I tend to focus on how clients can start structuring their time and getting back to activities that are gratifying. I want them to start reconnecting as soon as possible with the sense that they can enjoy things and feel effective again. As a long-time family therapist, I was always interested in how we interact with our environment. We explore the inner world too of course…we just don’t want to set up camp there when we’re down.
When depressed, we tend to become ruminative. It is as if we apply the mind to a problem of the mind…which is like trying to extinguish a fire with fuel. Meanwhile, the depressive rumination is a way to avoid things we don’t want to do but which may make us feel better in the long run.
Often, I want to help those with depression connect with emotions. Ironically, depressed people, while sad, are not always good at experiencing or expressing sadness fully. Sometimes you have to swim in the river to reach the other side.
I have the view that we tend to flee from sadness, grief and pain, which really are fully wholesome emotions and unavoidable in any full life. For sure, some of us become too steeped but on the other hand don’t want to repress it.
Is medication recommended? Sure, it might be. I can work with you on how you take it, how you manage any side-effects, which antidepressants you might want to discuss with your doctor and so on. I also work with many people who come through depression counseling only.