Come to me, all you who are weary and burdened, and I will give you rest.
Matthew 11:28
In yesterday’s blog, I talked about pushing on, to not give up trying, and to continue to work our program for health, even when it is difficult. Then I posed the question about depression. When one is clinically depressed, lack of hope and lack of motivation are hallmark symptoms. How does one go about keeping up with challenging disciplines when one is depressed?
I have had severely depressed clients who shared with me that it is difficult at times to even get out of bed. Getting dressed becomes a chore. Simple household duties become overwhelming. Work feels out of the question. Then what do we do?
When people experience that level of depression, medical intervention is imperative. A thorough physical examination is in order first to rule out various illness or hormonal causes of the depression. Clearing that hurdle, a psychiatric evaluation is in order to consider antidepressant medication. Supportive counseling is also a key therapeutic element.
Then we come to some behavioral work. It is important to validate to the client that what they are experiencing is real, and that they are truly suffering. Then I may begin to suggest the smallest behavioral tasks- maybe getting out of bed a little earlier than they did the day before; doing one household task per day- the dishes perhaps.
The idea is to go slow, but to put reasonable, achievable tasks before them. One little success makes the next step easier and to seem attainable. Every little success builds to the next one. Taking behavioral charge is still important, even when the client may feel it is so small. Taking control of small actions gives the confidence that life can still be managed, even though at a slower, smaller level.
It reminds me of an old saying in counseling- “Change one thing, change everything”.
I think that’s a true statement.
Prayer: Lord, give us strength, even when we don’t think we can move forward, Amen
Reflections of a Counselor 