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How to treat depression the easy way

3 steps you MUST take when treating depression

By Mark Tyrrell

Depression is a scary word. The prospect of treating depression without drugs feels daunting to many therapists. But we can really be optimistic when treating depressed people. Why?

Because antidepressant medication

  • doesn't significantly outperform placebos (1); and
  • doesn't work at all for two thirds of people (and has many possible side effects).

If you have the right skills, then any depressed person who finds you will be in luck - although they won't necessarily see it like that at first!

To treat depression effectively we need to understand that:

  • Depression is not 'genetic'. People are not biologically predestined. It's not caused by neurobiology (although it has neurobiological effects (2)). Depressive attitudes (such as pessimism, perfectionism, black and white thinking, learned helplessness) are learned rather than 'passed on through genes'.
  • Depression is a state of physical and mental exhaustion produced from too much negative non-solution-focused rumination, leading, in turn, to an excess of REM sleep which further exhausts the depressed person. (3)
  • The depressed person has become stuck and needs help to think, feel and act differently and to get the rest they need.

Here are three essential steps to treating depression.

1. Describe what is happening to them

As early as possible, we want the depressed person to begin to see their depression 'from the outside' as a pattern of experience rather than part and parcel of 'who they are'.

By describing the 'cycle of depression', you help your client understand how a build up of unresolved emotional worry overburdens the brain's REM response, leading to night time over-dreaming, leading to day time physical and mental exhaustion.

A depressed client feels that you really understand where they are coming from when they hear questions like:

  • Do you always feel exhausted when you wake in the morning - and the more you sleep, the more tired you get?
  • Does everything tend to seem very black and white, all or nothing, to you, with no shades of gray between?
  • Do you feel physically exhausted one minute and then over-agitated the next?

Such questions highlight how depression is an easily understood pattern of experience.

You can reassure your client that one of the first signals of recovery they'll experience as they start to come out of depression will be an increase in energy and a feeling of clarity and perspective.

2. Get your depressed client to relax

This is essential. A depressed brain is a stressed brain. (4) Master as many relaxation techniques as you can in order to be able to help clients relax effectively.

The most wonderful 'cognitive reframing' techniques in the world will have little effect on a brain worn out by stress, anxiety and exhaustion. In such a state, flooded with stress hormones, the brain struggles to take on new perspectives. It's like trying to see your reflection in a lake when a storm is raging.

3. Set 'tasks' which are intrinsically satisfying

Therapeutic tasks which satisfy have a beginning, middle and end. Even just writing a letter, putting it in an envelope, putting a stamp on it and posting it can produce a serotonin hit. We are rewarded with serotonin - a 'feel good chemical' - whenever we complete a task, especially one we've been putting off.

A depressed person may need to get back into the habit of actually taking steps to change unwanted situations rather than passively worrying about their problems but not acting to resolve them, and tasks can significantly help to get your client used to acting positively again.

In cases where practical changes are not feasible, you can still help your client to feel differently about what cannot be changed - and hypnosis is an excellent tool to help with this.

Of course, really effective psychotherapeutic depression treatment may need to include many more interventions, but these three steps, normalizing, relaxing, and setting rewarding tasks are an essential part of the mix and will get your clients well started on the road to recovery.

You can learn How to Stop Anyone Smoking with Mark Tyrrell on our Smoking Cessation Training Course (online).

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Mark Tyrrell
Creative Director