Many people visit a counsellor for help with the kind of depression which may affect us following a bereavement, loss or sudden change in circumstances such as redundancy, or family crisis. In such cases, it is natural to feel a sense of anxiety, despair or worthlessness (amongst many other feelings) which can lead to mild depression. Shorter-term counselling may be extremely valuable here in helping you come to terms with change and set plans and ambitions based on the new situation.
For other people, the depression may be significant or may have lasted many months. It may even be something that has been a part of their life, perhaps off and on, for many years. At times, seemingly ‘minor’ events may trigger a ‘major’ depression. In many such cases, the roots of the depression may lay in early life, rather than in the events of the present day.
Whilst it is hard to generalize, such depression may arise as a result of patterns of thinking and feeling that were adopted in early life as a response to trauma, abuse, anxiety or persistently unmet childhood needs. There may be so-called ‘unfinished business’ around these issues. The thinking and feeling associated with these may be re-played today with equally unsatisfactory results and hence more frustration, more sadness, continuing anger, and a sense of ‘failure’. Not surprisingly, depression is very often the result.
In these cases counselling can still be highly effective. It is important however that the person seeking help is properly assessed in order to determine the suitability for them of longer term counselling. Key to success is the ‘fit’ between client and counsellor, the client’s capacity for self-dialogue or insight, their motivation and their commitment to what may be a long and painful process of reflection. Once counselling commences the approach is necessarily more in-depth and requires longer time periods to be effective – usually many months.
Counselling is less helpful where the depression is very severe (leading to regular hospital in-patient treatment for example) or is so incapacitating as to limit the scope for communication or good psychological contact with the person concerned. Nor is counselling indicated where there is a history of diagnosed psychosis or personality disorder.