Do I Need Depression Counseling?

Many people struggle with depression but may not be sure if they should see a therapist. That’s why we’re talking today with Dr. Jane Rubin about depression counseling and how it can be helpful to you if you think you might be experiencing depression.

What Motivates People to Go to a Therapist for Depression Counseling?

At some point, people with major depression usually realize they need help. Major depression includes very serious symptoms, such as:

  • A depressed mood most of the day.

  • Insomnia or hypersomnia.

  • Difficulty concentrating.

  • Inability to take pleasure in things a person previously enjoyed.

  • Suicidal ideation and recurrent thoughts of death.

In cases of major depression, it usually becomes clear to the depressed person or the people close to her that she needs counseling and, possibly, medication.For other kinds of depression, that’s often not the case. In the book Shadow Syndromes, theauthors talk about how many people experience things that share some similarities with diagnosable mental health problems but don’t have nearly the same level of severity. In my experience, people who are experiencing this “shadow syndrome” kind of depression often don’t seek counseling, even though it could benefit them greatly.

What Kinds of Problems Can Be Treated By Depression Counseling?

The psychoanalyst Heinz Kohut identified three basic psychological needs that, he thought, all of us have. They are:

  • Mirroring:  We need to feel that other people value us and take pleasure in who we are. Kohut thought that mirroring was essential to the development of self-confidence.

  • Idealization:  As children, we need to feel that our caregivers are sources of strength who can calm and soothe us when we’re distressed. Kohut thought that these early experiences of idealization are the basis of our being able to commit ourselves to things outside of ourselves, such as religion, political causes, or our work. Kohut thought having meaningful ideals was one basis for having a fulfilling life.

  • Twinship:  Kohut thought that we need to feel that we’re similar to other people and share significant experiences with them. Twinship is the foundation of a sense of community.

If someone is struggling to satisfy one or more of these needs, he may be struggling with depression.

Are there Different Kinds of Depression Other Than Major Depression?

Yes, there are several. Two of them, I think, are the result of a person’s having unmet mirroring needs:

1. People whose parents were very critical of them will often very self-criticalas adults.  I’ve had patients whose parents were relentlessly critical of their physical appearance or their personality or their interests. This kind of criticism can create a kind of “shadow syndrome” depression. Even though these individuals didn’t have major depression, their self-criticism was extremely debilitating. It caused them to doubt their ability to find a partner or to do the kind of work they wanted to do. It ate away at their self-esteem and undermined their hopes for the future.

2. The other kind of depression is the opposite of this. I’ve seen many depressed people whose parents weren’t critical of them at all. Instead, their parents were barely there. They didn’t provide any mirroring or guidance whatsoever. These individuals often feel lost and without direction. They feel like they don’t matter to anyone. They often feel hopeless and have difficult motivating themselves.

How Can Depression Counseling Help These People?

For the first group, depression counseling can help people to understand how their parents’ criticism has affected them. Even more importantly, in depression counseling they can experience a kind of empathic mirroring that will help them to gain a sense of self-confidence.For the second group, having a therapist who genuinely cares about them and helps them to see their strengths allows them to experience what was missing in their early relationships—a sense that they’re seen and that they matter. From there they can gain a sense of hopefulness and direction in their lives.If someone feels that either of these descriptions applies to them, I strongly encourage them to seek depression counseling. Even if they think they aren’t depressed, they can gain a more robust sense of self-confidence and self-worth, as well as a more hopeful attitude about their lives.Click to learn more about depression therapy and treatment with Jane Rubin, Ph.D.Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.