DEPRESSION EXPLAINED





Clinical Depression is a pathological process characterised as follows:


Depressed mood (Sadness or emptiness) is often continuous and pervasive
There is an increasing impairment of normal functioning (work, school, and intimate relationships).
There is an irrational or exaggerated erosion of self-esteem.
There is a dramatic and specific change in vegetative patterns (e.g., sleep, appetite, sex drive, etc.) and the appearance of non-specific physical complaints.
In contrast to grief, the patient is often puzzled as to why he is depressed.


The diagnosis is posed, the treatment is then conducted at two levels:
Medication management-anti-depressant medicines are prescribed by psychiatrists
Psychotherapy: conducted by psychologists.

Varied research studies show the best outcome of treatment occurs when we realise a combination of the two above approaches.

Medication reduces and ultimately suppresses the symptoms. Psychotherapy treats the emotional disturbance and the root of the problem.

Someone who is treated only by medication would improve his level of functioning because of the reduction of symptoms. But the underlying emotional problem is still not treated and the person could have a rebound of the symptoms as soon as the medication is reduced or interrupted. Additionally, the drugs are powerful and have various side effects because they affect the chemistry of the brain.

With the help of Psychotherapy combined with the medication, the patient improves which makes the drugs less and less necessary.

INFORMATION ABOUT MY APPROACH IN THE TREATMENT OF DEPRESSION

Because the symptoms are taken care of by the medication my approach tends to target beyond the symptoms--the inner emotional dynamic of a person. In this context, there are as many depressions as persons suffering from depressions because each individual is unique. I use the word "person" opposed to "patient" because the concept is different. In general medicine, for example, a patient is supposed to be passive expecting for the drugs to be effective. On the contrary, in the psychotherapeutic approach, the subject is supposed to be active, working continuously with the guidance of the doctor, in search for the origins of the problems. As a metaphor, I would say that psychotherapy is a learning process in which an intensive training is necessary and the doctor plays the role of a coach. Like is any type of training, the frequency of the session is the key. This is the reason why, psychotherapy is, usually, effective with a frequency not inferior to one session per week.

I, also, always encourage the person to be free from the label of "Depression". The reason is that, if you are convinced to have a disease, you have a normal tendency to be passive because a disease is always some intrusion (i.e. virus), or some dysfunctional process from an organ or a system. The person is not in control of the mechanism involved. In an emotional problem, the person can and will be in control throughout the process of psychotherapy.

Besides, in the field of mental disorders, the structure applied in terms of symptoms and diagnosis, is the same applied in the physical disorders. The major difference is that in physical disorder, the diagnosis is made primarily after different objective tests have been used (i.e. CT-scan, x-ray, blood work, etc.). In the physical disorders, we can locate the problem identifying an organ dysfunction. On the contrary, in the mental disorders, we do not know, for example, where depression is located. The diagnosis is based on what patients show (symptoms) or says about his trouble. The objective proof does not exist. This is a reason why Psychology which always tries to be objective (i.e. clinical questionnaires, mental tests as a "measure" of intelligence) but is, in depth, primarily subjective.

Because my goal, in the treatments needs to be more connected with the inner dynamic of the person, my approach is called Psychodynamic.

INFORMATION ABOUT BEHAVIORAL AND COGNITIVE THERAPY

In the United States, several therapeutic techniques are inspired by this theory.

The basic principle is that our behaviour has been learned by conditioning reflex type process of a learning. Some negative learning process explains the dysfunction. The therapeutic techniques would substitute a positive learning and erase the negative one.

This theory emphasises the role of the cognitive opposed to the unconscious supported by the psychoanalytical theory. The cognitive approach is very effective in reducing the symptoms, teaching patient how to turn the negative into positive. For example when the patient has negative thoughts in Depression, he can learn how to stop the negative thoughts and have positive ones.

The words cognitive could be replaced by "cognition awareness". The criticism of this approach is that the learning process could be not durable if not reinforced.

In my opinion, this approach could effectively be used when the cause of the emotional disturbance is clearly identified as related to a specific situation. The best indication is the treatment of phobias. Another criticism is that a short-term therapy usually leads to a short-term effect.

INFORMATION ABOUT PSYCHOANALYSIS

In France and in Europe, this theory is still currently used to treat all types of neurosis which is the European terminology to name any type of mental dysfunction. The theory is based on the discovery by Freud that our unconscious does exist and that it is even more powerful than our conscious. One of the main technique is the dream analysis based on the hypothesis that the dream is the "Window of our unconscious" (Freud).

From my practice in Paris and because of my initial training, I have a long experience in this type of treatment. This is for the simple reason that, in France, all the Psychologists are required to have the psychoanalytical background and go through the training process.

In my daily practice, I am very eclectic and I successfully use both cognitive and psychodynamic approaches. The cognitive technique first help reduce the symptoms and breaking the vicious cycle of anxiety. The person is then more available to work though the inner conflicts.

All the above information are concise and simplified in order to allow the person who needs help to better identify and be more familiar with his/her problem. In doing so he/she would know that there is a cure. Many people spend too long a time trying to solve their problems by themselves. In this field, the do-it-yourself method does not work and presents the risk to worsen the trouble.

If you feel that you need help, seek help





INFORMATION ABOUT JOB ISSUES CONSULTING




The job place is where individuals spend most of their time. Good job performance depends upon different factors such as:
Skill
Motivation
Interaction with other individuals
Social Skills
Job environment

Each of the above could interfere with others.

The financial performance of the entire company depends upon everyone's job performance. For example, one can be skill in the work related skill position but show a low level of motivation. Or, good motivation and skill but a difficulty to relate to other people.

Job performance is also an important issue for managers, supervisors or persons in leadership roles. How is the manager handling his relationship with his people, he is supposed to direct or to guide?
Is he clear in the different instruction he gives to people?
Is he concerned about his power, or is he abusing it?
Does he have the competence in the leadership role?
Does he have the skill to motivate people, or, instead, is he frustrating them?


When it appears that a company is experiencing problems we primarily focus on the financial issues. But in various occasions, these financial problems arise as a result and not a cause. In this case an investigation could be conducted in order to find the origin of the problem. The diagnosis in several cases would point out a human dynamic issue.

For example, an important turn over in a company could be a symptom of some negative dynamic issues. People could have different types of emotional or personality problems such as; Depression, Anxiety, etc. When the problems happen at a certain degree, they become pathological. If the person is aware of them or does not function properly, he/she usually seeks help. But the person could be unaware of the problem or simply resisting to any help. (Do it yourself method).

In this case he/she would bring the problem to the work place and literally "poison" other persons of the whole job environment. If there are ten or twenty persons or even more in the company doing the same thing, then the whole company may be "poisoned".

Posing the proper diagnosis would help to find the most appropriate solution.

The benefit would be for both the individual and the company. This short information gives an idea about the area of intervention called:

Human Management






INFORMATION ABOUT PSYCHOTHERAPY

As a result of my long experience in the field, I strongly believe that psychotherapy has three major phases:
- Phase I:
The client is a " patient" implying that he/she is suffering and needs help. This is the phase when the symptoms are acute and prevent the patient to function properly.
In most of the cases, a positive relationship established with the therapist and the ability to speak out would reduce those symptoms significantly.
- Phase II:
The "patient" becomes a "person" and is now able to discover him/herself,, his/her personality.
- Phase III:
- The "person" is, now, able to grow.
I believe that this phase is close the philosophical approach.
Philosophy is, after all, the origin of Psychology. Ph.D. = Doctor in Philosophy.





DEPRESSION AND CREATIVE ENERGY







Like we said above, Psychiatry considers Depression as a disease and makes a diagnosis based on symptoms.
A symptom is what we observe, what the patient shows. A symptom is a signal of some reaction. As an example, fever is a signal of a reaction of our immune system responding to some aggression.
The problem is that symptoms observed in a medical disease are OBJECTIVE. Instead, when Psychiatry considers Depression as a mental disease, the symptoms rely on what the patient states and, therefore, are SUBJECTIVE. A part of the diagnosis is, of course, based on the patient’s behaviour. The behaviour could be the expression of some state of mind but, I believe, it is not a reliable observation.

I suggest that we try to understand the dynamic of Depression from “the inside”.
Because Depression is supposed to be a disease, Psychiatry uses the word “patient”.
In Psychology, I would rather use the word “person”.
Besides there is no “Depression”. There are “person who are depressed”.
What is happening “inside” a person who is depressed?

If we go beyond the symptoms, we see, in fact, that there is a major paradox.
People who are depressed have a tendency to show a symptomatic low energy level: they stay in bed all day, no desire of anything……
In my experience, asking the right questions to the person, we see exactly the opposite.

I came to the point that I could draw a general profile of a person who is depressed:
- This person has a higher level of intelligence based on the ability of introspection or “insight”.
- This person is highly ambitious but impatient. It is “all or nothing”.
- As a result, this person can experience a major frustration.
- This person has a creative potential but not used or unknown.
- As a result this CREATIVE ENERGY is REPRESSED.
- The high energy is still there but, then, becomes highly negative.

Consequently, this high energy is stuck in the emotional system and, as a metaphor, the person IMploses (vs EXplosion).

THERAPEUTIC APPROACH:

The ultimate goal of psychotherapy is to allow the person to express this repressed energy and rediscover the underlying positive energy.
We know that REPRESSION is a basic concept of the Psychoanalysis theory.



REPRESSION------------------DEPRESSION---------------EXPRESSION

In this terminology we have “…PRESSION” or “..PRESSURE”.
PRESSURE is an energy and psychotherapy would allow the release of this energy.