Thursday, 23 November 2017

5 Pieces of Damaging Advice for Treating Depression

There’s plenty of advice on treating depression. There are thousands of books, blog posts and magazine articles. Everyone seems to have an opinion. Try this herb or vitamin. Avoid sugar. Be grateful. Be more grateful. You just need some fresh air. Go to therapy. Don’t go to therapy—it’s a waste of time and money.

Of course, some advice is sincerely spot-on. Some advice seems helpful, but misses the mark for people struggling with clinical depression. And some of it is just plain bad. Which is why we asked psychologists who specialize in depression to share the damaging advice they’ve come across—which you’ll find below.

Decide to be happier.
Pasadena psychologist Ryan Howes, Ph.D, has heard this advice from many (well-intentioned) loved ones of clients with depression. Maybe they assume the person is simply in a funk or having a bad day, he said.

“They don’t get that it’s not that simple, and that [their depression] may have much deeper historical, biochemical, or trauma-based roots that require a much deeper and more intense process than just flipping a switch.”

This kind of advice implies that a person has decided to become depressed and it encourages them to wear a mask that keeps them from actually working on and through their issues, Howes said.

“Most often, my clients who have tried this approach are only prolonging their suffering as they avoid the hard work of confronting issues they need to address to overcome depression.”

A similar piece of advice is to focus on the positives and be grateful. “These are pretty good ideas in general, but for someone struggling with mental illness, hanging a motivational poster in their room, and starting a gratitude journal isn’t going to cut it,” said Stephanie Smith, PsyD., a psychologist in private practice in Erie, Colo. “In fact, trivializing depression by assuming that a clever-sounding phrase can cure it, can do much more harm than good.”

Use only “natural” or alternative treatments.
Treatments such as meditation, aromatherapy, light therapy and massage therapy are helpful in diminishing symptoms of depression, said Deborah Serani, PsyD., a psychologist in private practice in New York and author of three books on depression.

However, they alone can’t treat depression. Because “depression is a real medical illness.” It is a serious illness that’s life threatening.

“When I read articles or hear others talk about tossing aside evidenced-based treatments like cognitive-behavioral therapy, pharmacotherapy, and neurobiological treatments, I worry that lives are being put at great risk,” said Serani, who also lives with depression.

Skip therapy because it takes too long.
There’s a misconception that therapy takes years to treat depression—which can lead many people to assume it’s not a good option for them. However, as Serani pointed out, there are numerous highly effective short-term treatments for depression, including cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, behavioral activation therapy, intensive short-term dynamic psychotherapy and problem-solving therapy.

For instance, behavioral activation therapy helps patients increase meaningful, positive activities and accomplish their goals, one small, feasible step at a time. It teaches them to identify and work through behaviors that feed their depression.

Problem-solving therapy is a cognitive-behavioral therapy that teaches patients skills to effectively cope with stressful life experiences.

Intensive short-term dynamic psychotherapy helps patients explore “emotional aspects of depression by talking about the historical roots of their depression, looking at unresolved issues, attachment issues, transferences and defense styles, much like psychoanalysis,” Serani said. (But it’s much, much shorter.)

The key is to make sure you’re working with a practitioner who specializes in mood disorders, she said.

Just take medication. Medication can be incredibly helpful for easing symptoms of depression. However, Howes underscored the importance of not relying on medication as your sole treatment, because it “doesn’t teach you anything.”

That is, medication “doesn’t teach you coping skills, uncover unhealthy habits, or explore the underlying mechanisms at the root of your depression.” Howes shared this example: If you’re depressed because you feel hopeless and helpless at your dead-end job, taking medication will help you feel a bit better. But it won’t teach you the connection between your circumstances and your mood. It won’t help you figure out how to change these circumstances.

Therapy helps you “piece together why [you] are depressed; whom [you] can rely on for support; and what new habits [you] can incorporate to fight depression and prevent a recurrence.”

Try _______. It worked for me. People are often quick to share what’s worked for them—which can be helpful. However, when it comes to depression, it might not be. According to Smith, “Your friend says: ‘I’ve been so down recently. I haven’t been sleeping well, I cry a lot and I feel so irritable with everyone.’ You say: ‘That sucks! My exercise class/church/podcast/book is awesome and keeps me happy. You should try it!’”

What’s more helpful is to listen. Listen to your loved one’s thoughts and feelings. Listen to how they describe their depression and what it feels like for them. Because everyone is different. Because for some people, depression is bone-deep fatigue and deafening sadness, while for others it’s numbness and loss of hope.

Give people the space and permission to share what they need to share. And if you really want to mention a strategy that helped you, ask first, Smith said: “Would it be OK if I told you about something that helped me?”

And if you’re the one with depression and your loved one starts offering advice, simply tell them: Thank you for wanting to help. But what I need most is for you to listen. Just listen.

Because depression is so well-known, many people assume they understand how it functions and what helps. But often that’s not true. Often depression gets minimized and trivialized—and, even with the best of intentions, the advice can hurt. It might not be blatantly bad—snap out of it!—but it might keep you from seeking help. It might lead you to overlook something that can truly help (like therapy).

If you’re struggling with depression, make sure you’re seeing a professional who specializes in mood disorders. If you’re the loved one of someone with depression, make sure you get educated about what it really is. Because while people can decide to seek treatment, they can’t decide to be happier—to not feel numb, to not feel hopeless. Because, if they really could, they would’ve done it already.



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