In our Resources section we have a number of links, books, articles, essays & seminar notes that may be of help as a supplement to counseling.

  Articles 03/02

Working through Depression (Part 1)

by Steve Cadman MSW

             In this article, I will try to outline some of the key components involved in working through depression. To begin with, it is important to understand that the concept of what used to be called "reactive" depression is different than the concept of "hereditary" depression. "Reactive" depression is related to how our thoughts and emotions are or are not worked through, and how this can lead to depression even where there is no "hereditary" element. It is this "reactive" element of depression in which counseling / counselling can be the most helpful. The bodily chemical imbalance ends up being the same as that of "hereditary" depression, the difference being how it developed. The thought / feeling / physical bio-chemical unity of this "reactive" process would seem to fit well with the biblical teaching that "as he thinks in his heart so he is" (Prov. 23:7).

A "hereditary" predisposition to depression when under stress, when it is related to emotional hurts and anger as the stressors, would at least at times seem to be a mix of the two ("hereditary" and "reactive" depression). At a minimum, it would be wise to work through all emotional hurts & anger, in order to eliminate them as stressors that may be triggering a "hereditary" depression. There are probably often elements of "reactive" depression added to an existing "hereditary" depression. This additional "reactive" element results from the hurts, disappointments and anger that one goes through, and the false conclusions one comes to, as a "reaction" to the hindrances that the symptoms of  "hereditary" depression cause to one's emotional, relational and overall functioning in life. These elements are worth working through in counseling / counselling in order to eliminate this portion of the depression and its causes.  

             Once depressed it is very important to see your GP about beginning to take antidepressants, regardless how the depression developed. Unfortunately, some of the symptoms of depression (fatigue, lack of deep sleep, confusion, lack of concentration, loss of memory, social withdrawal, etc.) make it extremely difficult to work through the issues underlying the "reactive" portion of depression. As depression grows these symptoms will lead to an ever increasing and progressive emotional and functioning paralysis. It is therefore very helpful to deal with the physical bio-chemical side of depression with antidepressants in order to eliminate the above symptoms. Otherwise it can be like trying to deal with the underlying issues while pushing through molasses. It is a handicap that is really not necessary given how well antidepressants can largely eliminate these symptoms.  

            Seeing your GP is also important so that they can monitor the level or degree of depression that you may have. This is extremely important the more intense your depression becomes, because at its higher levels one of the symptoms is often thoughts of wishing one weren't born, here or alive, which is the beginning of suicidal ideation / thoughts. Antidepressants will eliminate this symptom as they restore bio-chemical balance. It is important to realize that suicide is not a logical, rational thought given your current situation, but is instead a symptom of depressive thinking. In "reactive" depression it may instead be (at least in part) a manifestation of the amount of anger that is being "stuffed", "sat on" & held inside instead of being worked through.  

             Emotionally, the easiest formula for understanding "reactive" depression from a counseling / counselling perspective, is that it is anger that is not being dealt with. It is useful to understand that underneath all anger is hurt and that anger is a legitimate protective mechanism. Hurt is the fuel that both starts and keeps the anger going, and unprocessed anger may be the fuel that starts and keeps the depression going. "Reactive" depression is basically a pattern of "stuffing" and "sitting on" legitimate feelings, hurts & anger, rather than working them through with the individuals they need to be directed to. This will initially manifest as moodiness, which if it continues to increase, can eventually escalate into depression.  

             Dealing with the anger alone will not work as this will only tend to get one wrapped up in escalating anger which can evolve into resentment, bitterness, rage and hate if dwelt upon. It is necessary to express one's annoyance or anger to others but then quickly move on to spending the bulk of one's time talking to others about the hurt that underlies it. This should work through & neutralize the anger over time, which in turn should eliminate the "reactive" element of the depression. It becomes an ongoing back and forth process of expressing both anger and hurt about a number of things that have piled up and sit waiting to be worked through.  

            The habit pattern of not facing and processing one's hurt and anger with others, tends to develop out of a number of hurtful childhood scenarios, a few of which I will list here. We can learn from one or both of our parents that conflict is to be feared and avoided at all costs. Or we can vow to be opposite to a parent who hurt us through their venting of anger in unbalanced and extreme ways. We can also fear to express who we really are or what we really feel because we grew up being criticized or getting subtle or not so subtle messages that we are not good enough in what we do or in who we are. This would include never being able to please a parent or getting messages that we are a disappointment because we are not living up to a certain standard (known or unknown). As a result we can end up fearing and avoiding failure, and trying to constantly please others and meet everyone's needs but our own.  

            This article will be continued as "Part 2" in next month's newsletter. 

books on depression

inventories on depression

Other articles by Steve & Heidi Cadman-Neu