5 Principles for Working with Depression

The word depression gets thrown around a lot. Socially, the word has become an overused synonym for sad, annoyed, frustrated, or simply disappointed. People often make offhanded comments like “I am so depressed that sweater hasn’t gone on sale,” which shows little thought or regard for those who bear the true weight of the word. The flippancy of its use can distract from the intensity of the lived reality of depression and can undermine those who have an intimate connection to it.

The reality of depression is that it is often all-consuming. It can steal the joy out of things once loved by the sufferer, alter perception of self and others, and, at its worst, manipulate a person into planning for the relief anticipated from death. Depression is calculating, vindictive, and strategic. It thrives when left unattended and unmanaged.

Depression is calculating, vindictive, and strategic. It thrives when left unattended and unmanaged.

From the clinician’s perspective, working with depression can be exhausting and overwhelming, but also rewarding. It is exhausting when clients struggle to make progress and suffer setbacks along the way, making the pace feel slow or stuck in place. The work is often overwhelming due to the effort it takes to stay positive and motivated in the face of the influence that depression can bring. However, this work can be very rewarding when signs emerge to show that the cloud is potentially lifting and progress may be more sustainable. Working with depression requires as much commitment from the clinician as is needed from the client.

Despite the existence of common symptom patterns, depression is often a unique and individualized experience. That is why it’s important for helpers to validate, empathize, and provide applicable strategies in acknowledging the diversity of depression.

Working with depression requires as much commitment from the clinician as is needed from the client.

A clearly outlined path of intervention can offer hope for the client, accountability for the helper, and momentum to the therapeutic process. From working with many people who struggle with depression, I have come to rely on the following five principles to guide how I assist individuals with accepting, navigating, and shifting their current – and for some, potentially lifelong – relationships with depression:

Make the mind-body connection

Address persistent cognitive distortions and self-deprecating thinking patterns that aggravate and reinforce depression symptoms and behaviours. This also includes tending to and using the body through movement to work against depression.

Distinguish depression from the depressed

Recognize when depression is overruling an individual’s ability to intake, generate, process, and/or apply information and strategies. This may include having the “is it time to have a conversation with your doctor about medication” conversation.

Ignite hope in the face of hopelessness

Empathize, normalize, and capitalize on the counsellor’s effect to generate the necessary engagement needed to implement thinking and behaviour-change strategies.

Motivate the unmotivated

Develop strategies for increasing behavioural change in the face of what can be chronic emotional and physical pain.

Build positive social connections by building connection capacity

Explore social isolation as both a cause and symptom of depression. Identify the influence of negative social experiences and the necessity of positive relationships for healing.

For some, depression can be a lifelong journey. For others, it is a very painful hiccup in a larger story. Regardless of its intensity or longevity, it infiltrates one’s relationship with both self and others. It alters one’s perception of self by highlighting or creating nonexistent deficiencies. Depression lies about worth within relationships and inhibits the ability to love and be loved. It prevents the envisioning of a peaceful and functioning future. Combatting depression requires acceptance and commitment. First, it requires acceptance that something is not working and is impacting the ability to experience joy and embrace hope. Commitment is then needed to move through the physical, psychological, emotional, and social toll. Battling depression requires that a person undertake a committed search for a more manageable and hopeful reality on the other side.

A clearly outlined path of intervention can offer hope for the client, accountability for the helper, and momentum to the therapeutic process.

Helping people reset their perspectives and regain a sense of control includes approaching depression from a holistic framework. It includes an integration of the mind and body with efforts geared at honouring both. This work also requires a commitment to behavioural change in recognition that motivation will follow and the use of social connection as a critical and non-optional caveat of change. An effective and purpose-driven action plan cannot overlook or underestimate the power of collectively building on these variables.

This blog comes from our book, Counselling Insights:  Practical Strategies for Helping Others with Anxiety, Trauma, Grief, and More.

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