Silvia Camastral PhD

Psychotherapy Counselling - Individuals - Couples - Supervision Training

Article on Depression

Process oriented counselling for issues of depression

© Copyright - Silvia Camastral.

Mental health lists a set of symptoms as belonging to the diagnosis of depression and mood disorders.

I see process oriented counselling as a useful addition to medical or mental health interventions and want to stress that it is not a healing method by itself. Where clients have a mental health diagnosis I strongly suggest working together as a team with a psychiatrist and/or medical practitioner. I will not work with clients who do not agree to such co-operation.

My approach and understanding as a process oriented therapist/counsellor is to look at the symptoms of depression as indications of an underlying process which needs to be explored in an individual experiential way in order to find new meaning.

The process oriented therapist is interested in the person's actual specific experience of the symptoms and how they affect the life of the sufferer. By doing this and listening carefully - connections can be made and solutions can reveal themselves in an organic way.

I find it useful to clusters some of the symptoms of depression according to general underlying processes:

A." Sadness and loss of meaning"

B. "Anger and feelings of disempowerment" and

C. mild chronic depression "not bad enough to make changes and not good enough to enjoy life" syndrome.

The symptoms of these clusters can be mixed, but I find it useful to make the distinction because they can relate to different underlying processes that might be generalised as:

A. "finding new meaning and value in life"

B. "finding my power and voice" and

C. to "taking oneself more seriously and daring to make changes".


A. Can show itself as an underlying sense of sadness, loss and grief because of:

  • Loss of health - e.g. serious health crisis that might create unemployment.
  • Loss of a job
  • Divorce - loss of a partner and/or family
  • Loss of life style
  • Death of a loved one
  • Loss of possessions, money
  • Drug and alcohol addictions or depression accompanying withdrawal
  • loss of interest and pleasure in life, family or activities
  • Eating issues
  • Addictions
  • Fatigue
  • Low mood
  • Lack of sleep or sleeping too much
  • Lack of motivation and energy

What can help?

  • Through counselling new meaning and purpose in life can be supported and enhanced

  • Support groups can help connect with others who have similar experiences

  • See medical doctor in combination to counsellor/psychotherapist/psychologist/psychiatrist.

  • Finding or reconnecting with creativity ( music, writing painting, singing, dance, drama etc)

  • Sport and nature activity (heightening of endorphin levels)

  • Finding a deeper sense of spiritual connection


B. Can show itself through feelings of anger, suppressed anger and feelings of disempowerment

  • Anger and frustration

  • Suppressed anger

  • Overt or passive aggressive behaviour

  • Feeling put down in many situations in the world, feeling belittled by general interactions, feeling neglected, lot loved or even hated,

  • Low self esteem and low self worth

  • Anxiety and panic attacks

  • Loneliness and feeling angry about feeling left out by others, feeling alone and unloved.

  • Addictions

  • Eating issues

What can help?

  • Process oriented counselling/therapy can help in "finding a voice" learning how to communicate in a more empowered and assertive way, daring to speak out, working on self esteem and self value and building trust in relationships.

  • Sport (using suppressed energy constructively)

  • Social activist: "Fighting for a good cause" speaking out about issues of abuse and disempowerment

  • Any activities that create a sense of assertiveness, acknowledgement and meaning

  • See medical doctor or psychiatrist if depression is severe and suicidal ideation exists


C. Can show itself in a sense of low mood and general unhappiness: "not bad enough to make changes and not good enough to enjoy life"

  • Overlay of slight unhappiness, with no apparent reason ( I have all I need but am unhappy)

  • Fatigue, low motivation and energy for new things

  • Caught in a "routine of life" : dragging on life energy

  • Feeling bored (with work, relationships, life)

  • Chronic unhappiness in relationships

  • Loss of earlier hopes, dreams and excitement about life

  • A sense of: "is this all there is?" And "oh well, you can't have everything", "this is a good as it gets" etc.

  • Fear of change is a big obstacle. "Life is not really really bad but there is chronic complaining about things "- things are not bad enough to leave and not good enough to stay" syndrome.

  • Alcohol often gets used as mood lifter and relaxant

  • Poor appetite or overeating

What can help?

  • Counselling can help you getting in contact with earlier hopes for life: through counselling and talking about them you might feel the courage to follow them

  • Meditation, Spiritual and/or nature connections

  • Community activities (church/spiritual communities)

  • Life changes (travel, relationship changes, further education, career change)

  • A "melancholic" type of person might naturally have a lower and slower kind of energy, and needs time introverting.


Contact Silvia about what your particular situation is and how she might be able to help.

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