Do I need to see a psychologist/therapist for my depression?

Apart from therapy, there are other things that can help. But it’s important to first educate yourself about this condition.

*To determine if you have depression, screeners might be an easy first step for you. However, it is not a substitute for professional mental health services provided by psychologists and psychiatrists.

Depression in children and depression in adolescents look different from depression in adults.  

What is depression?

There is a saying, “depression is like the the common cold.” Like most sayings, it contains a grain of truth that needs to be taken with a grain of salt. Depression is rather common, and so in that sense it is like the common cold. To those who suffer from the more severe form of depression, it is an extremely painful and debilitating condition. In that sense, it is a not like the common cold. 

If you suffer from depression, know that there are others like you out there, and it is possible to get better!

With depression in focus after Coco Lee’s death: “official data showed a 20 per cent increase in patients with the disorder at public hospitals over the past five years.” (SCMP, 2023 8 July)

Depression has different faces

Experientially, depression can show up as a loss of hope, vitality, and motivation. It can show up as the subjective experience that “life gets drained out of you”: there is no meaning to much of anything, the skies look grey, life is a dreadful thing the motions of which you go through day after day. Depression can also affect us somatically: your chest can feel tight, your head hurts, your skin feels numb, and your whole body feels as if it is soaked in emotional pain. (Psychosomatic conditions occur when our body takes over to express psychological distress with which our mind has difficulty coping.) Some days it can feel like the weight of the world is on your back, you feel isolated and lost, and you are so emotionally tired and mentally drained that you lose the ability to think and concentrate. Living feels like a challenge. 

Behaviorally, it can show up as crying spells, staying in bed all day, not wanting to go out, or burying yourself in work and other activities. You might suffer from insomnia because your mind is restless and hijacked by troubling thoughts. You might also sleep a lot because that’s when you get some relief from emotional pain. You might find yourself not wanting to see your friends or going to the movies. You might lose interest in food. Or you might eat a lot to drown your feelings. 

Emotionally, behind the more pronounced sadness you could be experiencing a cluster of disparate feelings: irritability, worry, guilt, fear, overwhelm, helplessness, and even numbness. These feelings might speak louder for some than others. For people with acute depression, it can also be extremely confusing. It can feel like life as you once knew it is over, and some days you feel like you are on the verge of losing it. The fact that you don’t know how long this painful and suffocating state will last can create another layer of hopelessness and despair on top of the multitudes of distress you are already feeling. 

Depression comes in different degrees

Like other mental health conditions, depression exists on a spectrum: from one end of feeling sad, empty, and irritable, to the severe and insidious end of wanting to end one’s life. (If you or someone you know is struggling with suicidality, it is important to seek help ASAP from a psychiatrist for medication and a psychologist/therapist for treatment. Like all health conditions, early intervention promotes treatment outcomes.) 

Depression has different phases

Depression can be chronic or sudden in onset. Some people can be saddled with it for as long as they can remember. Others can find themselves suddenly in the grip of depression after an emotionally challenging event: the loss of a loved one, the end of a meaningful employment, the termination of a relationship, or the discovery of a partner’s affair. Some people feel they just wake up one day with it, and they don’t know why.

Some people go in and out of depression if it is severe. They get better for a while before falling back into its grip. It can feel cyclical.

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is used by clinical psychologists for diagnostic purposes. It lists the following as the symptoms of depression: 

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

How is depression treated?

Medication (from psychiatrists) and psychotherapy provided by psychologists and therapists are common treatment methods. 

What can I do myself to help me with my depression? 

  • Social support is very important.

At times of difficulty, call/meet a friend and talk. Express how you are feeling and let it sink in that you are not alone. You need to be very mindful about the fact that people are there to support you, let their care touch you, and take in how that feels to you in a visceral way (notice, for example, if your heart softens up, your chest is less tight, and warmth starts to course through your body etc.) This will help mitigate, among other feelings, your aloneness, helplessness, and worthlessness.

(If your friends happen to like to provide solutions instead of listening, when you feel you want to be listened to, let them know: “I just need you to listen to me right now. I don’t need solutions.” Let them know what you need:  “You can listen with an open mind, and say ‘this sucks,’ or ‘I am here for you’.” If your friends, perhaps out of their own helplessness and protectiveness, blame you for your feelings by saying “You can snap out of this. You don’t have to feel this. You can choose,” tell them depression is not something anyone chooses! Refer them to online resources to learn more about depression. If they are resistant, find someone else who wants to learn and listen.)

  • Recognize when you are catastrophizing and encourage yourself to look for the silver lining.

We all are susceptible to making irrational mental leaps, such as from “I lost my job” to “I am worthless” or I will never find another job.” This is not something you can control, your mind has a way of going there on its own. However, when your mind makes that mental leap, you can catch yourself by saying, for example, “This isn’t right. Losing a job doesn’t mean I will never find another job.” A silver lining can sound like “Maybe this will provide an opportunity for me to reevaluate what it is that I want to do.”

(However, if your depression is resistant to the cognitive restructuring method mentioned above, and it ends up feeling disingenuine, invalidating, ineffective, or it just ends up making you even more depressed because you don’t feel you can do it or it is useless or it doesn’t resonate or it is not where you are at the moment, respect your feelings and don’t force yourself. This might not be your cup of tea. And that’s ok!)

  • Use distraction in moments of unraveling. 

Depression has a way of turning everything negative. So at times you might feel bewildered with loneliness, despair, and self-blame; and the next thing you know, you are spirally downwards and the rug is pulled from under you. If you can, nip the unravelling at its bud by going out, cleaning, tidying up your bedroom, calling a friend, etc. Distract your mind and give it something else to get busy with and focus on. Reassure yourself that feelings come and go. And you are waiting for your feelings to pass. (However, if you feel at risk of hurting yourself, call the Samaritan Befrienders at 23892222.) 

  • Exercise and sunlight are known to help some people.

If you don’t feel like going out and about, try motivating yourself by, for example, inviting a friend to come along with you. Make it fun. Instead of running, which you might find dry, go hiking and explore nature—if that’s your cup of tea—and take pics to make the activity more rewarding to you. Top it off with a nice dinner or a scope of ice-cream.

  • Other things to keep in mind include optimal self-care, such as quality sleep, a balanced and healthy diet, and mindfulness practices like meditation and yoga. 

There are guided meditation/visualization techniques available on the internet (e.g., youtube), of which you can make use to see if it is helpful to you. Some people report feeling more at peace and in control after listening to, for example, a soothing voice guiding you to visualize a safe place like a beach or a forest where you can take refuge and feel held and protected. Guided meditation can quiet your monkey mind and bring you moments of peace and re-centering. Best yet, these resources are free!

Support Services in HK 

Do I need to see a psychologist/therapist for my depression?

If you have been struggling with depression for a while, or if you feel your depression interferes significantly with your life, it is a good idea to talk to a psychologist/therapist to get help. Therapy is a good way to learn more about yourself and what gives raise to the difficulties you experience in your life. Some people are resistant to the idea of therapy because to them, it amounts to saying something is wrong with them. This view is unwarranted  because all you want is to feel better and to improve your life. We don’t ask people who go to the gym, “hey, what’s wrong with you that you want a healthier body?” Our mind requires at least the same level of care.