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Depression and Reluctance to Seek Assistance

Research articles I have read report depression a growing problem around the world and in the US. One statistic indicates depression is costing American businesses more than $40 billion a year through absenteeism and poor decision-making. Suicide statistics indicate that from 1999 to 2014, the suicide rate increased 24% here in the US. (a suicide fact sheet is available online at http://afsp.org/wp-content/uploads/2016/06/2016-National-Facts-Figures.pdf.)

As a mental health practitioner, I commonly see people in public evidencing signs of depression. In continuous mental health practice for 40 years, I have been saddened to see family members and friends alike who are in denial about their need for counsel. It continues to baffle me. When there’s so much information available in the news and in the public media about depression, too many continue trying to solve intractable mood problems by themselves. Too often they wait until they become desperately unhappy. By then, suicide often becomes seen as the only way out of their misery.

There is nothing new about the idea of getting help. In ancient wisdom literature, there can be found encouragement to seek counsel when facing problems. It is interesting to me that people frequently feel okay in asking for assistance with practical matters but not okay about asking for counsel from trained people concerning their feelings of despair and/or helplessness. For example, people who are experiencing plumbing problems will usually ask family or friends who they know that is a competent plumber. Therefore, it would appear logical that people would assess their mental and emotional situation for coping. When they find that their strategies for managing their dilemma is failing, they would then seek competent help to resolve their situation.  All too often, that is not the case.

Frequently people allow fear of judgment by others to stand between them and reaching out for help.

Also there are those who fear therapy because it is an unknown situation. It is unfortunate that this fear drives them to remain ignorant, silent and socially isolated in attempting to cope.

Every therapist training program that I’ve witnessed teaches the practitioners to be non-judgmental, genuine, and warm with their clients. There is nothing to fear. Usually, the worst thing that happens when a person goes to see a therapist is they discover the professional is not compatible with their personality and beliefs. There is no one therapist or set of therapeutic ideas that fits every human need. So like any other search for a competent professional in any field, it is often necessary to speak to several therapists n to find one the individual can work with.

Another factor that can make it difficult for people suffering from depression is a feeling of constant fatigue. When that is the case, blessed is the individual who has family and friends who care enough to confront them and encourage them to overcome their fatigue and get to a professional; perhaps even to the extent of actually taking the person to a therapist or doctor.

Sadly, family and friends of the depressed are often reluctant to confront their loved one due to fear of making matters worse. While this is understandable, individuals being confronted out of love usually understand the person talking to them does truly care about them. When in doubt about what to say to a depressed person, it is a good idea for concerned family and friends to consult with a competent, qualified mental health professional for suggestions on how to intervene.


Sigecaps and Depression

Some years ago, an acronym for the major symptoms of depression was created. It is a useful place to start in determining if you need therapy. People who are clinically depressed will usually demonstrate this cluster of symptoms with one or more of them being experienced more intensely than the others. The acronym is SIGECAPS. The symptom groups are listed below.

SIGECAPS: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor,


S stands for sleep. People who are depressed often experience disturbed sleep patterns either sleeping too much or finding it hard to go to sleep, stay asleep, or even get to sleep at all. When they do sleep, they will often wake up feeling exhausted with little interest in getting out of bed.

I stands for interest. Depressed people often lose interest in things they used to enjoy.

G stands for guilt. Often, the depressed feel guilty about their depression and their apparent inability to shake it off and be “normal”. They also may have guilt about some specific issue in their lives.

E stands for energy. Low energy and chronic fatigued feelings are present.

C stands for concentration. Often people experiencing depression are unable to focus and concentrate for any length of time.

A stands for appetite. People with depression often will eat too much as they find it comforting to do so. Obesity can develop as a result. Others will find themselves eating little and often lose weight rapidly as a result.

P stands for psychomotor. Severely depressed people often move and or speak very slowly. Their thought processes can slow down so much it can become difficult to carry on a conversation with them.

S stands for suicidal. Severely depressed individuals often think about dying as a way to escape the pain they are living in. There may be a history of suicide attempts or suicidal ideation.

If after reading these you think they fit, consult a competent mental health practitioner.

Depression and the Life Script

Some people suffer from a form of depression that is linked to a poor self image developed early in life. This self image or self concept is linked to experiences and decisions the person makes about him or her self and the outcomes they experience in their relationship with themselves and with other people. Repetitive patterns of behavior used to get needs met develop over time and the individual builds their unique self concept regarding who they are and what their life is like now and probably will be like in the future. Over time repeated thoughts and actions become habits that define the person’s life. In a sense, people develop meta-programs or scripts about how to handle situations, thoughts, and feelings. Once you observe the repetitive patterns a person manifests over time, a sense of the individual’s destiny can be developed.

Typically, chronically depressed people suffer from automatic negative thinking patterns including a powerful, negative sense of self. These automatic thoughts are mini programs of internal imagery, dialogue and accompanying emotions. The depressed individual is immersed in the thought programs they have built over time and can not see the proverbial forest because of the trees. Enter the need for a guide or counselor to educate the person on their current situation; to offer a broader perspective of life enabling the depressed individual to rise above the morass of pessimistic rumination and see that new directions are possible.

Part of the beauty of being human is that we can choose to change the course of our lives by making new decisions and learning new ideas and skills. In a sense, we can re-write our meta-programs and get out of the thought/action boxes we have habitually lived in for so long. By getting new wisdom about our choices and then executing actions based on the new ideas, we can choose a new destiny and escape the trap of our preconceived notions of our selves and our limitations. In effect, we can leave the depressive mind set and process behind.

For those individuals that have biological predispositions to depression, medication can often help alleviate some of the emotional pain these people experience. But, medication has its limits in that it can not change the quality of a person’s thinking. It can not change social relationship patterns developed over the course of the individual’s life time. Counseling should be an integral part of the chronically depressed people’s treatment in order for them to gain wisdom and understanding of the role their thoughts and social choice/actions play in their pain. Hope needs to be fostered that these behavior patterns have an origin in learned responses that can be replaced with new learning.

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