Depression is an issue that can be simple to identify, though not always. We've all experienced at least a taste of depression. Even biblically we see many individuas who likely struggled with depressive episodes. It would be hard to conceive that Job in the midst of all his struggles did not meet clinical criteria for depression. As you read some of the Psalms, it becomes pretty obvious that David had some very distraught moments in his life. Even Jesus experiences some element of depression in the garden before his crucifixion. I'm not saying that He met clinical criteria, but it is hard to believe that he didn't have moments of despair.
Yes depression can be simple to identify, but quite complicated in its causes. The complication comes from the variety of elements that influence its origin and continuation. I see depression as a Biopsychosocialspiritual problem. It has all those influences in its makeup.
My next few articles will deal with each of these four areas of treatement.
We know that there is a biology to depression. I could go into all of the neurological details, of course I'd need another three years in grad school to actually understand it fully. I do know that there has been direct correlation of serotonin levels and depression. Specifically, postmortem studies have noted a strong pattern of low serotonin levels in those who've committed suicide. I have dealt with enough clients who simply did not respond to talk therapy. Their chemistry was imbalanced enough that they needed medical intervention to get out of the pit of depression. The percentage of my clients in that situation is relatively low. More often than not my clients are dealing with a more moderate level of depression. With those clients, I discuss medication as an option, if they bring it up or if our treatment hasn't delivered the desired benefit.. If the client wants to go that direction, I'm willing to explore the possibility. If they would prefer try talk therapy alone for a while, I'm all for that as well. A lot of my clients don't even like the idea of medication. Somehow they feel inadequate or like a failure if they need psychotropic medications. Yet these same individuals may be on a variety of medications for high blood pressure, low thyroid, diabetes, and any other number of issues. So why is medication dealing with the brain such a sensitive area. Lets be honest, we think of our thought process as somehow different from other bodily functions. To a large extent I agree there is something different about how we think and feel. As a Christian I have to believe that we are more than a pattern of nerve interactions in our head. However, we cannot deny that part of healthy brain function is the appropriate balance and interactions of our brain chemistry. So just like some of us need medication to balance our insulin levels, others of us need medications, to balance our neurotransmitter levels.
While medication may be a useful tool in some situations, it is not the only biological treatment we use with clients. Let's not forget that diet, activity, improved sleep and even appropriate exposure to sunlight, may be helpful to clients struggling with depression. These are interventions I encourage for ALL my clients.