Overcoming Depression

Frequently Asked Questions about Depression.

What exactly is Depression?

Depression is best understood, not as an "illness" like diabetes
or influenza, but as a state of chronic mental and emotional exhaustion.
This often results from prolonged anxiety, which is exhausting in itself.
This happens especially when even during sleep, the mind spends
excessive time in dreaming,  trying to process its anxieties, and not
enough time in the deep, dreamless  sleep which refreshes and restores.
It is worse still when both kinds of sleep are insufficient.

Why can't I think clearly when I'm depressed? I'm perfectly intelligent, but I can't
drag my mind away from negative ideas.

Exhaustion prevents the mind from thinking intelligently, causes it to revert to a primitive, "black or white" type of thinking, in which extreme and even suicidal ideas
predominate. Learning to calm the mind as a first step makes, counselling
and other forms of psychotherapy more effective. Hypnotic trance enables new, healthier ideas to be suggested. In depression, ideas of helplessness and hopelessness predominate. Such ideas usually originate from childhood, when we lacked the power and independence we have in adult life.

I know my problems aren't that bad- and other people take much worst
problems in their stride. Why is this?

It is true that some people become severely depressed in response to comparatively minor problems, while others take terrible disasters in their stride. The
difference is not in actual events, but in how the mind interprets and responds to them.

How come people got through the Second World War without needing counselling? Are people just weaker nowadays?

Not necessarily. Problems which drive individuals in upon themselves are
especially likely to cause depression. Problems shared publicly by the whole
community can often be overcome with surprising cheerfulness. This is why
depression is actually less common during major wars.

What is the first step to overcoming depression?

Learning to relax your mind is the first step to overcoming depression. When we are fearful, furious, or anxious, we are less intelligent. The intelligent, problem-solving function of our brain becomes disconnected. We are reduced to animal instincts- dealing with our problems by fleeing from them, fighting them, or freezing. But our lives are much more complicated than an animal's. Fight, flight, and freezing cannot solve the problems we must deal with today.

Why do I feel tired all the time?

You may have had trouble getting off to sleep, or have been waking up too early in the mornings. Even if you had sufficient hours of sleep, you could have had too much dreaming
sleep as your brain sorts out the stresses of the day, and not enough deep sleep where the brain recovers and renews itself. In dreaming, your brain uses as much energy as when you are awake. Thus you are already tired before the day has even begun. If you use drugs or alcohol to get to sleep, hangovers may have added to your chronic tiredness. This tiredness may have led to exhaustion, inability to enjoy life, inability to find solutions to your problems, and finally despair.

What is the next step to overcoming depression?

Having taught you to relax, and to achieve sufficient natural refreshing sleep, the problem-solving stage of therapy can begin, Clarifying and agreeing goals is the first step.
How exactly do you want to be? Imagination is a useful tool for exploring the possible changes you might choose to make. There will be opposition to these changes- often from other people who have got used to you the way you are, but mostly from within yourself- the nagging thoughts that tell you "This will never work... You will always be a failure..." These beliefs are generally derived from childhood. In my experience there is always evidence against these false beliefs- evidence which, with practice, you will begin to notice.

I keep imagining the worst. Is it bad to have a powerful imagination?

Imagination is one way in which we are superior to animals. But if it is misused, it can give us problems which no animal would have. People who are anxious or depressed imagine all sorts of horrors and disasters. You can be taught to use your imagination to experiment safely with new ways to behave, going through a situation in your mind, remaining absolutely calm, until it has become familiar and unthreatening to you. The "Fast Phobia and Trauma Cure" is a special application of this method.

What therapeutic methods do you use, and how long does it take?

Solution Focused Brief Therapy aims to make changes in as few sessions as possible. I use a wide range of well-researched techniques to achieve this. These include techniques of teaching you to relax, let go of unwanted thoughts and feelings, and use your imagination constructively to rehearse new behaviour and create the future you would like to have. These techniques could be called mind training, guided visualisation, meditation, or hypnotherapy. Click on that last link for personal accounts of how clients experience hypnosis, and for an explanation of the misunderstandings many people have about this natural state of mind.

Does therapy involve focusing on my feelings?

Research has also shown that therapy focusing entirely on feelings is less effective than therapy which also looks at thought, imagination and behaviour.* Indeed, therapies which
encourage too much dwelling on the past and wallowing in negative emotions can actually be harmful. Clients who have those kinds of therapies may even find they feel worse! My aim is for clients to always feel better when they leave my office. Research has also shown that therapists who merely listen to their clients are less effective than those who also discuss what they could do differently. * Hence my clients and I often agree "homework" assignments- not written exercises like in school, but new ways of behaving for the
client to try out.

Does a therapist tell clients how to live their lives?

In my private practice I assist clients to achieve goals which they have set themselves. I do not direct the client's life, like a guru. I do not make decisions on the client's behalf, but I will help clients to clarify what consequences may follow from their actions.

Is everything kept strictly confidential?

Like all registered psychotherapists I am required to discuss my work with a small group of
colleagues. This is to ensure that all clients are receiving the best treatment. In these discussions, no information is revealed that could identify the client. I would of course be legally obliged to report anything concerning serious crimes such as terrorist activity or ongoing child abuse, but apart from that, all is confidential.

What if I feel suicidal?

If someone is coming to therapy, I would assume that they basically want to go on
living, despite any suicidal ideas they may also have. I would start by agreeing a practical plan to help them to resist any suicidal impulses.

* The research referred to is summarised in the Handbook of Psychotherapy and
Behaviour Change, by AE Bergin and SL Garfield, published 1994 by John Wiley
& Sons, New York.