Depression: A Counselor’s Perspective

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{My good friend Diana Cloud joins us today, lending invaluable perspective on the disorder as a mental health counselor.}

I have yet to meet a fellow human who can’t relate to the feeling of sadness. We have all had times where our thoughts, our other emotions, and our behaviors were clouded with this emotion. In fact, sadness is one of the five core emotions that we’ve all been acquainted with since birth. But a momentary feeling of sadness that blows away with the lapse of a short time (usually a couple of days) is different than the heavy and dark cloud of depression that hovers over the lives of nearly 8% of people in the United States who are 12 years of age and older. (Center for Disease Control, 2015)

Unipolar depression, i.e., depression that occurs without manic or hypomanic episodes, as seen in bipolar disorder has many “faces”, and I have never had a client with the same mix and match of symptom experience and expression. Genetics, age, gender, physiology, temperament, cognitive development, co-occurring mental health issues, environment, lifestyle, culture, past and present trauma experiences, stress, social support, and spirituality are all factors that impact one’s experience and expression of depression.

Many depressive disorders fall under the “depression” umbrella, such as: disruptive mood dysregulation, major depressive disorder, persistent depressive disorder and premenstrual dysphoric disorder (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Association, 2013). Depression can occur with anxious distress, low intensity mania or manic symptoms, psychotic symptoms or melancholic symptoms (almost a complete absence of the experience of pleasure). The disorder can also have a seasonal pattern or occur during pregnancy or during the 4 weeks following delivery. Finally, depressive disorders often co-occur with other mental health disorders.

All depressive disorders feature a persistent mood of sadness, emptiness, or irritability, occurring with physical and cognitive changes that cause either significant distress or significant impairment to a person’s ability to function socially, at work, or in other important areas of life (APA 2013). Mental health workers look at the intensity (symptoms may be mild, moderate, or severe), persistency, and consistency of the symptoms (the symptoms exist in most or all contexts of life) and the presumed cause of the depressive disorder to determine an appropriate diagnosis.

Most people are aware of the cognitive and emotional impact of depression. People who suffer from depression often mentally process themselves, the world, and their future through a negative lens, and experience intense feelings of hopelessness, sadness, etc., along with those thoughts.

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Many people are not, however, aware of the physical symptoms of depression. For two of the most common forms of depression, major depressive disorder and persistent depressive disorder, these symptoms include: an increase or decrease in sleep, diminished interest in life, i.e., hobbies, activities, and other interests that are usually pleasurable, feelings of guilt or worthlessness, poor energy, difficulty concentrating, increased or diminished appetite or significant weight gain or weight loss without dieting, psychomotor agitation or retardation and suicidal thoughts.

If you think you may have a depressive disorder, it’s very important to seek professional treatment. Research shows that untreated depression can lead to greater impairment in the future. The most common forms of effective treatment are antidepressant medication therapy and/or counseling; specifically, Cognitive Behavior Therapy or Interpersonal Therapy. Some people may also find help through specific nutritional supplement therapy. Less common, but sometimes very effective treatments for depression may also include electroconvulsive therapy (ECT) or transcranial magnetic stimulation.

As Christians, we must use the Word of God to help us evaluate the negative thoughts that contribute to our feelings of sadness, hopelessness, worthlessness, etc. However, because some of these thoughts are rooted in what we call “core schemas” (deeply-seated beliefs that are typically developed at an early age and often operate on an unconscious level), it is helpful to have a Christian counselor assist us in the evaluation, challenge and re-construction of our thoughts/beliefs. Often times, taking an antidepressant medication (if you suffer from a more moderate to severe level of depression) can offer us enough symptom relief that we are able to do this challenging work with a counselor.

It is also important to combine any therapeutic treatment with consistent and frequent aerobic exercise, frequent exposure to daylight, consistent and adequate sleeping habits, a healthy diet and annual physical examinations from a physician. Additionally, engaging in worship and utilizing music can prove to be excellent remedies. Finally, research also indicates that working to establish an attitude of thankfulness and humor can also help us effectively cope with the difficulties of managing depression.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Washington, DC: Author.

Center for Disease Control Retrieved online October 2015 from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6051a7.htm?s_cid=mm6051a7_w#x2013; United States, National Health and Nutrition Examination Survey, 2007-2010</a>

Suggested Reading Materials:

Mind Over Mood by Greenberger and Padesky

The Bible Cure for Depression and Anxiety: Ancient Truths, Natural Remedies and the Latest Findings for Your Health Today Audio CD – Audiobook, CD, Unabridged by Don Colbert

The National Institute for Mental Health http://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399

The Mind Connection by Joyce Myers


 

IMG_0737Diana Cloud is a 16-year “seasoned” wife who is still learning about the different “seasons” of marriage, a mother of two who has misplaced her “super mom” cape, and a daughter of the gracious, Most High God. Having fought depression and anxiety most of her life, she is also a university mental health counselor, who prays she is making a difference. Diana enjoys running, fellowshipping with her girlfriends, eating Mexican food, mowing the lawn, and worshiping God with music.

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{Navigating Depression: What Every Woman Needs to Know} is a month-long blog series devoted to the disorder. Read stories of women who have traversed its stormy seas. Receive encouragement and be equipped for your own battle against the darkness. Garner understanding, bleeding empathy for afflicted loved ones.

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