Stella Marklew MBACP Reg (Accred)

ARTICLES

Who would come to counselling and therapy?
Why antidepressants may not work for you
Is Depression a Mis-diagnosis of itself?

Who would come to counselling and therapy?

Most of us would believe that we are able to resolve anything that happens or comes into our lives, and for the most part that is most likely true.

Anyone can find themselves in a situation they don't understand but when that repeats itself, causing us repeated unhappiness in our lives or when we find ourselves feeling isolated with those closest to us or work being the problem - finding solutions can be difficult and the situation may go on for a long time, sometimes years.

The feeling that we are unable to speak about things to the person/s concerned or discuss thoughts and fears with someone else locks the ideas and emotions in our heads. Hearing ourselves say things enables us to begin unravelling multiple and complex issues or start to make sense of what is going on.

Understanding where it all started helps us to see why we respond in certain ways, how this may be helpful to us (or not) and link ideas to emotional responses in a way we may not have realised we do.

Thoughts, memories, emotions, responses, decisions all happen in our brains. Our experiences provide the memory base we automatically refer to when something happens - we don't think about the mechanics of taking the top of our boiled egg, autopilot takes charge. And so it should for the most part or we wouldn't achieve much in our day.

It's when autopilot takes over with an unconscious decision that we first made when we were aged 6 that it may be unhelpful. A simple example could be that if aged 6 we experienced shame because we hadn't understood the homework and there was laughter in class when we proudly produced it the next day, later in life making presentations may be the cause of much anxiety.

Sometimes we need to look at the hard wired decisions we make that keep us and our lives in places we don't intend to be.

So who would come to counselling and therapy?

Anyone.

Why antidepressants may not work for you

If you have made an appointment to see your doctor, been given a prescription for antidepressants or other medication, have been taking them and still don't feel any better - there may be a good reason why.

The reasons could also be multiple. Perhaps you don't feel you've been heard. GP's have a 5 -10 minute slot for your appointment during which you will need to talk about what is troubling you, the GP will tell you whether they will prescribe something or not, after which what happens next will be discussed - you may come away feeling that you haven't really been heard or that it wasn't possible for you to talk about the problem properly.

You may feel that the medication has added to your problem; feelings of lethargy, lack of concentration, libido has been affected, weight gain due to eating more and not feeling like moving out of the chair or bed very much.

You may not feel able to think properly since taking medication or feeling "numb" or even "zombied". If we can't think then we can't resolve anything and this can feel frustrating - sometimes a return to the spiralling thoughts may feel preferable.

It could be that a short period of a medication can help to "rest" from excessive thinking and worrying and may even sometimes be of help before starting of a course of counselling or therapy.

What the medication is trying to do is help us sustain good feelings and prevent our brains from going to places where we are unhappily worrying about things we feel we have no control over.

With help to explore the content of the thoughts, not being alone with our difficulties, getting support with painful feelings - we can begin to sustain our good feelings which will go to make us begin to feel happier.

Medication doesn't have to be forever.

Is Depression a Mis-diagnosis of itself?

There has been a great deal written in the press recently around depression and how it affects people, followed by defensive responses from mental health support charities.

Perhaps none of this is particularly helpful to the person who has depression and it certainly can't be for their families.

Depression isn't just depression, which in itself is symptom of a much larger picture. In a society where everything has to have a name, a diagnosis and a solution we have found a way of neatly categorising a complex and debilitating situation that many people find themselves in. Someone, somewhere decided that we will call it depression.

The reality is, it's not that simple. Depression falls into three different categories; clinical depression (an imbalance of chemicals in the brain that can be effectively treated with medications), life event depression (an expectable response to tragic life event; bereavement, loss of health or wealth etc) and lastly the inability to hold on to enough good feelings about most things in our lives.

It isn't that people with depression don't have any good feelings at all, it is that their good feelings evaporate rapidly and are just as quickly replaced by unhappy ones. The evidence of bad things, painful experiences and therefore the forecast of a doom laden future make most things seem pointless. When everything we touch feels as though it will turn to hurtful dust, there's not much to look forward to when getting in the morning. That in itself is sad making.

If this seems as though anything we look at turns into another problem, then that is what depression is. The feeling of stuckness in hopeless state - it's just too long to write on a sick note and it doesn't exist in the Diagnostic and Statistic Manual of Mental Disorders that psychiatry evaluates the human race by.

It's what I call swedes and turnips choices, anyone can choose champagne, caviar, holidays in the Bahamas etc, no problem. But who wants to have to decide between choices they don't want in the first place? And that's where life becomes really hard.

Hypothesis; you have a job which causes stress and worry, you can't sleep at night and develop anxiety from the responsibilities, during the day you have headaches and start to develop unexplained body pain. You go to the doctors and get a prescription for anxiety but you still can't sleep so you start having a few drinks in the evening to help you "relax and go to sleep". You feel guilt about your alcohol consumption.

You would really like to leave your job and go back to doing a job you had earlier on in your working life that was much more fun but didn't pay so much, you can't because there's the mortgage to consider and your family.

Waking up in the morning is becoming harder and the family feel like they always need more than you have inside you and the money you have in the bank, so you start to avoid them. Your friends seem like they have everything worked out and you feel shame or don't want to burden them with your troubles.

By the time we get to this point, all avenues are starting to close down and the world begins to look like a dark place. Allow it to go on much further and we can see how paranoid thoughts and other troubling issues may begin to come in to the equation.

If this seems a little long winded, it's because I don't think "depression" is adequately long. We need more words to sufficiently address this painful problem, not diagnosis and prescriptions.