Interventions for Depression: One Size Doesn’t Fit All

September 3, 2021   •  Posted in: 

I remember my first group breathing exercise.

“This will totally relax you,” our instructor promised. “Breathe in deeply….slowly….now hold it. Longer….longer….now breathe out as 

S-l-o-o-o-w-l-y as you can….”

In my chair, obediently following all the instructions, I was freaking out. Where was the relaxation? I was about to lose my mind! Get me out of here!

Depression Treatment Looks a Little Different for Everybody

What helps most people – slow, deliberate breathing, which is backed by lots of data, did not work for me on that day, and it still tends to make me anxious. The point is: what works for “the many” may not work for “the one.” And it may not work for you.

How many ways can you treat depression? Oh, let us count the ways.       

You Are A Creature

I think it’s always best to start with the body. We like to think we can overcome anything with the power of our mind, but, news flash, you can’t. You may have an MBA, run a mega-million corporation, or boast any number of achievements. But it all feels beside the point when you have a toothache, doesn’t it?

The “whole person” approach means not looking at yourself, or letting anyone else look at you, as just an operating system, or software, or simply your mind. It also involves looking at your “hardware” – you are flesh, blood, and bone.

Recognize that you need sunlight as much as your little plants on the windowsill (when’s the last time you watered them, by the way?). You need good nutrition, (garbage in, garbage out), exercise (we are made to move), and time in nature (wanna dig your feet in the sand at Edmonds Beach?).

Once you’ve got your machine humming again, it makes sense to turn to the brain running it.

CBT for Depression – DBT for Depression

Ever since Aaron Beck came up with the idea of how dramatically our thoughts affect our feelings, and our feelings affect our actions, and our actions affect our thoughts (and round and round it goes), CBT, cognitive behavioral therapy, has been considered the gold standard for helping people change their thinking. And thus, change their feelings of depression. Beck proved that depression can be cured!

Along came Marsha Linehan, considered to have a borderline personality disorder. Once considered untreatable, she didn’t let her disorder stop her. She dared to tinker with “the gold standard” and came up with dialectical behavior therapy, or DBT. 

Linehan freely admits she took already existing elements and simply combined them into a new framework. But what a framework! She started with CBT, sprinkled in some mindfulness, stirred vigorously, and out came DBT, effective treatment for many disorders. It is also the backbone of the whole person care program at The Center • A Place of HOPE. Think of DBT as another form of CBT, but one that encourages you to mindfully feel your pain and discomfort and not let it rule you.

What About Medication?

Ah, meds. Yes, they can be an important and crucial part of your depression treatment. Absolutely. But let me tell you a little story.

I have a friend I’ll call Marie who was in a horrible marriage. Her husband constantly belittled her, and made her feel so “less than.” Without her friends, Marie would have been totally unsure of her own worth.

Marie didn’t like her job very much, and her friends encouraged her to apply for one she had her eye on, reasoning that, if she could find fulfillment in her work, it would bolster her badly bruised ego.

In the middle of this process, her husband came home and announced he had his eye on a house he wanted to buy and he wanted Marie to withdraw her application for the new job until they qualified for the purchase.

Marie and I drove out to look at this house. The minute I saw it, my heart sank. It was a DIY nightmare. Lots of acreages, but peeling paint, a broken porch, and the inside weren’t any better. I could see Marie’s eyes filling with tears.

“I’m going to need to ask my doctor for an increase in my antidepressants,” she said.

“Marie, no,” I said. “Look. You’re working in a job that doesn’t fulfill you, you’re about to move into a house that is falling apart, to live there with a man who despises you. No amount of antidepressants can make that okay – and they’re not supposed to.”

Point is, many of us live in ways that are guaranteed to make us unhappy. And it’s not the role of antidepressants to make what is naturally intolerable, tolerable. The exception is in special situations like complicated grief, when we may need some help getting through. Some things are supposed to hurt – hurt like hell. Sometimes people are depressed for very good reasons. Depression can be a powerful internal GPS that says: you are going the wrong way!  A good therapist can help you identify what you need to change, and walk you through that process.

Antidepressants are meant to change your brain chemistry. Some of us are just genetically programmed to be sunnier, and others are born more Eeyore-ish. How many people in your family also have mood problems? 

If you weren’t blessed with a sunshine turn of mind, it may make sense to get a little chemical help with that. A good psychiatrist will need to be on your team for this.

All of It Has to Be Individualized to You

And all of it – your personalized care program – has to be tailored to your unique personality, biology, past experiences, and present circumstances. Your treatment may need to be taken in a little here, let out a little there, and you may want some fringe on the bottom. Don’t be afraid to ask for what you want. Also, don’t be afraid to listen to your doctor or therapist. After all, if you could solve it yourself, you wouldn’t have coordinated treatment. 

The “whole person” approach, addresses physical needs as well as faulty thinking with both CBT and DBT. It addresses brain chemistry and assesses life circumstances, all with a team of therapists and other professionals at your side. It is now recognized as a proven approach in the mental health community and is the philosophy upon which The Center is founded. 

With a combination of approaches, openness, perseverance, and a fair wind, it’s possible to find real hope and help for depression.

If you or a loved one is struggling with anorexia, it’s important to seek professional help. Our world-class team of eating disorder professionals at The Center • A Place of HOPE has helped many people recover from eating disorders through our focus on whole-person care. Fill out this form or call 1-888-747-5592 to get more information or to speak confidentially with an eating disorder recovery specialist today.

Karen Fallen-Rhodes, LMHCA

Karen Fallen-Rhodes, LMHC, had been a counselor at The Center • A Place of HOPE for five years. She oversees the group therapy department and writes curriculum for groups based on the works of Dr. Gregory L. Jantz, founder, as well as other sources. She runs a private practice centered around the ideas of positive...

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