David A Peters, M.F.T.

Sometimes in my practice I find I have a client who struggles with depression so debilitating that it seems resistant to regular treatment.  We talk about what troubles them and make a few changes in their lifestyle, but they experience no lifting of the depressive symptoms.  These clients sometimes come to me saying, "I tried therapy before, but it didn't work."  Even anti-depressant medication may have failed to help.  For these clients I recommend what I call a "Broad Spectrum Approach" to therapy.

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    What is the "Broad Spectrum Approach?"  Often in therapy, only one or two methods are used to alleviate symptoms.  But if you suffer from treatment resistant depression, you can't afford to limit your treatment.  In the Broad Spectrum Approach, we engage in a wide variety of treatment methods that are known to reduce depressive symptoms.  That is, we battle the depression on all fronts.  The Broad Spectrum Approach is outlined below.

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• Psycho-Education - After a careful evaluation of your depression, I give you a thorough education on the nature and causes of depression.  This would include psychobiology, life traumas, pathological relationships, & unhealthy life styles.
   

• Cognitive Therapy - Cognitive therapy is time and again proven to be the most effective method of treating depression.  Essentially, it is teaching mental techniques to "retrain the brain" to eliminate symptoms such as obsessions, negative self-talk, misperception of social cues, and undermining assumptions.  It's not enough to have your therapist merely listen to your sadness.  We have to retrain your brain.
   

• Medication Trials - If the depression is seriously debilitating, medication is essential to aid the process of recovery.  Not all doctors have enough training to prescribe anti-depressants in complicated cases.  A seasoned psychiatrist is necessary.  A variety of medications may be tried, with some in combination.  I will work with your psychiatrist to find the best medication for your situation, and continue regular contact so that you receive the best possible care.
   

• Recommended Reading - While many depressed clients are reluctant to begin reading a book, it can be a powerful way of extending therapy into the home.  After all, why should we treat the depression only in the office, when you could be getting help for hours on end in your home?  There are many helpful books available.  See the Resources page for some suggestions.
   

• Group or Family Therapy - We exist in relation to others around us.  Our relationships can either support our well-being or undermine it. Group therapy can be a powerful addition to the treatment plan, as it allows lonely clients to break their isolation and learn to build trusting relationships in a safe atmosphere of support.  Sometimes family or marital counseling is necessary to correct relationships that are contributing to the depression.  Family members can make adjustments that contribute to greater respect and promote the growth necessary for positive living.
   

• Journaling -  Journal writing is a great tool to build self observation skills, and allow for safe exploration of painful or anxiety producing issues.  Clients who journal regularly often bring into the therapy session new thoughts or insights they achieved while writing.
   

• Exercise - Many depressed patients with depression have very poor physical fitness.  Yet recent research has shown that regular cardio-vascular exercise can be as powerful as medication in lifting the weight of depression.  It improves oxygen flow to the brain and increases the availability of serotonin that contributes to an elevated mood.  Exercise is one of the most important interventions for depression.
   

• Dietary Changes - Poor nutrition can contribute to slowed metabolism, fatigue, and weight gain that undermines self-esteem.  A good nutrition program builds a sense of self-respect, and self-empowerment, and also improves energy. Foods high in Omega-3 fatty acids, such as salmon and tuna, are particularly good for brain nutrition.  You can also get Omega-3 fatty acids in fish oil capsules, available at most nutrition centers.
   

• Meditation - Particularly for depression that includes anxiety or irritability, Mindfulness Meditation has been proven to be a powerful tool for reducing emotional reactivity, and improving the experience of personal power.  I teach my clients Mindfulness Meditation techniques as an adjunct to psychotherapy.  You can also get books that teach the technique.  Again, see the Resources page for those.
   

• Spiritual Enrichment - No matter your religious persuasion, some attention to spiritual practice often fosters greater courage to make the personal changes necessary for healthy living.  Particularly for those who suffer great shame, spiritual renewal can be an important part of your therapy program.
   

    This approach looks like lots of work, and it is!  It requires a dedicated effort on the part of both your therapist and you.  And it takes time.  But if previous treatment failed, what else can you do?  Remain depressed?  I hope not!  Let's get to work.  If previous treatment has failed you, contact me and ask about the Broad Spectrum Approach to treating depression.