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What is what we call depression and how to find a cure?

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Depression is the most common mental disorder, and among the most disabling diseases in the world. Depression has serious social consequences on our friendships, relationships, education and work. Research show that one in five women are likely to be seriously depressed at some point in her lifetime, and roughly half that proportion of men.

It is evident that since the first mentioning of ‘melancholia’ (between 5th and 4th centuries BC) until today many people have been struggling to identify what depression is and where it comes from.

NHS (National Health Service) goes on in defining depression as a serious illness. It says that ‘depression is more than simply feeling unhappy or fed up for a few days’. It even says that the symptoms persist for weeks or months but encourages individuals to seek help after the symptoms have been present for two weeks. As a treatment NHS recommends medication or talking therapies (Counselling, Psychodynamic psychotherapy, Interpersonal therapy or Cognitive – behavioural therapy), or a combination of the two.

There are currently no methods available in standard mental health practice that can predict which treatment is going to work for which individual in helping to overcome depression.

Currently, scientists and mental health practitioners recognise that depressive symptoms might have biological, psychological and social causes although there have not been huge discoveries around identifying biological reasons yet.

In most occasions, in the UK, people are diagnosed with depression by their GPs during a 10 minute appointment. The most common help that people get when diagnosed are antidepressants although research results of the last decades show that medication does not help individuals more than placebos. In addition, they might advice to get counselling or psychotherapy but they very rarely refer to one of the talking therapies although NHS recommends it.

Counsellors and psychotherapists mostly see depressive symptoms as a clue to exploring the individual’s inner world. With these therapies people are helped to understand themselves better. The first step in the individual counselling of depression is to create a stable therapeutic relationship. For example Person-centered psychotherapy’s method is based on research that shows that an accepting, empathic relationship between a counsellor and a client helps a client become self-aware and self-reliant. The therapy is ‘designed’ to be adapted to each client instead of being a one-size-fits-all approach. Rather than analysing what is wrong with the client and subjecting the client’s feelings and behaviours to analytical interpretation, the therapist is a companion on a clients’ journey to cope with and find solutions to life problems.

The ‘problem’ with this is that counselling and psychotherapy take more time than the time needed to swallow a pill, and some would argue that more money has to be invested into the mental health system, i.e. people’s metal health.

One thing scares me. Many of my clients had been diagnosed with depression and many have been seeking advice on whether to take antidepressants, but none of them has ever been referred to counselling which means they were waiting for months before starting with therapy even though there are numerous research findings which indicate the benefits of these therapies in treating depression. From that perspective, it seems that not much has changed since the 80 ties, when my grandmother was diagnosed with severe depression. The psychiatrist saw her for 2 minutes in a hallway in front of his office. She was immediately put on antidepressants. She was never given a chance to explore her inner world and a month after she tried to commit suicide.

Regardless of the written, I’m glad to witness that treatment of mental problems has been lately improved, but unfortunately, there is still public stigma which prevents the equation of mental health problems to physical ones.