Depression Q+A

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Psych Central | Press Contribution, 2018

What are some important questions that you ask clients who are struggling with depression?

I always ask my clients about any notable changes in their mood, their thoughts, and their overall habits. For example, it is important to find out whether people are finding their daily routines progressively unmanageable or overwhelming; have they noticed a change in their sleep or appetite, or libido? I always ask about their relationships with both close friends and family as well as coworkers or classmates, etc. A hallmark of depression is a gradual interpersonal withdrawal and difficulty maintaining contact with other people. The most important question to ask when a person presents to therapy reporting depression is whether they have thought of suicide or self-harm, and whether they have a plan or any serious intent to attempt it. It is important to be very open and direct in assessing for suicide and self-harm to be sure that people feel validated, not judged. Having thoughts about death is not always a cause for concern but a sense of hopelessness and a lack of a vision for their future is.

How can clients with depression take care of themselves without giving into depressive urges i.e. the balance between sleeping more if tired, but what if oversleeping is contributing to the depression?

I think it becomes a delicate balance for each individual when caring for themselves to be sure that their actions are serving to relieve versus trigger depressive thoughts or feelings. For example, if someone knows that staying indoors tends to exacerbate feelings of loneliness and guilt, then “Netflix and binging” would not be an appropriate self-care strategy. It takes some planning and self-awareness to make sure that the self-care options they’re choosing are going to feel good or bad in the end. We tend to know what will give us a confidence boost and if we find ourselves choosing the opposite of that, then its not self-care. 

What are some of your top tips for someone who is struggling with depression?

I would absolutely advise someone struggling with depression to try and confide in close family or friends who they know will be supportive. Then I would say find a therapist! Ask around, do some research and if that feels overwhelming ask a trusted physician or other health/wellness provider for recommendations.

What are some coping strategies that you might suggest to someone who is struggling with depression?

The most helpful coping strategy again depends on the person and the things that they’d find uplifting. However, physical activity, healthy eating, spending time around people are pretty universal in alleviating depressed mood. Interpersonal contact relieves loneliness and hopelessness better than anything else so I’d say try as much as possible to push yourself to be more socially active. If those are too hard, then it might be a good time to talk with your doctors about medication to help boost energy levels and decrease negative mood/thoughts.

If someone is struggling with depression and feels like nothing they are trying is helping, what would you say to them?

I would say don’t give up! There are SO many options out there to treat depression that it’s very likely you just haven’t found the right one.