Depression Counselling Therapy

What is Depression?

Depression is is a mood disorder that describes persistent feelings of sadness, loss of interest, and sometimes anger. It is an extremely common mental health issue and can interfere with your daily functioning and quality of life.

It’s normal to feel sad or depressed during a hard time or after a major disappointment. Most of us struggle to “focus on the positive” when the odds seem like they’re stacked against us. Everyone has good days and bad days, and sometimes we just feel off.

For people with depression, feeling sad and unmotivated are a regular occurrence. Days can feel drawn out, empty, and painful, and feeling “off” is a common experience. Regular tasks become difficult and tiring, and some people may struggle to feel anything at all.

While “depression” usually refers to major depressive disorder (MDD), you do not need to meet the official diagnostic criteria to be depressed. Many people experience depressive symptoms that do not fit criteria for any one specific subtype. In fact, the word depression comes from Latin and means to “push down” – something most of us are familiar with when it comes to difficult emotions.

Signs & Symptoms of Depression

Some people go through just one episode of depression in their lives, although many people experience several episodes or low-level symptoms consistently. A person with depression experiences symptoms nearly every day, for most of the day. Men and women may present with different symptoms, although anyone can experience the following changes in:

• Mood: such as sadness, emptiness, hopelessness, loss of interest, apathy, self-loathing, irritability, frustration, anger, thoughts of suicide
• Cognition: such as trouble thinking, concentrating, delayed responses, talking more slowly, memory problems
• Behaviour: loss of interest, unable to find pleasure in activities, getting tired easily, social withdrawal, excessive drinking & substance use, compulsive eating
• Sleep: such as insomnia, difficulty sleeping or sleeping too much, waking up in the middle of the night, having trouble getting out of bed
• Sexual Interest: such as decreased sex drive, disinterest in sex, issues with sexual performance
• Physical Health: such as appetite changes, digestive issues, weight loss or gain, fatigue, low energy, chronic aches and pains.

Subtypes of Depression

Although many people do not fall into one specific category, there are a number of recognized subtypes of depression:

Major Depressive Disorder (MDD) features a persistently low mood for at least two weeks. People with MDD experience low self-esteem, low energy, lack of motivation, disinterest in previously enjoyable activities, and deep pain without an obvious source. 

Dysthymia (short for Persistent Depressive Disorder, “PDD”) is depression that lasts long-term, with symptoms that are often less acute or severe than major depression. Those feelings of hopelessness, disinterest in daily activities, and self-loathing stay constant over time, and sometimes last for many years. PDD can interfere with relationships, school, work and daily activities.

Seasonal Affective Disorder (SAD) is a form of depression that coincides with changes in the seasons. Most people with SAD develop symptoms of depression (such as moodiness and lethargy) in the fall and continue into the winter months. Less commonly, people experience SAD in the spring or early summer.

Premenstrual Dysphoric Disorder (PMDD) is a condition similar to PMS. People with PMDD experience severe irritability, depression, or anxiety as hormone levels fluctuate during the 1-2 weeks before menstruation.

Postpartum Depression is when new mothers experience a period of depression after giving birth. Hormonal fluctuations from pregnancy and childbirth drastically alter women’s mood and energy. Mothers often feel guilty about feeling depressed after giving birth, which makes symptoms worse. 

Bipolar Disorder is a mood disorder and form of depression. People with Bipolar I go through cycles of major depressive episodes and manic phases. They may exhibit feelings of grandiosity, paranoia, abundant energy, little need for sleep, and reckless behavior. Bipolar II is a milder version of Bipolar I. People with Bipolar II have experienced at least one depressive episode, but they experience less severe manic episodes (hypomania).

Adjustment Disorder is technically considered a stress-related disorder; however, it often shows up with depressive symptoms, and occurs after an identifiable stressor like a relationship breakup or job loss.

Remember, most people experiencing symptoms of depression or low mood do not meet diagnostic criteria or fit into one of the categories above. If you are feeling down or depressed, your experience is valid and legitimate no matter what an official diagnosis would say.

Treatment for Depression

Treating depression can make a significant difference in a person’s quality of life. Some people find practicing mindfulness, gratitude, and compassion to be very beneficial. Taking care of oneself through diet and exercise, seeking social support, or spending time in nature can also help improve symptoms and overall wellbeing.

If self-help techniques and lifestyle changes are not enough, medications and psychotherapy, or both together, are common and effective courses of treatment.

Medication

In terms of medication, most physicians will first prescribe antidepressants. SSRIs (selective serotonin reuptake inhibitors) (e.g. Cipralex, Prozac) and SNRIs (serotonin-norepinephrine reuptake inhibitors) (e.g. Cymbalta, Effexor) are the most common, although many others exist and are prescribed regularly. Most modern antidepressants require at least 2-3 weeks to take effect.

Everyone responds differently to medication, which is why finding the right drug and dosage requires patience. If the most commonly prescribed (“first-line”) medications for depression are not effective for you, or you experience excessive side effects, there are many other second-line options that your doctor or psychiatrist can explore with you.

In order to rule out any possible medical issues, it is also recommended that you ask your GP for a full blood analysis. Sometimes medical conditions such as hypothyroidism or vitamin deficiencies can cause or exacerbate symptoms of depression.

If you’re interested in exploring medication, you should make an appointment with a medical doctor to discuss your concerns. If you do not have a family doctor and are a resident of Vancouver, you can call or visit the Access & Assessment Centre (AAC) at Vancouver General Hospital to be connected with a psychiatrist. For other locations in the Lower Mainland please refer to the Vancouver Coastal Health and Fraser Health websites.

Counseling Therapy for Depression

For many people, medication is not a preferred treatment option. Any drug treatment comes with risks and benefits, and some people find either the side effects outweigh the benefits, or that medications do not help at all.

Therapy is an effective, evidence-based treatment for depression. It offers you a safe, supportive, and non-judgmental space to be heard and understood. Oftentimes, people will report that their first experience of truely being “seen” is with a counsellor. Talking with a counsellor also gives you the opportunity to work through the deeper issues that may be causing depression. In many cases, depression develops in response to unhealed trauma or complicated grieving.

There are many types of psychotherapy that treat depression. Some are more “short-term” and skills based, while others are long-term “depth” therapies. Many people find a combination of both is helpful in order to improve day-to-day functioning, whilst also healing old wounds and fostering long-term change.

For example, Cognitive Behavioural Therapy (CBT) teaches you how to recognize negative thoughts, beliefs, and behaviors and replace them with healthier ones. Other examples are Emotion-Focused Therapy (EFT) or Acceptance & Commitment Therapy (ACT), which focus more on emotions, attachment, and psychological flexibility.

Other long-term approaches can allow you to “deep dive” with your therapist, and develop a deeper understanding of the root causes of your issues. Sometimes a somatic or “bottom-up” approach such as Sensorimotor Psychotherapy (SP) can be helpful, especially for clients who are struggling with verbal expression, or to heal past traumas at the level of the body.

In terms of options for therapy, there are many independent practitioners as well as group counselling clinics offering services in Vancouver. For a more detailed guide on finding the right therapist in Vancouver, we recommend you take a look at our detailed Finding a Therapist Guide.

At ARC we have a diverse team of therapists who provide treatment for depression and related issues. All of our therapists have a minimum of a Master’s Degree and are in good standing with the BC Association of Clinical Counsellors (BCACC) or the BC College of Social Workers (BCCSW).

If you are experiencing a specific subtype of depression that we do not have specialization or scope to treat, we will let you know during the initial contact or consultation, and we will assist you in finding support that better meets your needs.

Please use the form below to request a consultation with one of our therapists and we will get back to you within 24-48 hours.