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Discussing Depression With Kevin

We covered this topic in an episode of our Podcast, Talk Therapy To Me. If you prefer to listen rather than read, you can do that here:

Kevin has been working as a counselor for 19 years, which he says has gone by quickly. He has experienced clinical depression in the past and feels fortunate to be able to provide an inside perspective on mental illness. He loves to help people realize how liberating it is to find ways to recover from their mental illness.

What are the most common symptoms that you see in your patients coming to see you for depression?

Oftentimes people are struggling with conflicts in their life. A parent may talk about feeling irritated with their kids. Some people might be fighting a lot with, or losing interest in, their partner. Someone living alone may talk about feeling isolated, losing friends, or a lack of communication. Another common problem that comes up is work. People say they hate their job and want to quit, or they’re missing a lot work lately, and they can’t identify what’s causing these feelings.

When people come in with these problems, we can easily identify them as depression. These symptoms clearly fit the criteria. Usually, the client doesn’t see themselves or their symptoms clearly.

It’s helpful for clients when everything starts lining up and making sense.

Yes, especially when they start connecting feelings like irritation to what they’re thinking about at the time. They start to gain a new perspective of the issue, allowing them to explore the things triggering these feelings.

It seems like feelings of anger and frustration are brought up a lot with depression.

Exactly. And one of the challenges that come in after is guilt. Depression and guilt go hand in hand, and it’s always hovering there. So there's the anger, let's say an explosion of anger or even angry feelings, and then after that anger settles, there’s this cloud of guilt that follows.

Toxic guilt is not something you can really respond to. It sits with you. It's not guilt over a specific incident that is necessarily appropriate. Sometimes people let that simmer over time, and then it becomes connected with feelings of shame.

What's really difficult is the connection between depression and self-blame for depression.

Yes, there's the depression itself, which is the illness, and then there's the kind of social conditioning around depression somehow being your fault. Over the years, a lot of my work shifted to changing thoughts and increasing behavior. In earlier sessions, we work on reframing the depression and helping the client move away from self-blame.

How do you talk to your clients about medication?

I start by asking if they’re already on medication or open to considering it. Some clients want to avoid medication altogether. And I think it can be harder to recover without it.

I often try to reframe an antidepressant as a painkiller. When you’re depressed, it can feel like chronic suffering. So an antidepressant can decrease that internal suffering, like a temporary painkiller.

For example, if someone has knee surgery, they will be in a lot of pain, especially when they try to start walking. When they first start, they take painkillers because it's too excruciating to move. Then they start walking to build up those muscles and strengthen their knee. They’re still in pain at that point, but it’s not as excruciating as post-surgery. So they take those painkillers for a while until they're functioning more effectively.

Antidepressants are a much better option for some people than not taking the meds early on with clinical depression. The success rate without medication tends to be really low. Medication brings you down to a more functioning level that you have more room or capacity to add in those coping skills

Do you have any final thoughts on depression?

Yes. Depression does not define you. It’s not your fault. It’s possible to get past it, have a meaningful life, and feel good about yourself.

Caitlin is a Behavioral Health Clinician who helps clients guide themselves into deeper meaning and purpose for their lives. She focuses on finding resources, techniques, and coping skills on their journey for further fulfillment.

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