Healthy News for Healthy Nation

Everyone knows that major life changes - divorce, death, unemployment - can be stressful and lead to depression.

But not many realize that even positive life transitions, like starting a great new job or getting married, brings stresses that can lead to depression.

And even in really good times, a person will often become depressed.

When this feeling of being depressed threatens to overwhelm, professional counseling may help. A counselor, like a good friend, does not tell her client how to deal with depression. A good psychotherapist does specific, concrete things to help her client deal with the depression,

If you are depressed and don’t know why, maybe you’ll find some counseling tools that I’ve described below of help.

Cognitive and self-esteem therapy for depression, or understanding yourself

One young woman who moved from a close-knit rural community to Detroit to join a high-prestige job found the change difficult. She had moved away from all her family and friends, and her new job was demanding. Because she was unable to say no to her colleagues when they asked her to do extra work, and because she bent over backwards for her family, she frequently found herself saddled with far more work than she could handle.

When she entered therapy, she and her psychotherapy counselor focused on giving her the tools to say no to unreasonable demands so that she could stay more in control of her life. They did role-playing and rehearsed what it was like to say “no”, so she felt more comfortable with the idea and would be able to say “no” when the time came in real life.

Later, as the young client became more confident that whatever she said would be kept confidential, she was able to open up and they could work on her anxiety and depression.

This young woman realized that she had a pattern of neuroses throughout her life, and that she needed help figuring out who she was when all the pain was stripped away. What was left? Was she saying “yes” to all these demands in order to make up for what she feared was lacking on the inside?

Discovering the truth of the matter gave her confidence in her abilities. She was able to transform her anxiety into success personally and professionally.

Marriage and relationship therapy, or learning to get along

Sometimes it helps to remember that life is difficult. Just because we are having difficulties does not mean that we are failures. Understanding this is important in close relationships like a marriage.

A marriage will often start out with both partners happy, but when the demands of day-to-day life come up, and often unrealistic expectations have to give way to a more mature understanding.

One partner or both may become depressed when reality sinks in, But almost every marriage and every relationship can improve with the correct nurturing.

People in relationships can in fact get past this point and end up better for it.

An elderly couple in Cincinnati entered therapy when they had become stuck in a high-conflict pattern. They were always arguing. No matter what it was about, they could not seem to get along.

Because their family had moved away and many of their friends had also died recently, both partners were also depressed at the way their lives had ended up.

Therapy helped them look beyond their problems to the happy times they had shared. They accepted that any marriage needed to be constantly nurtured to be a happy marriage, and that they needed to keep nurturing their relationship even though they had been married many years and had “been there and done that.”

The result was a much more enriching and happy relationship, and less depression.

Counseling for gender-reassignment - building a network of support

Even changes which a person has been longing for may not be as fulfilling as expected when they come, and can actually be depressing.

Modern cognitive theory shows us that we tend to over-estimate the happiness that a major life change will bring us.

I can use an unusual example for this.

Some people feel they have been born into the wrong gender, and that there is a mismatch between their mental and physical gender. These are the people who are likely to opt for a gender change surgery as a permanent solution.

They will look forward to the surgery often for months. They will develop strong feelings that their lives will be much improved after the gender-change.

But they often find that the reality is not as good as they had expected.

They find the process of surgery is itself traumatizing.

There is a loss of family support, and it is not easy to find acceptance for the new identity. The loss of the old identity needs to be grieved over, and new forms of socializing learned.

They can get very depressed over this. Most people, with therapy to help them, can recover.

A psychotherapist can stand by people going through the gender reassignment trauma and help them rebuild a network of community support and their own lives.

This is one of many examples of how people can get depressed for periods in their lives, and some of the strategies for dealing with the depression.