Lifestyle Choices

There are hundreds of different therapies for depression, and what you decide is right for you depends as much on who you are and your own preferences as it does on how bad your depression is or what caused it. Just as there are many causes, there are also many types of treatment which are not necessarily contradictory. One sort of cause does not mean that a certain treatment is necessarily required. For instance, a depression may have been precipitated by a marital separation, but if it is severe enough to cause strong physical symptoms, initially it may be best treated physically.

On looking through the possible causes charts, you may have picked out some causes that perhaps seem relevant to you and some that really strike a chord. Perhaps you find that your early family situation provided you with very little emotional support and a poor opinion of yourself— it is possible to explore these avenues with in-depth psychotherapy , which may be useful: but you may, on the other hand, decide that this is not right for you and that you would prefer to focus more on changing your lifestyle and environment. A purist may say, “But then you are not really getting down to the nitty-gritty, the real cause“. This does not necessarily matter for two reasons: first of all, this “real” cause may be one of many, and it may not be the most important one. Secondly, it is sometimes possible to change your feelings about yourself without analyzing them, as long as you have the strength and determination to make your present environment and experiences of life different and positive.

Reading through the sections in this part of the book may give you an idea of the kind of treatment you might prefer. You may also need to discuss it with somebody, in which case talk to your general practitioner, or else consult one of the agencies. In general, there are four factors which affect your choice of treatment: depth of depression, cause of depression, personal investment, and personal preference.

There usually comes a point in deepening depression when words become less effective than physical treatments. As a general guideline, loss of sparkle, blue and grey depression can often be treated through self-help or psychotherapy, while black and white depression generally tend to respond more effectively to physical treatments.

The problem with depression is that you seldom feel like helping yourself at all. The section on self-help is therefore purposefully directive. There are two main ways you can help yourself. Either you can deal with the cause of your depression by dealing with the life event or changing the life non- event, or you can deal with the symptoms. The best option is to do both. In the following sections, there are some suggestions that may strike a chord and others that will put you off. Although you are more likely to take up your preferred activities with more enthusiasm, you need to balance this against the need to try something different in order to challenge some of the views and rigid patterns which may havecontributed to your depression.

If you are deeply depressed, you may find it very hard to find the motivation to even look for, let alone try to deal with, a cause of your depression. If this is so, you may need to work on changing the symptoms first, either by helping yourself or by getting professional help. As soon as there is an uplift in your mood and motivation you can then return to looking at the cause.

Cause and treatment may not be obviously related. For instance, a life event may precipitate a depression too severe for psychotherapy to be helpful. Although the above guide is generally true, it is worth noting that there may be several causative influences, and that depth of depression, personal investment and personal preference are also important.

It makes sense to try self-help before seeking professional help, both in terms of the investment in time and money and in terms of the dividend of more self-reliance. If you need or want professional help, psychotherapy and physical treatments involve very different kinds of investment.

In terms of personal effort, time and money, psychotherapy is usually more expensive than physical treatment. Financially, this is because physical methods are more likely to be paid for either by the State or by insurance companies. There is only a limited amount of psychotherapy available through the State. Although short-term psychotherapy may sometimes take less time than a long series of physical treatments, in general it takes more time than physical treatment. In addition, psychotherapy, when it is effective, always requires personal effort, a willingness to explore pain as well as pleasure, and an openness to changing a view on life.

The other side of the equation is that your greater personal investment may pay longer-term dividends. If you can learn to handle your depression without drugs, you are more likely to be able to deal with a recurrence, if it arises, yourself.

To an extent, it is important to find a form of therapy that feels suitable for you. Most people will want to try some forms of self-help. Those with a more mechanical and materialistic view of life are more likely to prefer physical treatments,while those who like to find inner meaning and motive are more likely to prefer psychotherapy.

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