Category Archives: Depression

Seminars for Therapists: Working with Depression, led by Gill Bannister – 26th September 2015

On a clear, sunny autumnal Saturday last week, I was treated to a full day’s seminar on depression… the conflict of light and dark didn’t pass by un-noticed and in fact resulted in a feeling of optimism and lightness – a surprise considering the darkness and negativity of the topic.    Gill Bannister delivered her seminar with feeling and containment – two very important aspects of a therapist’s role when working with clients with depression.

Gill’s 30 years experience as a psychoanalytic psychotherapist working with depression in clients was delivered in a style in keeping with her classic training, enabling us to have time and space to think, to sit with ourselves and our difficult thoughts and feelings, allowing a process to occur.   Gill believes that depression is a result of a client experiencing loss.   The depressed client suffers from a lack of self esteem, often projecting a super-ego which is rejecting, despising and attacking.

The experiential element of the seminar was invaluable, thinking and sharing thoughts, Gill challenged us to confront our own assumptions, experiences and prejudices around depression.  A word which is now loaded with a vast array of interpretation and stigma.    We were guided through the day with exercises and discussion which enabled us to experience the core essence of working with depression in the therapeutic room – trying to get in touch with our client’s inner world.  By experiencing a 30 minute solo role play, I felt more connected and understanding of my client’s depression than I had done before and will be processing and using these insights future sessions with this particular client.

An enlightenment of depression…. most valuable.

See our future seminars at our website www.wendybramham.co.uk (seminars tab)

by: Jo Turner

29 September 2015

This seminar was assessed by attendees as 4.69 out of 5 for the overall quality of the event. The speaker was rated 4.75. Thank you to all who attended this and previous seminars, we appreciate your participation and your feedback.

Depression (blog 3) – Getting help, by Lindie White

lindie white

Lindie White

In the last of our blog series on depression, psychotherapist, Lindie White, writes:

Most people need help when they are depressed or have prevailing sadness and low mood. If we can’t acknowledge this when we’re suffering, then that’s part of the problem! The essential first step is to name your depression to yourself and someone else. When it is acknowledged, then what?

If you go to a GP you will be offered medication and/or some kind of talking therapy.
Medication can help some people, sometimes, although some find that anti-depressants don’t help at all or are not enough on their own.

Therapy really does help tackle depression and there are many different kinds of talking therapies on offer. Most commonly available through the GP is Cognitive Behavioural Therapy (CBT), often delivered by an in-house counsellor. This aims to address negative, self-destructive and ‘untrue’/unrealistic thinking patterns. Other therapies include psychodynamic or psychoanalytic – stemming from Freud and Jung’s thinking about the unconscious – and humanistic or person-centred – focusing on helping the client find their own answers. All therapies have different emphases and have been developed as people discovered that no one method serves all people or meets all needs.

Research has consistently found that what makes the real difference is the therapist rather than the therapy. So, do some research, see what appeals to you, and trust your instinct as to how you ‘fit’ with a particular therapist and how the first one or two sessions feel. A good therapist will facilitate this sort of discussion.

The following are important factors in successful counselling and psychotherapy:
• a good working alliance between therapist and client
• a therapist who listens well and is responsive and flexible within reason
• a therapist who displays qualities of empathy, warmth and care
• an agreement between the client and the therapist on the goals of the work
• a client who is highly motivated for change and relief of suffering
• a therapist who can enable the client to experience calm if the client is highly aroused with anxiety or other emotion

A key point in dealing with depression and its recurrence is that it is our emotional reaction to our emotions that keeps them going and complicates them. We can exercise choice about our reactions when we have greater awareness and can fully engage our will to heal ourselves.

As practitioners and clients, we need to keep exploring better ways to find this healing and bring a natural, organic quality of enjoyment and engagement to our lives. A recent development has been to integrate insights and practices of Buddhist-based mindfulness, yoga and meditation with more traditional talking therapies. (See The Mindful Way through Depression, Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segao and Jon Kabat-Zinn, Guilford Press, 2007.)

Many people are also helped by complementary therapies, an approach we promote at Wendy Bramham Associates. Acupuncture, homeopathy, massage, nutrition and chiropractic are all useful for different issues, so explore what appeals to you.

Whatever path of therapy you pursue, do your research and follow your own instincts, hints and leads. Each of us makes our own path by walking it, connecting and disconnecting with others as we do so. And if you feel so low that you don’t know where to go, ask yourself what might appeal if you weren’t feeling so depressed and follow that, maybe with the support of someone you trust. Therapy is a powerful tool for combating depression, so have courage to take the first step and seek help.

See previous posts on this blog for more information about types of therapy, the effect of life choices, how therapy helps and book recommendations.

We particularly recommend the following books on depression and how to live with and through it:
Depression – the way out of your prison, by Dorothy Rowe, Routledge 2003
Living with a Black Dog, by Matthew and Ainsley Johnstone, Pan Macmillan Australia, 2008
First Steps out of Depression, by Sue Atkinson, Lion Hudson, 2010
The Endorphin Effect, by William Bloom, Piatkus, 2011

Plus, on spirituality:
The Power of Now, by Eckhartt Tolle, New World Library, 2004
The Power of The New Spirituality, by William Bloom, Piatkus, 2012

And an audio CD for guided meditation:
A Meditation to help you relieve Depression, by Belleruth Naperstek, Health Journeys, 1993

Depression (blog 2) is a wake-up call – by Lindie White

In the second in our series on depression, pyschotherapist, Lindie White, writes about the causes of depression:

‘Every cloud has a silver lining’ and, as I wrote last month, with help we can make the cloud of depression our guide and our friend.

Proverbs carry much folk wisdom and the common sense we all share by virtue of being human. As humans we are hard wired for pleasure and pain and the whole gamut of emotions. We arrive in this world programmed to seek life, food, warmth, comfort and with the predisposition to attach and relate. How does the experience of depression sit with these facts? I wrote in last month’s blog about the experience of depression. This month I’m writing about the causes of what we call depression.

Depression is generally labelled a mental health problem and still carries a stigma although many well known people have spoken out about their own experiences: Stephen Fry, Richard Mabey, Monty Don and Will Young’s brother, who lives in the Newbury area.

The causes of depression are variously attributed according to how it is viewed. At one extreme, many psychiatrists name it as a chemical imbalance in the brain. It is seen as a physical illness and therefore comparable with other physical illnesses. From this angle depression is seen as bad, wrong and therefore something to be got rid of, treated and controlled. It is seen as a deviation from ‘the norm’. This begs the question, ‘What is the norm?’ We all know that ‘it takes all sorts to make a world’. Depression is widely seen as negative and, in the current Western mindset, negative is usually thought of as ‘bad’. In fact, negative and positive are like night and day, sun and moon, female and male. They are inevitable partners in creation.

Every sufferer knows that depression is not a purely physical affair. Why else would it carry a stigma? It is not seen in a similar way to a broken leg or cancer. The original meaning of suffering is ‘to undergo’. This comes closer to the mark. Most people who suffer from depression, and those who try to help, are aware that it is a part of being and staying alive. We are all happy and unhappy, we all go through the stresses of separation, illness, bereavement and change, more or less traumatic, in the course of our lives.

But not all psychiatrists approach mental health from a limited viewpoint. Joanne Moncrieff says: “If you want to understand mental disturbance, you have to try to understand how it is a response to an individual’s particular circumstances and history.”

Clearly there are extremes where the depressed person is severely disabled from participating in the flow of life. They are stuck. Dr. James Gordon, a Clinical Professor in the Departments of Psychiatry and Family Medicine at the Georgetown University School of Medicine, and Founder and Director of the Centre for Mind-Body Medicine in Washington, begins his book, Unstuck: Your guide to the Seven-Stage Journey out of Depression* like this:

“Depression is not a disease, the end point of a pathological process. It is a sign that our lives are out of balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives.”

So, if depression is caused by being alive, being alive holds the answers to the questions it asks or masks!

Next month I will be writing about ways of being helped, and helping ourselves.

*Dr James Gordon, Unstuck: Your Guide to the Seven Stage Journey out of Depression, Hay House, 2008

See also the graphic novel-style books, I Had a Black Dog, and Living with a Black Dog, by Matthew Johnstone (Robinson Publishing, 2007), which use words and pictures to talk honestly about the experience of depression and of living with someone suffering from depression.

 

Lindie White, 2013

BBC Wilts – Is depression linked to anxiety? by Wendy Bramham

Common symptoms of anxiety

Wendy writes: “The following can be symptoms of anxiety: numbness, feeling hot, wobbliness in the legs, inability to relax, light-headedness, unsteadiness, nervousness, feeling of choking, trembling hands, fear of losing control, fear of dying, difficulty in breathing, wanting to die, indigestion, pain or tightness in chest, feeling faint, and hot flushes and sweats when you are not unwell. These physical problems are often signs of deeper worries about loss or sadness in the past, or a fear of loss or sadness in the future.”

Does depression begin with anxiety?

“Anxiety can precede depression. Depression is often caused when we feel overwhelmed by sad and anxious feelings and can’t access them in a constructive way. We all fear the loss of someone or something we love. Loss is inevitable, and it can give rise to huge sadness and anxiety for a time, which is healthy and normal. However, it can also lead to depression if this process gets blocked in some way, or if it triggers deeper anxieties such as a fear of not being good enough.”

Wendy Bramham, June 2013 for BBC Wiltshire

Depression (blog 1) – the ‘D word’ by Lindie White

Many of our clients at Wendy Bramham Therapy come to us because they are suffering depressive symptoms. Launching our new blog, psychotherapist, Lindie White, begins a series looking at different aspects of depression and how therapy can help.

Gwyneth Lewis calls her book about her own experience of depression Sunbathing in the Rain. What a wonderful image – the suggestion of basking in warmth and light, even in the rain, indicates that the sunbather has found a place of relative equanimity within. As a foreword she writes: “To anybody who suffers from depression: DO NOT BE DISCOURAGED.”

The root meaning of the word courage is ‘heart’. So take heart! One in five people suffer from depression in the UK and it is one of the most common presenting problems brought to counselling and psychotherapy. But despite its prevalence it still carries a stigma. One of my own clients referred to it as ‘The D word’.

Depression is rather a blanket term. Depressive states range widely from a constant sense of dissatisfaction and persistent low mood, to a suicidal state of mind sometimes tragically ending in the taking of life. Although there are clearly identifiable features, the experience is profoundly individual. The following are some personal experiences of depression:

Gwyneth Lewis “felt ashamed of my wretchedness, as if I’d brought it on myself”. In Darkness Visible, William Styron describes waking in the early hours to a “yawning darkness, wondering and writhing at the devastation taking place in my mind, (the pain) like that of a broken limb”. Richard Mabey, in Nature Cure, writes: “I couldn’t bring myself to do anything. I stayed in bed most of the day, quaking with anxiety about the anxiety I was trapped in.” And in one of my own bouts of depression I wrote:
“All life is held
in the vice-like grip of frost.
A smile is a flower picked and given by other people.
It would crack my face,
if I dared.”

So why do we get depressed? Maybe it’s work, relationships, grief or illness. Maybe it’s fear of living or dying, or just the thwarting of our hopes and dreams. Whatever it is, when we’re depressed we’re under a cloud and the only voices we can hear are our negative thoughts and painful feelings.

What can we do about it? In therapy we start by deeply and attentively listening to the depressed person, making the depression our guide to what the person really wants or needs. There are no quick fixes, but listening to someone, as they are, is powerful and does its own work. As Gwyneth Lewis writes: “In my experience, depression can be a great friend. It says: the way you’ve been living is unbearable, it’s not for you. And it teaches you slowly how to live in a way that suits you infinitely better.”

We’ll be blogging about depression – its causes and treatments – over the next few months. Meanwhile check out http://www.mind.org.uk for more information about helping yourself or someone you know through depression, or tweet us with your own experiences @WendyBramham

Next month, Lindie writes more about the causes of and approaches to depression. Lindie White is a Kew-based psychodynamic psychotherapist. She has worked privately for 15 years and for 12 years in an NHS drop-in surgery for the homeless.

See also: Gwyneth Lewis, Sunbathing in the Rain, Flamingo, 2006; William Styron, Darkness Visible, Random House, 2001; Richard Mabey, Nature Cure, Chatto & Windus, 2008.