Which treatments should counselors know about? Beth Patterson, a licensed professional counselor LPC with a private practice in Denver, uses an eclectic mix of mindfulness practices, epigenetics and, in some cases, eye-movement desensitization and reprocessing EMDR to help clients with depression and anxiety.
Depression and anxiety also share an essential psychological component — namely, pushing people away from living in the present moment. Individuals with anxiety are continuously worried about the future, while people with depression are often focused on what has happened in the past, explains Patterson, a member of the American Counseling Association.
Although she uses the same basic methods to treat both depression and anxiety, Patterson says it is essential to discern what clients are saying to themselves to help them address their negative self-talk. She also gives them homework, instructing them to focus on noticing their self-talk. Another technique she uses is to have clients breathe in and out while visualizing that they are drawing breath through their feet.
Patterson also meditates with her clients, teaching them to focus on their breathing and center their bodies instead of always living in their heads. Another mindfulness technique is known as the driving meditation. Once clients start recognizing negative thought patterns, they can then use visualization or other mindfulness practices to break the cycle, she says.
Clients often feel ashamed of having anxiety or depression and tell themselves that they must be weak to be susceptible to the condition, Patterson says. One of the ways she helps her clients see the fallacy behind this thinking is by asking them to build a family tree to find out whether depression, anxiety or trauma runs in the family.
Some researchers believe that life experiences can cause these changes and that the alterations can be passed from generation to generation. For instance, Patterson says that depression runs in her family. Patterson also probes for trauma in the backgrounds of her clients because she believes it is common in people with depression and anxiety.
Patterson often sees clients with trauma-related depression. For those cases, she uses EMDR as part of the treatment. She sometimes also uses EMDR for anxious thoughts. Developed by psychologist Francine Shapiro, EMDR uses bilateral stimulation, or stimulation on each side of the body, to help alleviate the emotional distress caused by traumatic memories. The most common method of EMDR uses eye movement, but it can also be performed through physical stimuli, such as buzzers or tapping, explains Patterson, who uses hand-held buzzers with her clients.
After clients learn to recognize their negative self-talk, she says, they can use the other tools she has given them, such as meditation and visualization, to ultimately banish their negative thoughts and the anxiety or depression that accompanies them. Lori Russell-Chapin believes that neurocounseling — which combines traditional counseling with an understanding of how the structure and functions of the brain affect behavior and emotion — can deliver the most effective treatment for depression and anxiety.
Clients then learn that they can change some of these processes through neurotherapy. Russell-Chapin, an ACA member, begins counseling with a complete assessment of the client. For instance, she says, depression is related to frontal asymmetry — a condition in which the left frontal lobe, which is associated with positive affect and memory, is underactivated.
In cases of anxiety, she adds, the right frontal lobe usually has excessive activity. The process begins with an initial electroencephalogram EEG , which will reveal where the brain is dysregulated and the corresponding imbalance of brain waves. Neurofeedback sessions are designed to change specific brain wave activity, Russell-Chapin says. To make neurocounseling more effective, Russell-Chapin usually begins by teaching clients basic biofeedback skills such as controlling their breathing, heart rate and skin temperature.
Russell-Chapin also emphasizes to clients the importance of diet, exercise and sleep because they all have a significant effect on brain regulation. Do you know how much sugar is in them? Russell-Chapin firmly believes that all counselors should take a similarly holistic approach with their clients. We can do so much to help with this dysregulation. Humans are hard wired to have negative thoughts, says Vanessa McLean, and that is something she emphasizes to clients with depression and anxiety.
McLean, an LPC with The Westwood Group, a group practice in Richmond, Virginia, that offers a wide variety of therapies, has found that teaching people about the physiology of their emotions with intense brain-based psychoeducation can be very effective for treating depression and anxiety.
Learning that the tendency to react with fear or sadness is in part biologically driven helps to lessen the shame that often accompanies depression and stress, she says.
Do we feed it? McLean talks to clients about their personal histories and how they have traditionally reacted to and coped with negative emotional responses. She helps them understand that struggling with negative thoughts is normal, but they can learn to reinterpret or not dwell on these emotions. She urges clients who might be struggling with depression or anxiety to distract themselves with exercise and other activities that they find enjoyable or that give them a sense of meaning and purpose.
She also talks to clients — particularly those with anxiety — about how the body and brain can create a kind of tension loop. To short-circuit this loop, she teaches clients deep breathing techniques and progressive muscle relaxation. She also asks them about other activities that have helped calm them in the past. Mental health - a subject that, if mentioned, can bring shame and fear to the Asian community.
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Mental health and therapy within the Asian community Previously, I wrote about a lack of knowledge and understanding of mental health within a wide range of the Asian For example, if depression has caused someone to withdraw from life, that person may be encouraged to participate in hobbies or spend time with friends. Or a person may be gently coached, under supervision, to confront situations, things, or people that cause fear or panic.
Through practice, a person learns new, healthier behaviors. The therapist assures the person that their behavior and feelings are valid and understandable. At the same time, the therapist coaches the person to understand that it is their personal responsibility to change unhealthy or disruptive behavior. The therapist reminds the person when their behavior is unhealthy or disruptive—when boundaries are overstepped—and then teaches the skills needed to better deal with future similar situations.
Often times DBT involves both individual and group therapy. It looks at conscious, outward action, and social adjustment. It does not try to change the personality, but rather to teach new skills that can lessen symptoms. Therapy is meant to help support system and family members find more effective ways to resolve those difficulties.
FFT also focuses on the stress family members and support systems feel when they care for someone with a mental health condition. Often the person experiencing the mental health condition will attend sessions with support system or family members.
While talk therapy is the most common, there are many other forms of therapy that people find helpful. Often times the therapist may begin by encouraging the person revisit the trauma in their mind and share what they experienced.
This often helps the person better process the trauma that occurred. Interpersonal therapy IPT is another brief or short-term method used in counseling for depression that focuses on interpersonal conflict and poor social support, which can lead to feelings of depression.
This type of therapy can help you communicate better and address issues that make the symptoms of depression worse. Evidence suggests that IPT is effective in acute treatment of depression, and it may help prevent new depressive disorders. There are also some other treatment modalities that may be worth considering. For more severe and refractory cases of depression, electroconvulsive therapy ECT may be useful.
There are also complementary and alternative approaches that might provide additional benefits. Finding the right counselor, psychologist, or mental health expert to work with may take some time. When it comes to counseling for depression, the relationship between patient and counselor is key to the success of the therapy.
You may find that you need to see a few people before finding someone you can develop the best working alliance with. You can also contact any larger mental health facilities in your area. While they may not offer the services you need, they will likely know of counselors close to where you live that provide therapy for depression.
Another place to find referrals online is through one of the professional organizations such as the American Psychological Association or the Anxiety and Depression Association of America. Many of them have online directories that allow you to search for mental health experts in your area. Finally, spend some time researching the experts in your area. Go online and read their bios. Send an email asking for more information about their preferred forms of treatment and how they interact with clients.
Many therapists offer a free intro session to see if it is a good fit. Find out if they offer a free trial session and give it a try. One other form of counseling to consider, especially for more mild forms of depression, is online therapy. The popularity of online therapy has increased in the last few years and has accelerated considerably in the current pandemic.
Online resources and apps such as Talkspace offer support via a desktop or mobile app with a variety of services including individual sessions and other mental health resources that can help you work through issues related to depression, and come up with and practice coping strategies.
Living with depression can feel overwhelming at times. Working with a mental health expert in a therapeutic relationship provides you with a safe environment to identify the thoughts, feelings, and patterns of behavior that are contributing to your symptoms.
Counseling can also help you learn new coping skills and techniques to better manage the symptoms. Short-term counseling, which typically lasts less than six months, is often appropriate for mild to moderate depression.
If you feel like you could benefit from counseling for depression, talk with your doctor about getting a referral. Finding someone you trust and feel comfortable opening up to is critical in the success of the counseling process.
Everything feels more challenging when you're dealing with depression.
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