The vast majority of people will at some point in their lives suffer from Depression and therefore depression is probably the most common symptom or ‘presenting issue’ which brings people to Counselling and Psychotherapy. Psychiatrists tend to divide depression into two categories; Neurotic or Reactive Depression and Psychotic ‘Endogenous’, (from within), Depression with symptoms respectively ranging from loss of apatite and insomnia to hopelessness and suicide.

As Therapists, we are uncomfortable with the labels ‘neurotic’ and ‘psychotic’ as these have social connotations that are unhelpful to clients. Instead, we prefer clients to recognise the ‘normality’ of their conditions and rather than single them out as abnormal and perhaps without prospect or hope; we, in recognising their normality, offer hope and the prospect of overcoming their difficulties. We, therefore, prefer to use a scale by which we can describe the psychological traits of the vast majority of people. The scale we use is divided into two equal parts; the Depressive spectrum occupies one side and the Obsessive spectrum the other. Most people will fall somewhere on the Depressive-Obsessive scale and though it is a scale, an individual may occupy either one or two positions, i.e. just display ‘dominant’ traits or also display ‘subordinate’ traits. Most people display a significant number of traits which would result in them being described as having Depressive or Obsessive tendencies, however, they will also display traits from the opposing spectrum which ‘modify’ their dominant trait. That is to say that some people are either ‘purely’ Depressive or Obsessive but many are depressive-Obsessive or obsessive-Depressive.

The Depressive spectrum ranges from severe or chronic Endogenous Depression through milder Endogenous Depression all the way to Reactive Depression.

Counselling and Psychotherapy, when given the opportunity, can help with all forms of depression from severe to mild, however, there is sometimes difficulty with more chronic forms of depression because the efficacy (effectiveness) of Therapy is significantly affected by the Therapeutic Relationship and sometimes with chronic depression there is an inability for the client to relate to others or themselves which may thwart the Therapist’s attempts to form a relationship.

The following quote is taken from Shakespeare’s
‘The Tragedy of Hamlet, Prince of Denmark’, (Act II, Scene II).
In it Hamlet describes his melancholia or depression thus:

“I have of late, but wherefore I know not, lost all my mirth,
Forgone all custom of exercise;
And indeed, it goes so heavily with my disposition;
That this goodly frame, the Earth, seems to me a sterile Promontory;
This most excellent canopy the air, look you, this brave overhanging firmament, this majestic roof, fretted with golden fire:
Why, it appears no other thing to me, then a foul and pestilent congregation of vapours.
What a piece of work is a man!
How Noble in Reason?
How infinite in faculty?
In form and moving, how express and admirable?
In Action, how like an Angel?
In apprehension, how like a God?
The beauty of the world, the Paragon of Animals;
And yet to me, what is this Quintessence of Dust?
Man delights not me; no, nor Woman neither. ”

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