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Psychotherapy

Psychological treatment of depression (psychotherapy) assists the depressed individual in several ways. First, supportive counseling helps ease the pain of depression, and addresses the feelings of hopelessness that accompany depression.  Second, cognitive therapy changes the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create depression and sustain it. Cognitive therapy helps the depressed person recognize which life problems are critical, and which are minor. It also helps him/her to develop positive life goals, and a more positive self-assessment. Third, problem solving therapy changes the areas of the person's life that are creating significant stress, and contributing to the depression. This may require behavioral therapy to develop better coping skills, or Interpersonal therapy, to assist in solving relationship problems.
Unfortunately, many poorly trained counselors never move beyond providing supportive counseling. This alone will not eliminate the depression. As a result, the depression, and the therapy, continues indefinitely, with little improvement. Supportive counseling "feels" helpful, and as part of the overall treatment plan does help. But, unless the depressed person makes critical life changes, the depression will continue. These changes are both internal and external. Internal changes are usually needed in problem assessment, self-evaluation, the evaluation of others, and the expectations the depressed person has for himself/herself, others and about life. External changes may be needed in problem solving skills, stress management, communication skills, life management skills, and the skills needed to develop and sustain relationships. 
The length of treatment will vary, according to the severity of the depression, and the number and kind of life problems that need to be addressed. Most people will begin to experience some relief with 6 to 10 sessions, and approximately 70-80% of those treated notice significant improvement within 20-30 sessions.  Mild depression may be treated in less sessions, and more significant depression may require extended treatment. Treatment sessions are usually scheduled once per week, although they may be scheduled more frequently initially, or if the person is experiencing significant life crises.

Medication

Except in the more severe depressions, and bipolar depression, medication is usually an option, rather than a necessity. Antidepressant medication does not cure depression, it only helps you to feel better by controlling certain symptoms. If you are depressed because of life problems, such as relationship conflicts, divorce, loss of a loved one, job pressures, financial crises, serious medical problems in yourself or a family member, legal problems, or problems with your children, taking a pill will not make those problems go away.
However, some symptoms of depression, such as sleep and appetite disturbances, significant concentration problems, and chronic fatigue, interfere with your ability to make the life changes necessary to eliminate the depression. In more serious depression, suicidal thoughts and urges, and preoccupation with death, may require medication in addition to psychotherapy. Antidepressant medication can help relieve those symptoms, and allow you to make needed life changes.  The decision to take medication, in addition to participating in psychological treatment, should be discussed with your treating psychologist and your primary care physician. Your thoughts and feelings regarding medication, after considering information about both the benefits and risks involved, are an important part of a collaborative treatment approach between psychologist and client. If medication is part of your treatment, either your primary care physician or a psychiatrist will supervise the medical part of your treatment, while you continue psychotherapy with a psychologist.  If you have a chronic medical condition or a serious illness, and you are taking medication for that condition, then the medical specialist treating that problem should be involved in your treatment. The medical specialist may supervise all of your medications, or coordinate the medical treatment with the physician providing the antidepressant medications. 

source : http://www.psychologyinfo.com/depression/treatment.htm

Depression is not wrong...

Let's face it, depression feels bad, but what's wrong with feeling bad? We may not like it, but it's not wrong... or right, for that matter. It's just our experience. Unfortunately we seem to have developed the notion that certain feelings are wrong and need to be eliminated, controlled or changed. Part of this belief stems from the fact that we live in a "feel good" society, where TV and the press publicize the idea that anything less than absolute happiness, all the time, should be fixed, drugged or therapized. Another, subtler influence stems from the dichotomous nature of western philosophical thought, itself, which separates mind and body, as well as dividing other things into categories that are mutually contradictory, like good/bad, right/wrong, love/hate, etc. A third, perhaps even subtler factor, stems from the linguistic idiosyncrasies inherent in our language, especially the practice of nominalization, which allows us to turn a process into a thing. For example, we use the word "depression" as if it were a noun with static thing-like qualities, like a bowling ball or an orange. We do the same thing with words like relationship; relationship is not a thing, it's an ongoing process of relating. In the same way, depression is not a thing, it's an on-going process of depressing. Viewing it as a solid thing effectively cuts off our readiness to see its process-like variability. Therefore, what might have been transient uncomfortable feelings seem solid, bad and in need of fixing.


We've been set up...

In a way, we've been set up by these powerful, yet often unquestioned, underlying assumptions. But what if we did ask questions; what if we began to deconstruct this whole catastrophe? What would we find? First of all, if we looked deeply into the nature of the depressive process, we'd discover that our feelings are, in fact, transitory and fleeting; they come and go, much like the weather. Looking deeper still, we'd also discover that it is we who participate in making them rock-solid, permanent and bad. How do we do this? What actually transpires between having a transient feeling of sadness or loneliness and ending up with solid-state depression? Well, besides the cultural, philosophical and linguistic issues already mentioned, it's the thinking mind that gets in the way.

You are what you think...

Thinking, in and of itself, is not a bad thing; it's the nature of the mind to think. From an evolutionary point of view, it's what separates us from other living creatures and perpetuates our success as a species. Our mind's ability to plan, decide, innovate, question, review the past, anticipate the future, and create patterns has kept us safe and thriving; but there's a downside. Thinking can get stuck in a self-perpetuating feedback loop that continues long after the triggering situation has passed. I should also add that this thinking mind does not operate in isolation, as the Cartesian principle would have us believe; it's intimately connected to our feeling body, which is why we feel worse, the more we think negatively about things. Next time an emotional situation comes up, observe what happens in your body and mind. Notice which physical sensations and thoughts arise in direct response to your experience, notice which feelings, thoughts, images, memories, ruminations and worries continue long after the situation has passed, and notice how these thoughts and feelings seem to build and intensify each other through time.

How does this happen...

By way of an example, suppose someone wrongly criticizes you. You initially react with a tightening in the chest or stomach as you recoil into a flood of half thoughts, fuzzy images, partial memories, physical sensations, and emotions. This flurried activity of the body/mind, causes the original tightening to intensify; however, this usually happens so fast, you're barely aware of it. Perhaps, at the moment of impact, you froze and said nothing or perhaps you were flooded with adrenalin and felt rage. In an odd way, however, you've effectively derailed from the uncomfortable feeling that first showed up with the experience. Later, you continue to ruminate about all the "woulda, coulda, shoulda's" you didn't act upon. You may engage in thinking of ways to isolate and avoid this person or anyone like him in the future. Other thoughts or memories of shame, guilt and hopelessness may set in. Here again, the original feeling of distress is lost, but the thoughts and newly associated feelings continue to fuel the pain with incendiary self-talk. As you see, you're no longer reacting to the original criticism, but rather to your thoughts about the experience. Pretty soon the thoughts feel more real than the raw experience and you find yourself immersed in a problem saturated tape loop that seems rock solid, impenetrable and larger than life. And, because we're a pattern making species, these patterns coalesce and become a tightly woven depressive filter through which life, itself, is lived. Unfortunately, the original feeling of discomfort has never been addressed.

Getting out of the trap...

So, how do we get out of this trap? Well, we can start by actively noticing precisely what it is we're doing, thinking, saying and feeling and how these processes interact to derail us from being present with the immediacy of our experience. Just noticing this process is enough to jump-start the change process because it brings an element of consciousness to patterns that had previously been under cover. Working with a therapist can help you acquire the skills necessary to separate experience from your thoughts about experience, as well as helping you develop the courage and willingness to explore the feelings you've been trying to avoid. In fact, modern cutting edge therapies have re-discovered what wise sages have known all along: learning to be present with your feelings, as they arise, without suppressing, denying or acting out in your habitual way, is the royal road to fearlessness and the antidote to suffering. It all sounds so simple, but contacting our deepest fears and the places that scare us, is not for wimps. It requires courage, strength and faith; which ironically begin to surface in a very unique way, as the work proceeds.

Non-fear elements...

Strength, courage and faith are born from experience in two important, yet paradoxical, ways. First, as you stay present with your fears without avoiding, struggling or attaching to your usual story line, you'll find distressing feelings begin to pass right through you... like clouds through the sky. You will have stayed present, touched your deepest fears and not died, which is often our unconscious belief about what might happen. This takes courage, because it feels so downright annihilating to sit through the fire. But the truth is, feelings are transitory and fleeting. Paradoxically then, this act of courageousness brings a recognition of the true nature of feelings. This in turns brings a deep sense of inner freedom, strength and lightness. Nice to know.

Second, as you explore depression, you'll discover brief moments of non-depression, lightness, energy and maybe even happiness. These pockets have been there all along... unnoticed and untapped. They were missed due to the tightly woven depressive worldview I spoke about earlier: when depressed, the whole world verifies this by providing us with experiences we define as depressing. But, the willingness to explore fear allows us to tap into the non-fear components that come along for the ride. The truth is, nothing is as it seems and everything carries with it, its opposite. Also, nice to know. For wrapped up in the unlikely package of fear and depression, is an inner kernel of wisdom, knowledge and even joy. By deeply touching our fear, we come to know the nature of fear as well as the nature of non-fear elements like joy, compassion, patience and generosity of spirit. Nice perks. Now all you have to do is make the non-fear conditions bigger, longer and sustainable and you're halfway there.

Sandra Paolini is a psychotherapist in private practice in Antioch CA. She specializes in treating anxiety, panic, depression and anger and is the originator of "Changework Strageties", a methodology that reflects her ever-evolving understanding of consciousness, change and the human condition. Please visit her website and blog at http://www.sandrapaolinimft.com for more information about this approach.

Article Source: http://EzineArticles.com/?expert=Sandra_Paolini

Depression is unbelievably common. 1 in 4 will be diagnosed with depression at some point in their life and it is the number 1 condition treated by GPs in the UK. Despite the commonality of it, it still carries a stigma of somehow meaning that you are weak and lack mental strength, which is quite frankly absolute nonsense. Depression is completely indiscriminate and has hit some of the most extraordinary and influential people in our history, including Winston Churchill and Charles Darwin.

If you are a sufferer, you will no doubt have realised that it is a pretty horrible thing to deal with. Firstly you will need to admit that you are ill, which is tough. The signs are often subtle and creep up on you over a period of time.
You learn to accept that you feel sluggish, unhappy, irritable and weepy all of the time and make excuses for it just being the way things are at the moment and that in time your mood will lift. Sadly, this is not the case. You can't snap out of 'clinical depression' you are ill and need medical treatment and probably some time off work to rest and get better. You wouldn't hesitate to take time off work if you had a serious illness of any kind, but for some reason we struggle to acknowledge 'depression' as a reason to rest and recuperate.

Some people will only ever get depression at one time in their life, caused by something like a bereavement or childbirth but for some reason, others suffer again and again throughout their life and will need to learn to manage the condition long term. With this in mind, you should know that it is perfectly plausible to hold down a good job and continue to progress through your career with depression. If you are currently suffering with depression for the 1st time you probably think I am talking rubbish, but believe me once the dark cloud has lifted, you will find that you can see things with a better perspective than you have ever done.

My husband has bad asthma. When he has an attack, his breathing capacity is severely restricted. Normally however his breathing is better than mine. He gets a device from the doctor which you use to measure the output of your lungs and he is always miles better than me, except during a asthma attack. Think about this and depression. Yes, in the throws of a severe attack of depression, your mental capacity is poor. Concentration is not good, you will be overly emotional, either irritable or weepy or both and you will have a very pessimistic view on life. Once your mood lifts and you will have inevitably spent weeks or months in self analysis, you will come out the other side, unbelievably self aware, more patient and empathetic. You will certainly have more control over your own moods and emotions and your optimism will return. In effect you will have more control and mental strength than those who have never suffered with the illness.

I have worked successfully with depression for years. It has not always been easy I admit, but it is possible. Every employer is different and you may face some difficulties from those who are ignorant of the condition. Unfortunately this is inevitable. The law however is on your side. In the UK 'depression' is covered by the 'Disability Discrimination Act' (DDA) and as such your employer cannot punish you or treat you differently because you have the condition. Depression is not straightforward however in relation to the DDA, as there are certain exclusions. Firstly depression as a one off condition is not covered. The way the act looks at depression is that you must have suffered or are likely to suffer for 12 months or more to be covered by the act. Employment law is really complicated, but in layman's terms it has to be a long term condition to consider the DDA applicable in your case. The effect the condition has on your day to day life, should be measured within the act as to how you would be able to function WITHOUT medication. If you are unsure, you should seek independent legal advice.

If you feel that you have been discriminated against, you should make sure that you have done certain things. Firstly, you must let your employer know that you have the condition. They are not mind readers, they cannot be expected to know just from your behaviour. If you choose to keep it secret, you have no rights under the DDA.

Secondly, before you take any legal action, you must raise a grievance and give your company an opportunity to address your concerns within their internal processes. If after this you are not satisfied, then you should attempt to take a legal route. This kind of case is very difficult to prove so make sure you keep any documentary evidence and if possible get witnesses who are willing to speak up for you. This is not going to be easy, as these people will still be working for the company and might feel threatened or intimidated by the thought of upsetting their bosses. It is much much better to deal with these things amicably within the company, if it is at all possible.

You could, if the company has this service, ask for a 'Occupational Health' adviser to do a work place assessment to look at the factors present in the workplace, that may have a detrimental effect on your health. Your employer has to, under the DDA make 'reasonable adjustments' to help you manage your condition. I would say it is better to work with them than to make unreasonable demands. A reasonable adjustment might be flexibility over your hours, for example you may have bouts of insomnia and if that is the case, perhaps allow you to start later in the day and finish later. You might be allowed to work from home 2 days a week or work from an office closer to home. Remember that you should still be able to do the job you are paid to do. If your condition means that the job is no longer suitable and after trying to find an alternative position within the company you have not found a job which you can do, your employer can terminate your contract on 'capability grounds'. This basically means you are no longer able to do the job you are paid to do, therefore they do not need to continue to employ you.

I see no reason why, if you have your medication right, you cannot continue to work effectively. You may need to ask yourself the question as to how much of your job is causing you to be depressed. That's a tough one, but the reality is that if your job is the major factor, then you will never be fully well until you change it. You will just be papering over the cracks until the next bad attack.

For more information and self help on depression, my website is www.crazymadbonkers.com

Good luck

http://www.crazymadbonkers.com. I am passionate about spreading the word about depression and how to live a good life with depression as a long term condition. I want people to talk freely about it and not feel stigmatised or embarrassed that they have the condition. I want employers to take more responsibility for the welfare of their people and instead of building HR policy around how to avoid litigation, but to build HR policy around keeping people well and happy at work. I want governments to start to take Depression seriously and realise by raising its profile and managing it better, they can save tax payers billions in lost work hours and productivity.

Article Source: http://EzineArticles.com/?expert=Helen_Leah