Kim Barlow-Miles Counselling

Conquering Depression

On Wednesday this week, I took part in a discussion about how best to treat depression, on BBC Radio Nottingham’s Morning Show.  News was just in of a fourfold increase in prescription medication for depression, compared with 5 years ago. Frances Finn, presenter of the Morning Show, wanted to challenge Dr Ian Campbell and me about these statistics - are people being prescribed medication by their GP almost automatically, after a quick consultation ?  Wouldn’t a talking therapy (counselling) be better than medication which might become a ‘crutch’ that people learn to depend on and struggle to give up ? And maybe some people are labelling themselves ‘depressed’ and seeking help when if they just ‘got a grip’ and got on with life they could overcome it by themselves.

All interesting points….

Dr Campbell explained the medical origins of depression: it can be inherent in the person, a feature of their psychological/physiological make-up, or it can be caused by a specific event- such as relationship breakdown, redundancy or loss of some kind.

Medication can really help the person to be able to function enough - to keep going at work for example, when it is essential (as they might see it) that they do this. And it can also help them feel ready to tackle the cause of the depression, or underlying issues that have been triggered and have now come to the surface. Selective Serotonic Re-uptake Inhibitors (SSRIs) such as Fluoxetine (commonly known as Prozac) and Citalopram work on restoring the level of serotonin in the brain and maintaining adequate levels of this; serotonin seems to encourage a sense of calm and makes feelings of anxiety and distress less acute and raw. 

Although medication is very effective for many people, the ideal would probably be that those who want counselling as well, or prefer to avoid medication and just have counselling could be offered this ; sadly there are indeed long waiting lists eg 6 months, in some locations, despite the investment made by the previous government in the IAPS scheme (Improved Access to Psychological Therapies) which has seen a dramatic increase in numbers of trained counsellors (usually in Cognitive-Behavioural Therapy). It seems this has been more than matched by the numbers of people presenting with depression. Some reports suggest that 1 in 3 of us has or will have an episode of depression at some point in adult life.

Depression has been described as a Black Dog (eg Winston Churchill). The stigma surrounding it is diminishing due to various celebrities ‘coming out’ - Alastair Campbell, Ruby Wax, Stephen Fry and many others. Most people know that it is characterised by a dark negative mood, outburst of anger or general grumpiness, tearfulness, loss of energy and interest in activities that were previously enjoyed, appetite changes, sleep disturbance and a tendency to want to withdraw and isolate oneself.

In Cognitive- Behavioural therapy the emphasis is on identifying ,monitoring and encouraging activities that bring feelings of pleasure rather than effort and also in challenging Negative Automatic Thoughts.  In other therapies, we also work with underlying ongoing problems, often unfinished emotional business from the past, helping people to come to terms with these, accept the situation or take necessary action, and move on.

Depression certainly can be treated with counselling/psychotherapy, and this process can be supported by medication, which I particularly recommend when someone is in such a distressed state that they are unable to focus and engage.

If counselling waiting lists are too long, there are other local (Nottinghamshire) sources of possible support. Some of these agencies and charities may only ask for a small donation towards the cost of their service:

Nottingham counselling Service - 0115 950 1743

Nottingham Womens Counselling Service - 0115 978 2040

New Dawn  (Christian) - 0115 917 0500

Cruse (bereavement and loss) - 0115 924 4404

Relate (couples and relationship issues) - 0115 856 5205/0115 950 7836 /01623 636553

There also agencies which specialise in alcohol/drug related difficulties including depression/anxiety

For emergencies there is also Samaritans 08457 909090

There are some excellent self-help books available:

I Had a Black Dog - Matthew Johnstone

Living with a Black Dog - Ainsley and Matthew Johnstone

Overcoming Depression - Paul Gilbert

Depression The way out of your prison - Dorothy Rowe

Help online includes websites where you can download free leaflets like northumberland  tyne and wear nhs and various cognitive behavioural programmes.

You don’t have to just ‘get a grip’ - but you do need to reach out for support when you may least feel like doing so!



Some people would prefer to avoid medication of any kind and opt for counselling.

Questions? Referrals? Contact me today »