by Heather Schuldt
In his book “Christian Counseling: A Comprehensive Guide” 3rd edition, psychologist Dr. Gary Collins described depression as one of the five prominent issues in counseling. Depression can vary from a milder form of common sadness that we all experience on a smaller scale to a more severe condition with feelings of despair, fear, exhaustion, immobilizing apathy, hopelessness, inner desperation, or even thoughts of suicide. Symptoms of depression can affect individuals of all ages and can vary in one’s feelings, thinking, behavior, and physical health.
Collins described the following ten types of depression: reactive, endogenous, primary, secondary, dysthemic disorders, seasonal affective disorders, bipolar disorders, postpartum disorders, major depressive disorders, and other mood disorders. First, reactive depression can be in response to either real or imaginary trauma. Second, endogenous depression involves intense despair from within the person, sometimes accompanied by self-destructive tendencies, often called psychotic depression. Primary depression occurs by itself while secondary depression is more of a side effect of an influence, diet, medication, or illness.
Fifth, a dysthemic disorder is a chronic daily condition lasting more than two years, but the person can still function usually with low energy, little enthusiasm, or not much ability to enjoy life. This type of depression can be treated medically and with effective counseling. Sixth, seasonal disorders are periods of withdrawl, often during the winter months. Evidence of light therapy is proven to be helpful as well as counseling. Seventh, bipolar disorder used to be called manic-depressive disorder because behavior consists of cycles of boundless manic uncontrolled behavior interspersed with depressed mood swings. It can be controlled with medication, but talk therapy helps a great deal with the individual as well as their family.
Eighth, postpartum disorder lasts longer than just a few days of the baby-blues after giving birth. It can be treated with counseling and medication. Ninth, major depressive disorder is the most severe and complex, often seen in episodes that disrupt everyone. The causes can be psychological and/or physical. More severe cases do not respond well to regular talk therapy, and they require antidepressant medication from a specialist. Tenth, mood disorders is an emotional state that can include depression as well as other emotions, found in all the nine types of depression mentioned above.
Counselors should take the bio-psycho-social approach to examine three possible causes of depression, including biological-genetic, psychological-cognitive, and social-environmental. It is important to distinguish between genetic and possible environmental causes. Genetic causes include anything from a lack of sleep, insufficient exercise, side effects of drugs, physical illness, improper diet, or PMS, to other more serious causes such as a chemical imbalance in the brain, neurochemical malfunctioning, or a brain tumor. Environmental causes can include things like caring for a family member, divorce, political climates, social suppression influences, or an unreasonable boss. Psychological-cognitive causes include a wide range of influences. It affects an estimated 10% of the population. These influences include background issues, stress from losing a loved one, feeling helpless, a negative view of the world, a negative view of self, a negative view of the future, feeling angry, or feeling guilty from a wrong action. Solutions vary from finding areas in life where one can control a portion of their environment, talk therapy, finding a true sense of worth, and relying on God for protection and guidance.
Collins offered the following ways to approach depression in counseling and soften the severity of depression: teach the real facts about depression, encourage support, urge people to reach out, deal with physiology, stimulate physical fitness, deal with possible causes, identify negative thinking patterns and deal with thought patterns, deal with inactivity, deal with the environment, deal with potential self-harm, and as King David said, “I will put my hope in God!” (Psalm 43:5). In part two of Collins’ book, he gave helpful insight into the following five prominent issues in counseling: depression, anxiety, anger, guilt and forgiveness, and loneliness.