Depression


Brief Introduction

This document is provided as a guide for choosing a psychologist for the treatment of Major Depressive Disorder and Dysthymic Disorder.  It is not meant to be a guide for treatment.  The information here is not meant to replace an evaluation by a qualified practitioner.  For definitions and information on depression, visit the National Institute of Mental Health.  For the purposes of this document, depression refers to any of the depressive disorders.

Therapist Qualifications

Because depression is so common, there is usually no specific training for it.  As such, therapists tend to rely on their own theoretical biases.

It is widely agreed that there are a number of possible causes to depression, including medical/physiological conditions (i.e., hormonal or metabolic), nutrition, genetic predisposition, or a recent stressful event.  Still, there are a number of therapists who tend to focus on only a single causal factor (such as an overbearing mother or simply genetics).  Such a one-sided approach can lead to further difficulties and risks exacerbation of the symptoms.  Ideally, a therapist will take a broader perspective to the treatment.

If depression occurs in conjunction with another disorder, such as substance abuse or mental retardation, it may be helpful to consult a psychologist with training and experience in that disorder.

What to Expect From Testing

Psychologists may administer a general battery of tests along with specialized tests for depression and suicidality.  Psychologists use these tests to rule out diagnoses such as PTSD, Attention-Deficit/Hyperactivity Disorder, and others that share common symptoms with depression.

Therapeutic Focus

As previously mentioned, the focus of therapy depends on the theoretical background of the psychologist. 

While it is still common for therapists to focus on a single causal factor across all patients, the ideal therapist will take a well-rounded approach.  This involves consideration of every facet of the patient’s life, including medical history, family history, nutritional and exercise habits, current living situation, and stressors.

The therapist should be able to create a treatment plan with goals that reflect the individual needs of the patient and take into account the specific nature of the symptoms.  The treatment plan should be adjustable depending on the progress of the therapy.  The therapist should remain flexible throughout treatment and should be willing to work with the patient if a particular approach seems to be ineffective.

What to Expect From Sessions

Sessions may take place on an individual basis and be supplemented by individual, family, marital, or group sessions according to the case.

*Important Things to Watch For*

Depression is often confused with other diagnoses.  This can be particularly dangerous if the patient receives the wrong medication due to improper diagnosis.

Children are particularly susceptible to misdiagnosis.  Children with symptoms of depression often appear to have Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD) among others.  When examining children, the therapist must be careful to differentiate between depression and other disorders.