Working with Depression
Depression is the most common psychiatricÂ disorder and the fourth major cause of diseaseÂ burden worldwide (World HealthÂ Organization, 2001*). In the UK, one in fourÂ women and one in ten men experience atÂ least one episode of depression requiringÂ treatment during their lifetime and moreÂ than half of these will have at least oneÂ more episode (NationalÂ Depression Campaign, 1999).
World Health Organisation:. World Health Report: Mental Health – New Understanding, New Hope.Â 2001. Geneva, Switzerland, WHO.
Main Features Of Depression
- Beck described depressed people as focusing on unrealistically negative views and having a ânegative cognitive triad; depressed people typically have a negative view of themselves, the world and the futureâ (Mytton, 2000)
- Thoughts about loss, defeat, failure will be the main themes of the NATs
- The client will have a negative, rigid bias in most areas of life, e.g. wonât remember good events, or will put them down to âflukeâ
- This maintains depression (rather than causes it, there is still debate about the cause of depression)
How To Work With Someone With Depression
- Write to GP/consultant telling them you have been approached by the client and asking their agreement that you can work with this client.
- You can use a depression inventory (e.g. HADS or Mind Over Mood Depression Inventory*) to measure how depressed your client is if you choose to. These can be useful to assess how serious the clientâs symptoms are and to see improvement and progress.
- Clients need to see how they âconstruct realityâ and maintain their depression
- It is important to educate your client about depression generally and what makes it worse etc. Get to know their triggers, thoughts and biases and help to make them conscious
- Work out what specifically is relevant for this client
- Help clients to uncover, challenge and change NATs
- How has the client experienced coping/achieving/enjoyment? Enable the client to remember positive coping strategies, achievements and pleasurable activities. Make a list of goals about these features.
- Set goals that show progress e.g. sleeping longer at night