Is depression really a “disorder”? Can counselling help people in Hastings more than pills?

It has become common nowadays to think of depression as a medical condition. If you visit your GP he or she might ask a few questions about your appetite, sleep, personal relationships, and mood. If you answer these questions in a particular way, you might get told tell you that you have “Major Depressive Disorder”. The assumption is that it a real illness. And, like any real illness, it tends to get dealt with by medication.

But there is an alternative to medication. Counselling in Hastings and elsewhere offers a different way to the medical approach for helping with depression.

The medical way of thinking about depression is really the product of a discourse that has been used so much that it tends not to get questioned anymore. The talk about depression as an illness is really the result of a more overarching trend in the mental health field to reduce life to objective behaviors or symptoms. We take two individuals and observe how they act, talk, or say they feel. We extract the behavior they have in common, and jump to “a symptom”.

One person’s low mood, for example, is equated with another person’s low mood, and what we now have is the symptom of “mood disorder”. When we observe a collection of such abstract symptoms that appear to frequently occur together, we end up with a “syndrome”, or a certain cluster of symptoms. And when we give a name to such a cluster, by inventing nouns like “Major Depressive Disorder” or “Generalized Anxiety Disorder”, these words then take on the status of illnesses that appear to pre-exist and explain the appearance of the symptoms.

But this can mean we have abstracted the symptom from the life of the person.  Without this person, the symptom has lost its meaning. The idea of the symptom as some abstract behaviour erases the differences between unique individuals and treats each individual’s behaviours as if they were the same. When depression becomes a universal set of behaviours, its true meaning is lost. Even though we may label two people’s behaviours as depressed, the meaning of their depression can vary widely. One person may be depressed because they are faced with a life situation that demands they assert themselves, but have fears about doing so, and therefore can do nothing but admit defeat. Another may be depressed because they have cut out social contacts to deal with their social anxiety and now find themselves devoid of meaningful relationships. In short, depression is a unique experience for each sufferer.

The risk is then that it is symptoms which get treated, not people. Instead of professionals taking time to listen and understand, to help people figure out what depression means in the context of their other life problems, out comes the prescription pad for some anti-depressant.

Depression can only be shorthand for a multitude of particular ways that people struggle. Only when we understand the life of each struggling person, will we succeed in understanding what depression really is, for it is many different things to different people. It is a marker of a particular stuckness in a person’s life.

But counselling can offer the opportunity to be heard as an individual and to gain insight into one’s own distinctive issues. Counsellors have the time and expertise to help each client make sense of their own experience.

 

added at 12:01am on 19th January 2014

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