Working with depressed people

Abstract

The picture illustrated above is one of a man with severe depression. His thought processes are all negative, about himself and the world around him. He is miserable, preoccupied and wrapped up in self-criticism, berating himself constantly. He appears to have lost his sense of purpose, is confused, dejected and has a hopeless and powerless vision of his future. This continuum of depression (see Figure 6.1), however, is not necessarily experienced by all. Individuals may never proceed to the depths of hopelessness described; others may not experience sadness, but find themselves suddenly in the grips of despair.

Andrew: ‘I’ve had enough. I’m such a big fat useless slob. I just can’t get anything right. I’m totally useless.’

Nurse: ‘Totally useless?’

Andrew: ‘Yes, I can’t do my job properly. I can’t keep relationships. I cock up everything I do and then I run home like a big kid...I had a house once but I couldn’t hack it. I sold up after three months, lost a load of money and ran home to my mother. I go out to the pub, act like the life and soul of the party and pretend everything’s OK. You know, have a laugh and a joke, but it’s all a sham, an act. I’m just a figure of fun, bit of a joke really. Everyone expects me to be like that all the time...but when I get home I start blubbering like a baby, weeping and wailing all over the place. Who’d want a pathetic man like that?’

Nurse: ‘Pathetic?’

Andrew: ‘Yeah! Useless, a failure, total mess. I can’t see an end to it. It seems to go on for ever. Me cocking things up, upsetting people, blowing it.’