Depression and anxiety are terms which commonly refer to transient emotional states. However, when used clinically, they refer to disorders, which are sustained and debilitating to an individual's ability to meet ordinary life challenges. The notes below are only a brief discussion of these complex, difficult but common disorders.

Therapy for depression and anxiety starts from the basic understanding that there is an ongoing and circular pattern of interaction between thoughts (cognitions), actions (behaviours) and emotional states. Essentially, how we see a situation impacts how we interpret it, how we feel about it, and how we act upon it. 

From that basis, therapy can be as simple as modifying behaviours or challenging unhealthy thoughts in order to feel differently. However, the incorporation of learning to be mindful (present in the here and now, not in the past or future where depression and anxiety often dwell) is important. Similarly an essential aspect of recovery is the process of acceptance of some of the realities which we may not be able to effectively change. 

Dialectical approaches work on balancing acceptance and change, recognize that the intensity of emotional pain is a powerful force which pulls us away from accurate, logical thinking and interpretation. This doesn't mean that emotional experience is wrong or something to power through or dismiss. Emotion is both essential and provides meaning and context, when we are able to develop that balance and hold both our emotional truths and our rational understanding. 

Working with depression and anxiety also recognizes that the patterns of our historical relationships and the learnings of our past are connected to how we adapt to our lives in the present. While we are absolutely the product of our history and circumstances, by seeking to understand those influences, we can evolve and change how we move into the future.

Depression and Anxiety

Depression and Anxiety

Some common signs and symptoms of both anxiety and depression:

  • emotional reactivity or agitation
  • physical agitation/restlessness
  • problems with memory, concentration & focus
  • difficulty with decision making
  • persistent negative and unwanted thoughts

Anxiety disorders arise from a high level of emotional tension and are marked with:

  • physical experience of stress, i.e. agitation, increased heart rate, lightheadedness, shakiness
  • emotional states of fearfulness, worry and stress
  • repetitive and intrusive thoughts, impacting your ability to make ordinary decisions effectively.

Depression is generally characterized by a low mood, which is reflected in:

  • sadness or despair which persist regardless of the situation
  • loss of interest in ordinary pleasures
  • decrease in libido
  • significant change in appetite
  • significant change in sleep patterns
  • physical lethargy or slowed response
  • flat or dull emotional state
  • thoughts of death or suicide

Most people can recover fully with effective treatment. Severe episodes are often treated with a combination of medication and counselling. I would recommend you consult with your family physician to discuss medical options. Diagnosis should be made in consultation with your health practitioner. I can help you prepare for this discussion. With more moderate or early symptoms, counselling alone can be effective. I approach counselling for depression and anxiety with a combination of approaches, informed by Mindfulness Based Cognitive Therapy (MBCT), Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Dialectical Behaviour Therapy (DBT).

Brenda Duncan MSW RSW Individual and Couple Counselling