MyThoughts

     In this month's blog I would like to wrap up this series on depression by discussing some of the causes of depression.  Contrary to popular belief, there is no concrete evidence that depression is genetically inherited or that it is caused by a chemical imbalance in the brain.  There are some research studies that show some slight evidence for those two things as being contributing factors to depression but the research in general is inconclusive.  Depression for the most part is caused by psychological factors which means that psychotropic drugs such as antidepressants will do little to cure depression.  Antidepressants are a palliative approach to treating depression which means that they only work on relieving the symptoms of depression such as irritable mood, insomnia, hypersomnia, or fatigue.  They do not work on treating the psychological root of the problem which is why psychotherapy is recommended to help alleviate depression from the underlying cause.

What are the true causes of depression?

• Depression is centered on a sense of loss.  In essence, the depressed person feels that he has lost someting that is essential to his happiness or survival.  This could include the loss of a loved one, the loss of a job, feeling that youth or physical attractiveness is lost, or many other things.  Whatever the sense of loss is centered around, the feelings engendered by it are equivalent to feeling that life will never be complete or fulfilling.
• The gap of where one thinks they should be in life and where they actually are in life is too great.  An example of this would be a woman who feels that she should have accomplished much more in her life by age 40.  She feels depressed because she thought she would have been married, graduated from college and started a family by 40.  Depression occurs in these situations when people feel that defects in their personality or character are at fault for the underachievements.  
• Existential concerns.  Depression often occurs when people do not understand what their purpose is in life or why they have been put on Earth.  Severe religious or spiritual conflicts and moral and ethical dilemmas may also be of relevance in this category.    

     The causes listed above are only abreviated and highly generalized categories.  There are many more psychological causes of depression but, many of the causes will fit into one of those categories.  Those who may be afflicted with depression can take comfort in the facts that depression is highly treatable in many cases and that there are many experienced and qualified counselors and psychotherapists that can provide answers and treatment. Those who may be unsure if they are depressed or not could benefit from talking to a professional in the mental health field before things deteriorate further. Preventative measures can be taken to thwart depression before it becomes unmanageable which is perhaps the most preferred method of treatment.

Sincerely,

Nathan M. Comerford, MA, LLPC, NCC

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334
Phone: (248) 932-7799
www.thoughtperspectives.com

• If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
  Just call (248) 932-7799 to set up an appointment with
  Nathan Comerford, MA LLPC NCC.
      
  Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!
  
  Visit the "Ask the Counselor" Blog at:www.thoughtperspectives.com/blog
  
• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

 In my last blog I shared some staggering statistics concerning depression and answered the question of why people who may be depressed choose not to seek help.  In this blog I would like to answer some questions related to the definitions of depression.

• What is Clinical Depression?

     Clinical Depression (also known as major depression, major depressive disorder, and unipolar depression) is classified as a mood disorder by the DSM-IV-TR (a clinical reference manual for mental disorders).  This is an abbreviated definition of a Major Depressive Episode from the DSM-IV-TR: At least 5 of symptoms from the list below must have been met for at least a two week period and one of the symptoms must have been either 1) depressed mood or 2) loss of interest in pleasure. 
1) Depressed mood the majority of the time.
2) Loss of interest in pleasure.
3) Significant weight loss or weight gain.
4) Significant increase or decrease in sleep.
5) Psychomotor agitation or retardation.
6) Fatigue.
7) Feelings of worthlessness or excessive guilt.
8) Diminished ability to think or concentrate.
9) Recurrent thoughts of death or suicide.
     The symptoms must cause significant impairment in social, occupational, or other important areas of functioning.  The presence of two or more Major Depressive Episodes would constitute Major Depressive Disorder, Recurrent (long term depression). 

• What is the difference between Clinical Depression and Situational Depression?

     Situational depression is more commonly known as sadness related to an unfortunate  event or situation that may occur in everyday life.  Situational depression is normally temporary or short term and has little to no interference with one's normal life and daily functioning.  However, situational depression can lead to a more severe case of clinical depression if it is not treated or dealt with in a healthy and timely manner. 
     Clinical depression is characterized by overwhelming feelings of loss, hopelessness, helplessness and despair that is more long term (at least 2 weeks or more) and interferes with one's normal life and everyday functioning.  Pyschological treatment is strongly recommended for clinical depression.  Pyschiatric treatment in the form of psychotropic drugs may be needed in some cases.
     In my next blog I will be answering questions related to the causes of depression.  Until then, enjoy the summer months while they still last!
Sincerely,

Nathan M. Comerford, MA, LLPC, NCC

• If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
  Just call (248) 932-7799 to set up an appointment with
  Nathan Comerford, MA LLPC NCC.
      
  Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!
  
  Visit the "Ask the Counselor" Blog at:www.thoughtperspectives.com/blog
  
• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334
Phone: (248) 932-7799
www.thoughtperspectives.com>

 Depression Statistics:

• 14.8 million (6.7%) adult Americans are affected by Major Depressive Disorder in a given year.  (Archives of General Psychiatry, 2005 Jun; 62(6) : 617-27)
• Women experience depression at twice the rate of men.  (Journal of the American Medical Association, 1996)
• Depression is the cause of over two-thirds of the 30,000 suicides reported every year in the U.S.  (White House Conference on Mental Health, 1999)
• Despite its high treatment success rate, nearly two out of three people suffering with depression do not actively seek nor receive proper treatment.  (Depression And Bipolar Support Alliance, 1996) 

     Over the next several months I will be writing about depression and answering questions related to depression.  As you can see from the statistics presented above, the pervasiveness of depression is highly significant among our population and it only gets worse as time moves forward.  I would like to start this series out by looking at why people with depression do not seek treatment or why they wait until the level of severity becomes so intense that it becomes much more difficult to treat. 

Question: If depression has a high treatment success rate, then why do people forego treatment?

• When people are depressed, the motivation to seek help can evaporate.

     The paradoxical nature of depression is perhaps one of its most debilitating characteristics.  A person who is truly depressed can experience an almost complete reversal in behavior and personality traits.  When depression hits, instincts for self-preservation disappear, the panacea of sleep diminishes and biological drives such as sex and hunger become irrelevant.  Any enjoyment in life is replaced with the drive to intensify emotional pain and suffering.  For example, the depressed person will intentionally avoid engaging in behaviors or activities that will improve their situation.  Exercising, eating healthy and seeking out counseling or therapy are just a few things that will be avoided even though they are known to be helpful.  Escape, avoidance and withdrawal consume the depressed person.

     The motivation to seek help is absent because those experiencing depression become enraptured by pessimism and negative thought patterns. This in turn engenders beliefs that they deserve to be miserable and that they are undeserving of a happy and fulfilling life.  In other words, they do not seek help because they do not believe they are worthy of being helped.       

• Stigma in seeking help is still present.

     Even though counseling and psychotherapy have become much more accepted and mainstream since their inception, the stigma to seek out mental health services still presides.  Most people do not have a problem seeking out medical services when they are physically ill or having a medical crisis.  The same cannot be said for people experiencing mental illness or emotional crises.  Perhaps it is because people see that medical problems are outside their locus of control whereas emotional problems are not.  When it comes to emotional difficulties, many people feel that they should be able to handle them on their own without any outside assistance.  On a similar note, some even feel that they have some how failed in their personal lives if they have to ask for emotional assistance.  Not too many people feel guilty or ashamed to ask for help when they are afflicted with medical conditions like diabetes or cancer.  The fact remains that those who can humble themselves to seek help for their emotional and psychological problems are more likely to make improvements in their lives.

     In my next blog I will be discussing several definitions of depression as well as what depression really looks like.

Sincerely,

Nathan M. Comerford, MA, LLPC, NCC

• If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
  Just call (248) 932-7799 to set up an appointment with
  Nathan Comerford, MA LLPC NCC.
      
  Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!
  
  Visit the "Ask the Counselor" Blog at:www.thoughtperspectives.com/blog
  
• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334
Phone: (248) 932-7799
www.thoughtperspectives.com>

Here are 5 tips to keep in mind when choosing a counselor or a therapist:

• Find a counselor who can understand you and your needs: It is important that you find a counselor who can listen well and understand what it is that you are trying to convey.  Is the counselor asking enough questions?  Is the counselor asking the right questions?  If you feel like you are being misunderstood, then you might consider trying to find another counselor.   
• Find a counselor that will challenge you: One of the reasons counseling can be so effective is because it can make you look at your life more realistically.  If you have low self-esteem, a good counselor will challenge you to improve your self-image and not just flatter you in an attempt to boost your self-esteem artificially.  An effective counselor will be more proactive by giving you tasks and assignments to help you improve your situation.  If you feel like you are not being challenged, then maybe it is time to find another counselor.   
• Find a counselor that you can trust and connect with: It is imperative to find a counselor to whom you feel connected with and with whom you feel safe.  One of the goals in counseling should be to intentionally let yourself feel vulnerable to the counselor.  While that might seem frightening, that is one very important process that promotes growth from learning that you can put your trust in someone without becoming devastated by the aftermath.  Enabling yourself to feel vulnerable means that you must feel safe and be able to trust the counselor. 
• Find a counselor that will accept your true identity: The only way that you can feel safe disclosing personal information to a counselor is to know that the counselor is not passing judgment on you.  No matter how ridiculous or repulsive you may think your thoughts or feelings are, it is the job of the counselor to accept you for who you are and not to dispense judgments or preconceptions.
• Finding the appropriate counselor may take patience and persistence: If you are interested in making progress in your treatment, then rule number one is not to settle for a counselor that you feel will not be able to help you to your fullest extent.  Just like any other profession, there are good and bad counselors in the field.  Several research studies have shown that the theoretical approach or even the credentials of a counselor or therapist do not matter as much as the relationship that is developed between the counselor and the client.  This analogy may illustrate the point better; it is possible to walk several miles in a pair of shoes that do not fit or that are uncomfortable.  However, walking several miles in the right pair of shoes will most likely get you there faster and make the whole experience more enjoyable along the way. 

    
Sincerely,

Nathan M. Comerford, MA, LLPC, NCC

• If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
  Just call (248) 932-7799 to set up an appointment with
  Nathan Comerford, MA LLPC NCC.
      
  Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!
  
  Visit the "Ask the Counselor" Blog at:www.thoughtperspectives.com/blog
  
• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334
Phone: (248) 932-7799
www.thoughtperspectives.com

I would like to continue demystifying the counseling process by explaining why counseling is effective in helping people to overcome their emotional issues and mental health problems.  

• The fact that a professional counselor is not a friend or a family member is actually beneficial to the counseling process.
         The fact that a counselor is not a friend or family member actually makes it easier for the counselor to help you.  The advice of friends and family members can often be colored with biases, judgments, or preconceptions.  Not only do counselors work to be objective and non-judgmental with their clients, that is what they are trained to do.  The goal of a counselor is to assist the client in getting what they want out of life not to assist them in getting what someone else wants for them.   
• Counseling can help one to help oneself.   
         The goal of counseling is not to have the client become dependent on the counselor for answers and advice but for the client to eventually learn to counsel oneself.  A good counselor will teach clients how to think through their decisions before making them, to communicate their needs more efficiently, and to identify and manage their emotions.
• Counseling can give one a place to vent emotional pain and frustration.
         Sometimes people just need to unload their thoughts and emotions to someone that really knows how to listen and understand what they are going through.  Well-respected counselors are excellent listeners that can also pick up on the underlying thoughts and emotions that are not verbalized.  A professional set of ears can be invaluable for helping people to release stress and figure out what it is they are actually feeling. 

     In next months newsletter I will be discussing how to choose the right counselor for your needs.  I wish you good mental health Metro Detroit!

Sincerely,

Nathan M. Comerford, MA, LLPC, NCC

• If you or someone you know needs to speak to someone regarding relationship issues, emotional difficulties or mental health problems, help is a phone call away.  Schedule an appointment today!
  Just call (248) 932-7799 to set up an appointment with
  Nathan Comerford, MA LLPC NCC.
      
  Visit www.thoughtperspectives.com for more information on counseling and psychotherapy!
  
  Visit the "Ask the Counselor" Blog at:www.thoughtperspectives.com/blog
  
• This is a question and answer blog where Nathan answers questions concerning mental health topics.
•  If you have a question, you can send it to: questions@thoughtperspectives.com to have it answered by: Nathan Comerford, MA, LLPC, NCC.

Nathan M. Comerford is a psychotherapist in Farmington Hills, MI who has been helping people with their relationship issues, emotional difficulties and mental health problems for the past 8 years. 

Thought Perspectives Counseling
31275 Northwestern Hwy., Suite 120
Farmington Hills, MI 48334
Phone: (248) 932-7799
www.thoughtperspectives.com