Treating depression with talking therapies
One common feature of all psychotherapies is the therapist’s belief that she will be able to help modify your feelings, views and ideas about yourself by counseling. A second common feature is that she is not there to find answers to your problems, but to allow you to find your own answers through the technique of exploratory discussion. By developing your own strategies, you will gain in maturity and strength, so forming the foundations for managing your future life.
Psychotherapy is far from being an easy option. It requires motivation, commitment, time and money. It can be emotionally painful but it can prove rewarding and of long-term emotional benefit. Psychotherapy is said to be most effective when combined with medication.
Talking to a friend when you are depressed can be of inestimable value. Some forms of psychotherapy are similar, with the therapist not expected to find solutions or make judgments. Supportive psychotherapy enables you to air your problems as you perceive them to a sympathetic ear. This is a necessary element in helping anyone recover from depression and, ideally, also forms part of any medical consultation for any illness. Many different health professionals are trained to offer this help, including doctors, specialist nurses, counselors, psychologists and health visitors.
People with a phobia can find behavioral therapy helpful. You are gradually exposed to the feared object or situation and shown that you will not come to harm. You learn techniques for dealing with anxiety and panic. After increasingly close encounters with the object of the phobia, you will gain confidence in dealing with it.
If you feel that the roots of your depression lie in your relationship with your partner, marital therapy may be suggested. This gives you both the opportunity to air your grievances, without fear of recrimination, in the presence of an objective third party.
Together with interpersonal therapy (see below), cognitive therapy is at the cutting edge of modern psychotherapies. Cognition describes thinking, memory and perception. Cognitive therapy may be defined as help with how we view events and situations. It works on the basis that as how we think determines how we feel, by modifying our automatic reactions and thoughts, our feelings and moods will be altered.
The aim of this therapy in treating depression is to identify and challenge negative and pessimistic thought patterns with a view to developing more realistic and more objective thoughts. These, by definition, are more optimistic, so your mood improves and your depression starts to lift. If you try cognitive therapy, you will be encouraged to keep a diary to record your moods, thoughts and activities, to challenge stereotypical behavior, to set targets and carry out self-help tasks as homework and to instigate a system of rewards for each small positive step and achievement.
This therapy is especially suitable for problems of low self-esteem and for patterns of destructive behavior, such as uncontrollable anger, compulsive gambling and alcoholism. It is most useful for people with recurrent depression who have developed a negative and self-defeating way of thinking about themselves so that any adversity can provoke a severe depression.
Aimed at improving personal relationships, interpersonal therapy is based on the view that the crucial factor in depression is your social network or interpersonal relationships. These are determined, to some extent, by life events and parental relationships. Three themes can commonly be seen in people with depression: a failure to achieve a safe and harmonious relationship with their parents despite attempts, the experience of being told repeatedly that they are stupid, naughty, unlovable or incompetent and the loss of a parent while still a child.
Interpersonal therapy can help you to explore your reactions to grief and loss, conflicts with friends, family and colleagues, your social skills and any problems you may have of adjusting to major life changes – bereavement, divorce, retirement – with a view to modifying your perceptions.
A group of people, united by the similarity of their problems, can be given psychotherapy together. This can prove helpful in that it shows you that you are not alone and that others are in a somewhat similar situation. Each member can contribute to the progress and well-being of the others by posing questions, offering constructive criticism, appraisal and encouragement.
Key Facts: It is important to talk to someone about your problems and about how you feel. Talking to a sympathetic and non-judgmental professional enables you to air your feelings, problems and worries freely and, through discussion, to work out your own strategies and solutions. Everything that you discuss with or tell to a professional therapist remains confidential, just as it does with your family doctor. Marital therapy is not always focused on reconciliation; it may, in some cases, be used to help each partner to accept separation without bitterness.
Note: Keep a diary to record your feelings at the end of each therapy sessions and access your progress at the end of each month. Do not give up if you do not feel at ease with and respect your therapist; seek a different one by consulting your family doctor. Do not stop taking your medication when you begin a talking therapy as they work best together. Many support groups – alcoholics anonymous, slimmers’ groups, quit-smoking groups and compulsive shoppers’ group – use the principles of group therapy. And all talking cures require time and commitment from you and from the therapist.