Depression: an unwelcome visitor who will not leave

Depression is one of those conditions that everyone sort of knows about. It is surprisingly common to have personally been through a period of feeling a bit depressed or to have known a friend or relative who has succumbed to it. In fact, one in four of us will possibly be affected in some way by depression at some point in our lives. Its symptoms can range from feeling emotionally low and lethargic for periods of time to being completely unable to function in daily life or in some instances not even being able to talk, as in catatonia.


Thankfully, most people’s experiences of depression are not so severe. That said, even mild depression can be a bit like having an unwelcome visitor to stay for far too long and getting in the way - of fun, creativity and enjoyment of a good enough life.

What are the signs or symptoms of depression?

Generally speaking, key signs of depression may include these symptoms, as well as others not included: persistently feeling low to very low in mood, lack of energy, poor concentration, a tendency towards social isolation, decrease or increase in appetite, potential reliance on substance abuse including increased consumption of alcohol or narcotics, negative thoughts about oneself, loss of interest in the wider world, despondency about the future.

What causes depression in the first place?

Depression affects some people when there is a major change, like going through a painful separation or divorce, for example. It may result from having a long-term illness or from missing one’s family who may live many miles away. It may follow after the death of a loved one or at the birth of a baby, in the form of post-natal depression.  

Successful treatment of depression can stem from viewing it as a problem, with being able to deal with anger in our lives. When things get hard in life from time to time, some of us turn not just sadness but also anger back upon ourselves, and this in turn creates depression. Whilst this might read like a neat description or formulation, there can be many different causes for anger/depression, and these will affect people very individually.

But what is depression? Is it just all in the mind?

In the main, medical doctors define depression as a disease. In many respects this approach to depression is helpful because it takes away a sense of blaming a patient for the way that he or she might be feeling: the nature of depression as a disease would suggest that it can just erupt somewhat out of the blue, leaving its victim perplexed and greatly troubled. Most good doctors also recognise that periods of sustained stress in life, or sudden traumatic experiences, can also trigger underlying propensities for depression.

Some other professionals like psychotherapists, for example, who work closely with their patients' emotional and psychological lives, don’t tend to stress that depression is a disease of the mind and body. Rather, they look for causes for depression in their patients’ current lives, paying particular attention to factors causing stress or conflict – or both. Some therapists will look for root causes in their patient's childhood experiences too.

So what sort of help is available for treating depression?

Doctors regularly prescribe anti-depressant drugs to help lift patients’ moods and to enable them to get on better with daily life. It seems that in the past patients worried more about becoming addicted to antidepressant medication. These days there is a wider range of antidepressant drugs that patients can stop taking when ready and with few side effects.

Psychotherapists, psychologists and counsellors take different approaches to depression. Primarily, these practitioners offer ‘talking cures’ for depression without having to resort to medication. Sometimes talking to a therapist or counsellor whilst also taking medication works well too.

Who can be helped?

Professional talking therapies and counselling provide help for men and women, whole families, or individual young adults and children too. It works by being able to express worries and concerns in safe, confidential environments and where patients – or clients as they are also called – are encouraged to speak openly about their difficulties. Less concerned with the status of depression as a disease, these talking cure approaches emphasize that a patient can overcome feelings of depression. The patient is not seen as being stuck in a disease with which they have no control.

How does the help work?

Cognitive behavioural therapy (CBT) encourages patients to rethink negative thoughts and behaviours, turning them into positive ones and where new personal goals can be defined and aimed towards. It is solution-focused and patients are given homework to do. Patients may be assessed each session to see how much progress they are making.

For depressed patients struggling with long-standing or historical trauma, or upset from childhood, it may be that CBT will only provide short-term benefits.

Psychodynamic and psychoanalytic approaches

Other approaches like psychodynamic counselling and psychoanalytic psychotherapy can be especially helpful and effective for people who feel they have had long-standing bouts or periods of depression, sometimes going back to childhood experiences and trauma, and who want a bit of time to explore this, in order to move on with their lives. These approaches are insight-driven, where a patient would be encouraged to explore, for example, why it is that they choose destructive relationships if this is happening.

There is significant emphasis placed on ‘why’ the something that is causing depression is actually happening, as well as finding ways to cope with life rather than becoming depressed.

In psychodynamic counselling and psychoanalytic psychotherapy, it is not assumed that patients always consciously seek out things that are bad for them, but rather that we don’t always understand the less rational, or unconscious, parts of ourselves. For example, growing up with an angry, aggressive parent can lead to choosing a life partner who is also angry and aggressive, because we are used to being around it. But the constant exposure to others' anger can be depressing.

By looking for causative factors, it is common for patients to start to feel they have a better understanding of their depression and to regain some control over their lives after a few months of psycho-dynamic or psychoanalytic psychotherapy.

Depression is absolutely not fun. Anyone who has experienced it will know the misery of feeling trapped in unwanted negative thoughts and feelings. If you, or someone you know, may be feeling depressed: get help. And always expect to receive high standards of professional support and care.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Chesham HP5 & Hammersmith W6
Written by Helen Swords, MA UKCP
Chesham HP5 & Hammersmith W6

Helen is a psychoanalytic psychotherapist and specialist counsellor, supervisor and tutor. Licensed by the UK Council for Psychotherapy, for over 15 years she has worked in the NHS, schools, for commercial business, the voluntary sector and in private practice. Previous careers in broadcasting, arts journalism and teaching.

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