Depression | RelatedMinds.com

Depression is one of the most common mental health problems in North America with over 20 million people suffering from symptoms of depression. Symptoms of Depression are very similar to normal feelings and moods we have all have. Everyone feels sad, blue or down on occasion. Individuals suffering from depression experience these feelings more intensely and for longer periods of time. They also might experience tiredness or fatigue, irritability, difficulty focusing, concentrating and planning, as well as changes in appetite or sleep patterns. These symptoms are reviewed during out initial meeting.

For those suffering from Depression which is causing difficulties in their day-to-day lives I offer two primary forms of therapy: Cognitive Behavioural Therapy (CBT) to help you address, control and change specific symptoms, and Mindfulness Training, which has beed found to be effective in avoiding relapse. Both of these therapeutic techniques are Evidence Based Therapies (EBT), meaning they have been scientifically shown to be effective.

Frequently Asked Questions (FAQs)
 Are there Different Types of Depression? Some People Seem to Have Few Symptoms, and others I Know Have Real Trouble Functioning? 
There actually are several forms of depressive disorders. They differ in nature and severity and include the following (among others):   Major Depressive Disorder,  Dysthymic Disorder,  Postpartum Depression, Seasonal Affective Disorder and  Bipolar Disorder. These symptoms can vary greatly in severity. A comprehensive assessment is usually called for in order to understand the nature of the problems you may be having.

Can you Tell Me About Counselling for Depression?
The most frequent used therapy for Depression is Cognitive Behavioural Therapy, or CBT. CBT was started by two important psychologist, Albert Ellis, and Aaron Beck. Beck’s theory states that depressed people think the way they do because their thinking is biased towards negative interpretations. According to this theory, depressed people acquire a negative schema of the world in childhood and adolescence as an effect of stressful life events. When the person with such schemata encounters a situation that in some way resembles the conditions in which the original schema was learned, the negative schemata of the person are activated. Cognitive Behavioural Therapy for Depression helps a client understand this pattern of thinking, and teaches specific tools and skills to address it. These include learning to approach problems differently, to understand your biased thinking, and some very specific skills such as “thought Stopping” to deal with intrusive thoughts.

Cognitive Behavioural Therapy has been shown as an effective treatment for clinical depression. Recently some CBT practitioners have returned to more behavioral approaches to the treatment of depression such as behavioral activation. A large-scale treatment study found behavioral activation to be more effective than cognitive therapy and on a par with medication for treating depression. In my practice in Burnaby and Vancouver I use both Cognitive Behavioural Therapy for Depression as well as techniques derived from more behavioural approaches, such as behavioural activation for Depression.

Is CBT Effect for Depression with Children and Adolescents?
The use of CBT has been extended to children and adolescents with positive results. CBT is one of the few empirically-supported psychosocial treatments for young people “CBT for Children and Adolescents”. It is often used to treat major depressive disorder, anxiety disorders, and symptoms related to trauma and posttraumatic stress disorder. Significant work has been done in this area. CBT is also used as a treatment modality for children who have experienced complex post-traumatic stress disorder and chronic maltreatment.

Can You Tell Me More About CBT for Depression?
Cognitive and Behavioral Therapies for children and adolescents usually are short-term treatments (i.e., often between 6-20 sessions) that focus on teaching young people and their parents specific skills. CBT is different from many other therapy approaches by focusing on the ways that a person’s cognitions (i.e., thoughts), emotions, and behaviors are connected and how they affect one another. Because emotions, thoughts, and behaviors are all linked, CBT approaches allow for therapists to intervene at different points in the cycle. Though approaches can differ somewhat, they have the following in common:
The therapist and child or adolescent client develop goals for therapy together, often in close collaboration with parents, and track progress toward goals throughout the course of treatment.
The therapist and client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on him- or herself. The therapist seeks to help the client discover that he/she is powerful and capable of choosing positive thoughts and behaviors.
Treatment is often short-term. Clients actively participate in treatment in and out of session. Homework assignments often are included in therapy. The skills that are taught in these therapies require practice.
Treatment is goal-oriented to resolve present-day problems. Therapy involves working step-by-step to achieve goals.

 Summary
Treatment for Depression (or any of these “Mood Disorders”) is often most effective when clients receive a combination of counseling (Cognitive Behavioural Therapy) and medication treatment. For many forms of Depression CBT has been shown to be as effective as medication, and is often used alone.

Cognitive Behavioural Therapy, or CBT, is an evidence-based therapy that has been shown to be highly effective with many mood disorders, from depression to bipolar disorder. Cognitive Behavioural Therapy for depression or mood disorders can range in length from a few sessions to several months of sessions. A treatment plan is developed between you and your doctor/therapist which matches your needs. Often times self-help books, videos and audio programs are suggested to suppliment the work we do in the office. Cognitive Behavioural Therapy teaches you about the nature of your mood disorder, how your thinking patterns effect how you feel, and teaches you specific skills that you may use to help control these patterns. Often meditation (reflective practice), relaxation (MindfulnessTraining), behavioural interventions and thought stopping techniques are used in combination to control the many different symptoms that make up your mood disorder.

Resources for Depression
One excellent resource found on line here in British Columbia is “Here to Help.” (www.heretohelp.ca) This web page has several workbooks and on-line activities for those with depression. Most of these are evidence-based programs, either behavioural interventions of Cognitive Behavioural Therapy (CBT) based. Here are some, more to be added:

Help to the Prevention of Relapse: http://heretohelp.bc.ca/skills/managing-depression/relapse
If you have trouble with that link, Depression Relapse Toolkit.

Summary
Depression, often in combination with Anxiety, is a common problem for individuals living in North America, including BC. Counselling and therapy for Depression and Anxiety is available in both my Burnaby and Vancouver offices, and these offices are located to serve Burnaby, Coquitlam, Vancouver, New Westminster, Port Moody, Port Coquitlam and Maple Ridge. I provide both assessment/diagnostic services for depression and anxiety, as well as treatment. Treatment should start with a visit to your family doctor, to rule out other possible causes of your symptoms. Often medication is used, but this can be used in combination with therapy/counselling, or therapy/counselling can be used alone. Cognitive Behavioural Counselling has been found to be highly effective with both depression and anxiety. CBT is a short term, problem focused therapy that has undergone many years of research and development. I hold an advanced certificate in Cognitive Behavioural Therapy (CBT) from the Albert Ellis Institute in NYC. CBT will teach you skills to deal with your particular symptoms of depression and anxiety.

Appointments are available for counselling focused on depression and anxiety at both my Burnaby and Vancouver offices. These include both daytime and evening appointments. As a registered psychologist my services are covered by most extended health care plans in BC.

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Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):
ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/)
Anxiety and Stress (click here: http://www.relatedminds.com/anxiety-stress/ )
Autism and Asperger’s Disorder (Click here: http://www.relatedminds.com/autism/)
Individual Counselling (click here: http://www.relatedminds.com/individual-therapy/)
Child Counselling / Therapy (click here: http://www.relatedminds.com/child-therapy/)
Testing and Assessments and Learning Disabilities (Click here: http://www.relatedminds.com/testing/)
Couples Counselling / Therapy (click here: http://www.relatedminds.com/couples-therapy/)
Depression
The Angry Child (click here: http://www.relatedminds.com/dealing-with-angry-aggressive-and-explosive-children/)
Anger Management (Click here: http://www.relatedminds.com/anger-management/)
Pain Management and PTSD (Click here: http://www.relatedminds.com/pain/ )
Forensic Services (Independent Medical Examinations or IME)

About Dr. Roche
I am a Registered Psychologist and a Registered Marriage and Family Therapist (RMFT) in British Columbia. In addition to my doctorate in clinical Psychology (The Union of Experimenting Universities), I hold a master’s degree in family therapy from Goddard college, a certificate of advanced graduate studies (CAGS) in school and educational psychology from Norwich University, and have completed two years of post doctoral studies in neuro-psychology at The Fielding Institute in Santa Barbara, California. I am also a certified school psychologist, certified teacher of special education (New York and California), and a Clinical Member of the American Association of Marriage and Family Therapists (AAMFT). Finally, I hold a doctoral degree in law (JD) with an emphasis in medical malpractice and education law. Beyond my academic credentials, I have completed two years of supervised clinical experience in both hospital and community based clinics and two years of post doctoral training in neuropsychology. I have served as director of behaviour programming for several school districts, as a consultant on autism for the province, and have held numerous academic positions including Clinical Instructor in Psychiatry at New York University and Bellevue Hospital in New York as well as being a faculty member at NYU, Brooklyn College, SUNY New Paltz, and Norwich University.

My offices in Burnaby and Vancouver serve Burnaby, Vancouver, Coquitlam, Port Moody, Port Coquitlam, New Westminster and Maple Ridge. Clients often come to my Vancouver office from North Vancouver, West Vancouver and even as far as the Sunshine Coast. For more information on the location of my Burnaby and Vancouver offices, please see my “Office Location” page, which contains a Google map.