New Year- New thoughts or not- The young and the rise of depression

What’s happening to our younger people- Grantham and beyond

I work with many clients who range from 15 upwards and there seems to be a rising increase of cases where depression is cited. Initially from the parent or carer and then the client themselves. What is the cause of this I ask myself. Why are so many young people feeling depressed?

Depression is striking increasingly younger people, even children. Many more teens are now regularly consuming antidepressants too.  The proportion of people becoming depressed is now ten times greater than in 1945. Depression is on the rise in all age groups, but mostly in the young. Here in our practice in Grantham we have seen an increase of new admissions to therapy and we are working hard to help our clients and their families support them through this challenging place they find themselves in. Only yesterday on the news there was talk of social media such as Facebook and Twitter being a big cause of depression and anxiety in this age group, so we are trying to understand this more and allow our clients to find ways to work with this pressure and remain positive and part of something they really enjoy.

Is this possible? Someone said perhaps we should get rid of social media all together. Would this help?

It seems there is something about their lives now that is causing widespread harm. We, you and I, need to help stem the tide so that future generations are healthier and happier.

Cognitive Behavioural Therapy (CBT) has long been seen as a useful tool in helping lift depression. But weirdly, its reputation seems to be sinking.

CBT is only half as effective as it used to be

Through a meta-analysis of 70 studies between 1977 and 2014, psychological researchers Tom Johnsen and Oddgeir Friborg drew a strange conclusion: Cognitive Behavioral Therapy is now around half as effective in treating depression as it used to be. While we offer this approach in our Grantham practice we also integrate other talking therapies to support our clients.

Additionally, this may make sense in the context that depression thrives on negative rumination and expectation. In the early days of CBT, depression sufferers would have likely had high hopes for its effectiveness. But as the novelty of CBT has worn off and reports have emerged questioning its effectiveness, the positive expectation (placebo effect) may have fallen away a bit.

Half of CBT’s initial effectiveness in the treatment of depression may have been purely due to the sense of hope it generated in those being treated. Hope is an antidote to depression, perhaps the most powerful antidepressant of all. Knowing how to generate hope is a vital therapeutic skill.

The crux of the problem with some CBT-based approaches is that strong emotion most often arises not after we have thoughts, but before. Thoughts are more often a reflection of feelings (especially powerful feelings) than a cause of them.

So it’s more effective to change feelings in order to change thoughts than the other way around.

That’s not to say that changing thoughts can’t change feelings, but when the emotions are powerful, our clients can feel swamped. It can be hard to think anything when we are caught in the grip of intense feelings.

To put it metaphorically, how can we expect to clear scattered leaves when the wind is still whipping them about? I know in my own garden this is almost impossible!

The whipping winds in Grantham!

You can sweep your pathway until kingdom come, but if the wind won’t let up the leaves will only come swirling back.

When the mind is calm, then we can examine and widen the context of thinking.

There are more neural connections leading from the emotional centres of the brain to the cognitive centres than vice versa.

We must always remember that when feelings are powerful, as they certainly are in depression, we need to work to calm those feelings first and foremost. But once the mind is sufficiently calm, then we have a chance to help the depressed client widen their context by seeing reality above and beyond the usual thinking and depressive thoughts associated with the condition.

Then, and only then, we can help the client get into the habit of generating non-depressing causes for life events, and therefore thinking differently. And this will have an impact on emotions.

Whenever I help a depressed client view their reality differently I are applying a therapeutic reframe. In a sense all CBT techniques can work as reframes. But it’s vital to understand something about reframes:

They’re not just cognitive.

A reframe happens as an experience in the client’s mind. It’s not simply a matter of logical deduction or reasoning. The client needs to feel as well as think that the new way of seeing is truer than the old depressing way.

I try to bear in mind that:

Trying to change thoughts while strong emotions still dictate those thoughts may not work.

I may need to change a client’s emotional state before widening their cognitive context through a reframe.

I need to deliver the cognitive reframe in such a way that it appeals directly to feelings as much as thoughts.

Depressed people hold very strong, emotionally driven beliefs (as to how bad things/they/others are). The more we directly oppose someone’s strong beliefs, the more they will tend to protect and cling to them, even when those beliefs damage them. With this in mind, I like to use CBT techniques subtly and to integrate bits of other therapy that I feel the client will benefit from in their world.

I hope at least some of this blog makes sense to you? If any of it does and you are yourself suffering from depression or unhealthy thoughts or feelings or perhaps you are the parent or carer of someone young why not get in touch.

Jason