We spend a good deal of time talking about his strong identification with his father, and Michael has become increasingly aware that he grew up learning many coping strategies from his dad --- strategies that in fact end up reinforcing his own depression and keeping other people at bay. Michael now often sees the glass as half full. At the same time, he knows he needs to continue therapy, because he finds that our work together helps give him the courage to reach out more to others for comfort when he feels his mood dipping.
As with Ellen, depression is sometimes the result of a specific incident. In Michael's case, his depression was more linked to his family makeup. For both, therapy has helped them find their footing and become more engaged in their lives.