Clinical depression is different than 'normal' feelings of sadness or disappointment, and is also different than feeling unhappy with the circumstances in your life. It has a pronounced effect on your physiological state - energy level, appetite, sleep, focus, irritability, motivation etc. - and a similarly pronounced effect on your thoughts and feelings.

For example, in the face of a relationship break-up, 'normal' sadness might say: "I'm sad and disappointed about losing someone I cared about. I'm going to miss having them in my life, and the prospect of dating again is scary and demoralizing." Depression would sound more like this: "I've been abandoned again and I just can't bear it. I'm going to die alone - what's wrong with me? No one ever chooses me."

So although it's our emotions that cause us pain - we feel abandoned, unloveable, hopeless, etc. - emotions always follow thoughts. To put it simply, we have to understand what has happened before we can have an emotional response to what has happened, and understanding what has happened is a cognitive (thought) process.

Part of counselling for depression involves looking at our thoughts and beliefs, identifying any distortions, and arriving at more rational and self-supporting ways of understanding and talking to ourselves about an experience.

Freeing yourself from depression does not mean living in a state of uninterrupted joy and bliss - in the example given above, sadness is an understandable and appropriate response to the break-up of a relationship - but it does mean being able to hold the grief associated with an experience in a way that allows you to heal and move on.


I think depression is best understood as a Biopsychosocial-spiritual disorder. That means that it impacts (and is impacted by) all of those areas of functioning:

Biological, which for some people may mean brain chemistry imbalances and for all of us includes things like diet, alcohol or drug use, exercise, sleep, breathing, having a balance between work and play, etc.

Psychological, including unresolved trauma, self-esteem, managing anxiety, looking at how you speak to and about yourself, etc.

Social, meaning school or work, and the quality of your relationships with family, friends, and others.

Spiritual, which can mean religion or connection to a Higher Power, and can also mean feeling that there is a sense of purpose and meaning in your life.

Depression can make everything feel hard and overwhelming, including the prospect of reaching out for help. Therapy for depression begins by looking at how you're doing in each of the above areas, and starting to define small steps you can take that will help you create an anti-depressing experience of your life. Our work will likely focus on helping you do better, even while you don't feel better; in depression emotions are often the first thing to go offline, and can be the last to fully recover. But starting to take small steps in a desired direction can help keep hopelessness at bay, and give you the motivation to continue to do (and eventually feel) better.




I am in that temper that if I were under water I would scarcely kick to come to the top.

- John Keats



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