Depression

Depression is not trivial and is a serious and genuine medical condition. It is a real illness with real symptoms. Depression isn’t a sign of weakness or something you can “snap out of” by “pulling yourself together”. Depression (major depressive disorder) is common (one in six people will experience depression at some time in their life) and it affects negatively how you feel, the way you think and how you act. Many people will go through short periods of feeling low, miserable or “down”, but when you’re clinically depressed you feel it persistently for weeks or months and, in some cases, years.

Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and work; social life and family are all impacted negatively by one’s depression.

Several factors can play a role in depression such as biochemistry, genetics, personality and environmental influences. Fortunately, though, depression is among the most treatable of mental disorders. The good news is that with the right treatment and support, most people with depression can and do make a full recovery.

Do I Have a Problem with Depression?

There are numerous signs that suggest someone is suffering from depression, including:

• Feeling down, upset or tearful
• Feeling restless, agitated or irritable
• Feeling guilty, worthless and down on yourself
• Feeling empty and numb
• Changes in appetite – weight loss or gain unrelated to dieting
• Isolating and unable to relate to other people
• Finding no pleasure in life or things you usually enjoy
• Having a sense of unreality
• Having no self-confidence or self-esteem
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
• Feelings of hopeless and despair
• Having suicidal thoughts and/or ideation.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal and that life is no longer worth living.

Depression Treatment at Strong Hope

Many clients that present with depression come to us on prescribed medication, which may or not maybe the most appropriate medication for them. For many doctors, prescribing the right medication is trial and error however using Strong Hope’s genetic pharmacological analysis we can tell at an individual genetic level what antidepressants are likely to be the most effective – based on which we will then inform the client of any possible change or even to cease all use.

For those not on medication it’s not Strong Hope’s practice to use antidepressants routinely to treat people with persistent subthreshold depressive symptoms or mild depression because the risk-benefit ratio is poor. However, we would consider a possible short course for people with a past history of moderate or severe depression or initial presentation of subthreshold depressive symptoms that have been present for at least 2 years or subthreshold depressive symptoms or mild depression that still persists even after previous therapy.

When depression is accompanied by symptoms of anxiety, our priority will usually be to treat the depression first. However if the person has an anxiety disorder and or morbid depression or depressive symptoms then we would consider treating the anxiety disorder first (since effective treatment of the anxiety disorder will often improve the depression or the depressive symptoms).

Outside of medical support our approach to treating depression is through high intensity psychological interventions (CBT & DBT), nutrition, sleep hygiene and exercise.

Through the depression programme clients will look at the underlying causes of their depression, which may be related to a whole host of things including trauma. It is vital that these underlying issues are identified and addressed as they are key to relapse prevention.

We explore these through a range of talking and non-talking therapies, so that clients understand why they do the things that they do but equally importantly then learn new skills and coping strategies in order to reduce the chances of returning to a depressive state. This we do through individual 1:1 work and group work for those that have chosen this modality.

One aspect of our depression programme that is key to recovery is for clients to learn to experience “joy” and “pleasure” as this is often absent from those suffering with depression. We do this through adventure therapy using the natural resources that the island has to offer – and as such clients can begin to realise that joy and pleasure are obtainable.

All clients work to a daily schedule that is tailored for the individual in relation to their treatment plan and consists of a balanced programme of psychotherapy, complementary therapies, adventure therapy, health/nutrition and fitness. Clients will be expected to work on therapeutic assignments based on issues that are identified as part of their treatment, which they do outside of the core face-to-face hours, and present these in their sessions with their therapist. As clients come to the end of their treatment they will work with their primary therapist and therapy team to produce a relapse prevention plan, which Strong Hope will support through the aftercare programme that we offer.

Each client will have an experienced and fully trained primary therapist who is an expert in dealing with depression, and this therapist will support and coach them throughout their stay even though the client may engage with other members of the therapy team according to need.

Programme Duration

Strong Hope offers a range of depression programmes from just 14 days up to 42 days depending on client availability and need. For those clients staying 28 days or more we also offer an inclusive family programme towards the end of the clients stay.