Depression: what can you do to help someone?

Firstly, let’s look at what depression is: 

"Depression negatively affects how you feel, the way you think and how you act. It causes sadness, and/ or a loss of interest in activities you once enjoyed, it can lead to emotional and physical problems and can decrease a person’s ability to function in work or at home." 

Approximately 1 in 4 people in the UK will experience a mental health problem each year. In England 1 in 6 report having a common mental health problem (anxiety/ depression) in any given week. (Source: mind.org.uk).

What can we as practitioners do to help someone with depression?

First, we need to have knowledge of the symptoms of depression in order to be able to provide a treatment plan for our clients.

Some common symptoms are: 

• Feeling sad or depressed mood
• Loss of pleasure in things they used to enjoy
• Changes in appetite (eating more or less)
• Trouble with sleeping (getting to sleep or staying)
• No energy
• Feeling worthless or guilt
• Difficulty concentrating
• Irritability
• Thoughts of suicide

The client needs to have these symptoms for at least 2 weeks for a diagnosis of depression, and a counsellor will recommend that they visit a GP to discuss medications if necessary.

When we think about helping someone with depression it is important to consider how low they are presenting in therapy, how long they have been feeling this way, what are the risk factors, do they have support mechanisms? A recommendation to visit a GP to discuss anti-depressants would always be an important therapeutic practice for me if I have had any concerns to the answers above.

Depression can be difficult to work with at times, due to the lack of motivation/ energy that a client is presenting with, this is why it is important to take small steps, and to work at the clients pace, whilst applying some degree of challenge in order for therapy to be beneficial.

It is important to educate your client on what depression is, statistics, and how it is affecting them within their life. This brings about some normalisation for the client, they are not the only people to feel like this, and they are not going crazy.

Coming from a cognitive behavioural background, I would then look at addressing some of their negative thoughts, these normally are statements like: "the future is hopeless; I am not worthy; I am boring; others do not want me around; people would be better of without me".  These thoughts do not help someone experiencing depression and will cause them to ruminate and continue deeper and deeper into depression. I would help a client identify these negative thoughts and show how they are unhelpful and help them challenge the truth in this. Therefore, helping them to change the way they are thinking about things.

It then is important to get your client up and about, depression causes a client to do very little, withdraw, and avoid. I would look at what a normal day to them is currently and then check out how much pleasure and achievement they are getting within each of the activities. Normally to begin with a client will describe their current activities: lying in bed, watching TV, avoiding people or jobs, within this they will describe little or no achievement or pleasure. Therefore, it is my job to highlight the continuing negative cycle their current behaviour is having on them and begin to implement changes into their daily routine. To do this, I need to know what they used to do and enjoy and gradually filter in activities for them to carry out daily. Starting of small will usually help the client to achieve. Working your way up with the client to the harder things, like going back to work, mixing again with people. However, a client will achieve this if they gain the evidence from the pervious tasks and can see the difference it is making to them.

Self help books can also be beneficial for clients, I would use Mind Over Mood by Dennis Greenberger and Christine Padesky, or Overcoming Depression by Paul Gilbert. This helps give the control back to the client and help them to understand that they have the power to change how they feel.

Depression can be slow to work with at times, however the difference some of these tools discussed above can make are overwhelming. The client will see a change and the change will motivate them to push themselves further. Yes, set backs can happen, but encouragement to begin again will bring the client back to their journey.

"Although the world is full of suffering, it is also full of the overcoming of it.” - Helen Keller. 

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