Depression: A Treatable Problem
Carlos Durana Ph.D., M.Ac. offers counseling and therapy in Reston, Virginia, Washington, DC, and Bethesda, Maryland.
Most of us experience some type of depression as we face life’s challenges. Depression can be mild, moderate, or more severe, as in the case of a clinical depression. At its worst, a depressive disorder can interfere with our ability to work, eat, sleep, and enjoy life. A person can experience one or more depressive episodes; symptoms may include sadness, hopelessness, helplessness, irritability, fatigue, changes in appetite, guilt, worthlessness, and thoughts or attempts of suicide. Depression is a treatable problem, and individual counseling or therapy is an effective way to treat depression.
Depression can be characterized by persistent, pessimistic, and faulty views of oneself and the world. These views are faulty because they exhibit a negative or biased attitude towards oneself and the world. They distort the processing of information. In counseling and individual therapy, I see this when a client regularly magnifies or exaggerates the importance of undesirable events and minimizes or dismisses the significance of positive events.
Aaron Beck uses the negative triad cognitive theory of depression to describe three key elements present in depression; these include:
· Negative views about the world
· Negative views about the future
· Negative views about oneself
Negative views about oneself: The person dismisses accomplishments and positive attributes as minor or unimportant. Problems are seen as stemming from an inner deficiency, unworthiness, or unlovableness. This makes it difficult to see oneself as capable of success or to feel good about oneself. There is an expectation of failure – “I don’t have what it takes,” that makes it very difficult to experience pleasure, joy, and life’s rewards.
Negative views about the world: Our biased views will misinterpret the care and good will of others. We anticipate and predominantly see rejection and indifference from others. We may experience the world as overwhelming filled with pressure, thus rendering our efforts, actions, and goals as ineffective and unimportant in affecting the outcome of events.
Negative views about the future: Our pessimism creates a sense of helplessness and hopelessness which paralyzes our action and our will. We expect our efforts to result in failure or catastrophic outcomes – “Tomorrow will be like today or worse, my troubles will go on forever, nothing much will change.”
The goal of cognitive behavioral therapy (CBT) is to address this triad. Developing effective and successful ways of thinking and behaving will create positive feelings and experiences of oneself, the world, and the future. In my own counseling and therapy work, I use a caring and supportive mindfulness-based cognitive behavioral therapy to treat depressive disorders. I work together with the client to attain a better and brighter life and achieve desired life goals. With an integrated and comprehensive approach, we work together to transform faulty or distorted thinking patterns, enhance self-esteem, learn effective life coping strategies, and enhance wellness and positive feelings.
The use of CBT helps transform the biases and distortions that cause so much suffering. In addition, mindfulness helps one learn to manage difficult emotions, to deal with the inner critic and the negative beliefs/thoughts. CBT encourages positive thoughts, feelings and behaviors, while research on mindfulness-based CBT suggests that it is just as effective as medication in relapse prevention.
I have also seen the benefit of using exercise as an effective tool in treating depression and preventing relapse. My experience is now supported by ample research on the benefit of moderate exercise in preventing the reoccurrence of depressive episodes. The positive feeling experienced after exercise (the “runner’s high”) is a result of the release of brain chemicals. Our brains and bodies are designed to release rewarding chemicals that make us feel good. Regular exercise improves mood, confidence, and reduces stress and negative thoughts.
Medication can also play an important role in the treatment of depression for those with more severe symptoms who do not benefit solely from therapy and life style changes. Medications are not magic bullets; they carry benefits as well as risks. Only 30% of people with depression go into full remission after taking medications .
I also teach and encourage the use of methods to help improve relationship skills, develop healthy lifestyle habits (enjoyment, pleasure, social life, nutrition, etc.), and to pursue actions and meaningful life goals that strengthen a positive sense of self. In my years as a counselor and therapist, I’ve learned that for some people, recovery from depression may also entail exploration of meaning, life purpose, and spiritual concerns.
Carlos Durana, PhD practices therapy and counseling in Bethesda and Reston.