Depression: When should you consider therapy?

What is depression?  

Depression is a mental disorder that manifests itself through a number of symptoms that have a major impact on your daily life. Several psychological, biological and environmental factors contribute to the onset of the disease.

Depression causes various mood disorders, such as constant sadness and loss of pleasure, and leads to a pessimistic perception of oneself and one's surroundings, encouraging isolation from the outer world.

Such depressive state persists for more than two weeks and can cause:

• severe fatigue
• sleep disturbances,
• fluctuations in appetite or weight,
• problems with sexual desire,
• cognitive problems,
• loss of interest in activities that you previously enjoyed,
• feelings of guilt and/or despair,
• suicidal thoughts.

These symptoms can be mild, moderate or severe and can last for a long time.

There are effective treatments for depression, such as therapy and medication. Some people also practise self-management through relaxation exercises, sport or the support of family or friends, which is surely helpful, but can sometimes be insufficient.

Left untreated, depression can worsen and have serious consequences on physical and mental health.

People with depression are at increased risk of cardiovascular disease, anxiety disorders and addictions. Family and professional relationships may also deteriorate, and suicidal thoughts may appear.

When should you consider therapy for your depression? 

Depression is often cyclical, but when symptoms last for more than two weeks without improvement, this may indicate that professional help is needed.

When depression prevents you from maintaining healthy social, professional or family relationships, it is high time to consider therapy.

Psychotherapy is a first-line treatment for mild depressive episodes, for which antidepressants are not indicated. It should also be considered as a priority in moderate depressive episodes, where it may be combined with medication depending on the practitioner's clinical impression or the patient's choice. In the case of severe depressive episodes, antidepressants are prescribed from the very beginning, and the patient is quickly referred to a psychiatrist for treatment combining antidepressant medication and psychotherapy. If depression diagnosis is confirmed, the choice of treatment should be made in accordance with the patient's preferences.

Psychotherapy offers a number of distinct approaches that are nonetheless based on common principles. First and foremost, it is based on sympathetic listening, taking into account the whole of the person, with empathy and without judgement. Therapists are obliged to respect confidentiality, thus providing a secure framework for the patient. This encourages authentic expression of the person's experiences and feelings, without fear of judgement.

The effectiveness of psychotherapy is recognised by the medical world and confirmed by research.

What types of therapy can help with depression? 

There are many different types of psychotherapy, but the two best-known approaches psychoanalysis and cognitive behavioural therapy (CBT).

Cognitive behavioural therapy (CBT) 

The duration of CBT is usually short to medium, and its aim is to manage the current crisis by modifying thoughts and behaviour that provoke or influence the depression. They are suitable for mild to moderate depression and help prevent relapse.

Psychoanalysis 

Psychoanalysis and similar types of therapy explore childhood blockages and traumas, enabling the person to modify the unsuitable life pattern. These longer-term therapies go beyond the immediate crisis and are initiated after the acute phase of depression.

Alternative therapies, such as art therapy and meditation (including mindfulness meditation), are also used to treat depression, often as a complement to traditional psychotherapies. Among these approaches, mindfulness meditation has become particularly widespread recently; it offers exercises designed to reduce stress response and better manage anxiety.

How can you find the right therapist? 

When you're suffering from depression, it is important to be able to talk to a professional whose outside view and attentive listening can help relieve your suffering. For the successful treatment and management of depression, it is important for doctors and patients to form a sort of therapeutic alliance based on trust, empathy, and support.

Supportive psychological help can be provided by a general practitioner, psychiatrist or clinical psychologist.

Psychiatrists are doctors who have completed specialised training in various mental illnesses and their treatment.

Unlike psychiatrists, psychologists are not doctors. As such, they cannot prescribe treatment alongside psychotherapy.

A qualified therapist who is experienced in depression and with whom you feel comfortable is an essential criterion for choice. You can check the practitioner's qualifications and experience.

How can you prepare for your first therapy session? 

It is common to feel uncomfortable seeking help, for fear of judgement or failure. So it is important to remember that depression is a health condition that requires treatment.

The first session is often a chance for you to express your expectations and talk about all your symptoms.

To maximise the benefits of psychotherapy:

• Be honest: express yourself without filters so that the therapist can help you better,
• Share your expectations: this clarifies your objectives and guides the work of the healthcare professional,
• Put judgement aside: welcome your thoughts and emotions without self-criticism,
• Accept silence: pauses can facilitate the emergence of new thoughts,
• Take notes after the session: this helps you keep track of your progress,
• Be patient: change takes time,
• Apply what you learn: test ideas between sessions,
• Welcome feedback: the therapist's observations help you progress. 

NB! 

Depression is a multifaceted mental disorder. This illness often requires therapeutic treatment to prevent it from getting worse. Different types of psychotherapy, ranging from cognitive behavioural therapy (CBT) to psychoanalytical approaches, as well as alternatives such as mindfulness, can help you manage and overcome symptoms.

Choosing a competent therapist and preparing for sessions are key to effective treatment.

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