Depression: Help and Treatment

Treatment options for depression abound, particularly when one looks at both traditional and alternative approaches.  The most important factor in considering treatment is starting with what appeals to you.  It is equally important to let go of self-judgement about getting help.  As humans, we are naturally an interdependent species; receiving is as natural as giving, although it is not always easy to see it that way at first.  Sometimes we think that getting help is a sign of weakness and that a “stiff upper lip” is in order.  I argue that seeking help is a sign of strength as it involves facing aspects of ourselves (often uncomfortable) that we may have been sweeping under the rug for many years.

What’s Out There

Treatment needn’t be an “either-or” situation.  Many people combine different approaches for a complementary effect.  Some of the most common treatment options include:

  • Counselling or psychotherapy – often a great first step for mild-moderate depression. Cognitive behavioural therapy (CBT) is usually the therapy of choice although other therapies (e.g. interpersonal therapy) can be effective too.
  • Antidepressant Medication – Perhaps the most commonly recommended option, although opinion varies on its effectiveness.  Some consider medications a life-saver while others are opposed philosophically.  It is important, particularly with medications, to assess what is right for you; to go by your guts and not simply others’ opinions.  If you have a trusting relationship with your family doctor, the use of medication may be an important conversation.
  • A combination of counselling and medication
  • Group Therapy – Groups can be either therapy-oriented or educational (skill building). Also, groups will be either peer or professionally-led.  Many people do not feel comfortable in a group context although group work can be an excellent complement to individual therapy.
  • Exercise – Although the importance of exercise can seem like a cliche, research continues to demonstrate exercise’s antidepressant effects.  We know now that exercise is vitally important in helping to regulate mood
  • Bibliotherapy or psychoeducation – learning as much as possible about mood disorders, treatment options and other strategies via books, articles, fact sheets, etc.
  • Healthy diet and vitamin supplementation – Often used as an adjunct to other treatments.
  • ECT (electroconvulsive therapy) – This treatment remains controversial and is generally used in treatment-resistant depression and with the elderly.  Some claim it to be miraculous in treating their depression, working when nothing else would.  Others cite longstanding problems like short-term memory loss (a side effect of ECT) or report that ECT did not work for them. It is typically administered in a hospital setting.
  • Light therapy—A commonly recommended treatment for seasonal affective disorder. Full spectrum or “blue light” is often prescribed.  This is a treatment best done under the guidance of a mental health professional.  Light therapy is generally contraindicated for bipolar disorder as it may trigger a manic episode.
  • Complementary therapies such as relaxation techniques, acupuncture, naturopathic medicine and therapeutic massage, to name a few.

The Willow Tree Way

In my downtown Vancouver counselling and therapy office, I create an individualized plan for change for anyone I meet with.  This means that I do not see my clients as “problems” or “disorders”; rather, each person carries a unique balance of both strengths and challenges.  When depression is the presenting issue, I will often employ cognitive behavioural therapy (CBT) which has been shown repeatedly in the research literature to be effective for the treatment of depression.  CBT looks at converting the distorted thoughts that often accompany depression to realistic ways of thinking and perceiving the world (the cognitive component of CBT).  At the same time, CBT also recommends specific behavioural interventions aimed at promoting healthy change and lifestyle improvements. Improvements in one’s thinking style, as well as one’s behaviour are believed to make a significant difference in mood.  Homework is routinely given to help you make the therapy last throughout the week and to help you achieve change outside of the sessions—in “real life” where applying what you have learned in counselling really matters. For those clients who are not interested in CBT, or for whom CBT has not been effective, I always work with my clients to select alternative therapies to best suit their needs.

As with all my clients, we formally assess both client progress as well as satisfaction with each session every time we meet in order to ensure that the therapy is working well and is making a difference in your life.  Your feedback is always encouraged.

I may make recommendations to supplement your therapy experience, such as additional readings or community resources.  Having goals and staying on track with your goals, is an important part of the counselling experience.

Please call or email me if my approach to helping with depression interests you.  I look forward to hearing from you!