Approaches to Managing Depression
Managing depression - Tidying the cupboard
When dealing with clients with depression it’s sometimes helpful to use analogies to help them understand what is happening to them. One I use quite successfully is tidying the cupboard.
The picture at the top of the hub is of Dali’s ‘The City of Drawers’. It is based on some of the psychoanalytical references of Sigmund Freud; the open drawers of humankind's subconscious.
For me personally it has great strength and meaning, such emotions and suffering; the drawers open, contents strewn out. One wants to help, to care and to tidy the mess and bring some peace and contentment. The subject of the sculpture itself reaches out, in part pushing away perhaps, in part reaching out for help.
There are times when we all have to tidy a cupboard; it gets too messy, too full and if we’re not careful it all comes tumbling out when we least expect it. Then there’s a mess to clear up. Things we haven’t seen in a while, things we thought we’d forgotten, all in a pile that needs sorting out. I have kitchen cupboards just like that!
That’s something like our emotions. We all have a ‘cupboard’; we all put things in it, emotions, and feelings – tucking them away. Sometimes in the right place, sometimes just quickly put in, and at times just shoved in anywhere – that’s when things can get in the wrong place.
Now don’t get me wrong – it’s OK to have an untidy cupboard - who doesn’t? But sometimes it needs the odd spring-clean to prevent the big fallout when it gets too full.
All of us tidy the cupboard as we go. Sometimes leaving it a bit too long, but generally keeping things pretty straight on the shelves.
When a person with depression is faced with a cupboard that needs tidying – it can be a daunting time. The energy required to do it early on in depressive illness just isn’t there. They may need the help of antidepressants to stabilise mood along with rest, good diet, fresh air and as much sleep as possible, although the latter can be disturbed early on in depression.
Once stable and with some re-charging of the physical and emotional batteries, the cupboard tidying can begin.
Sometimes the tidying exercise needs to be easy, reflective, and gentle, that’s where counselling comes in. It can have a supportive approach, helping the person pick things up, take a look at them and then put them back in the cupboard, taking things at the pace of the client.
Sometimes, things that have tumbled out need careful handling; they may be precious things – feelings, thoughts and emotions perhaps. A counsellor will help the client to hold these precious things, take a look at them, understand them; sometimes re-visit them, linking memories and experiences and then put them safely away once again.
Other things that have tumbled out are in themselves perhaps pretty harmless, but it is our view of them that disturbs us. How we think of them, that’s what stirs up the emotions. This needs a different approach, helping us to see things from a different perspective.
The Greek philosopher Epictetus (AD 55–AD 135) said ‘Men are disturbed not by things, but by the view which they take of them.’
Cognitive Behavioural Therapy (CBT) is more active approach to cupboard tidying, taking the client to places where they see a different view of things. When tidying the cupboard, looking at things from a different angle can make them seem less fearful, then they can be put back in the cupboard without fear of seeing them again. It allows us to know they are there and not be afraid any more. We’ve seen that whatever it may have looked like, actually it is harmless and cannot hurt us anymore.
If you are suffering from depression, tidying the cupboard can make great differences. Sometimes you have to do it alone; sometimes you need help. The two approaches of counselling or CBT can be used effectively as a structured way to achieve your goals.
So, tidying the cupboard – a good analogy? Personally I think so, I hope so. It allows me to help clients explore things in a safe way; a way that they can relate to and is realistic.
- Depression Alliance UK | Help & Information About Depression Symptoms and Self Help Groups | Get
Help & information about depression; depression symptoms and self help groups. Depression Alliance is a UK charity for people with clinical depression and anxiety.
- Depression - A Self Help Guide | Health | Patient UK
Depression - A Self Help Guide - This guide is written by clinical psychologists from Newcastle, North Tyneside & Northumberland Mental Health NHS Trust. Used here with permission.
- The Salvador Dali Gallery
The Salvador Dali Gallery, the world's only gallery dealing exclusively in authentic works of Dali.
- Dali MUseum Florida
The official site of the museum in St. Petersburg, Florida, featuring a comprehensive collection of works by Dali.