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Depression? But what treatment?


The diagnosis of depression is made on the basis of one’s stated emotional state and observable behaviour. We ask how one is feeling and if sleep, eating or self-care has been disrupted. Without digging deeper, the diagnosis won’t determine the basis for the depression.


A person may be biologically predisposed to depression wherein one would likely feel this way, even in the absence of external issues or the depression may be situationally determined the result of a loss or other tragic events. In other words depression may be predominantly biologically determined or a psychological response to an untoward external occurrence.


Whether biological or situational, there is also the impact of depression upon one’s relationships. The issue is, what is the impact of one’s depression upon others and they in turn upon the affected individual? How might the influence of others be helpful or antagonistic to the severity of the affected person’s depression and/or recovery?


Thus to determine a reasonable course of treatment for depression, assessment must be based upon a bio-psycho-social model.


Assuming a family history of depression, it may be safe to conclude there are biological factors at play in your depression. Given the presence of biological determinants, then medication comes to the fore as a more reasonable treatment strategy for consideration.


In the absence of a family history of depression, yet the presence of distressing life events, then it could be reasonable to conclude that the depression relates to one’s response to this real life issue and the matter is more psychological than biological. If this is the case, then counselling to address the issue of distress may be a more appropriate choice for treatment over that of medication.


Of course, life can throw a curve ball and there can be both strong biological as well as psychological factors at play. If this is the case then a combination of treatments are worthy of consideration and would include medication as well as counselling. Think of this as “that and” rather than “either or”. Further, given the interplay of one’s relationships, particularly spousal and family, can also figure significantly in recovery, then couple and/or family therapy may be indicated.


Regardless of treatment, medicinal, psychological, marital or family therapy, education is also vital. Persons must be educated with regard to the treatment options and treatment implications to make informed choices such they can best manage their depression.


Education is not just for the affected person, but also for those around the affected person who might otherwise not know how best to provide support.


Depression can be remarkably debilitating and most people suffer in silence. Truth is, for successful treatment, depression is best considered multi-facetted and to get the most appropriate treatment, a bio-psycho-social model of assessment and treatment is the best course of action.


If you are suffering from depression contact both your physician and mental health care provider.


Gary Direnfeld, MSW, RSW
(905) 628-4847


Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead and the parenting columnist for the Hamilton Spectator. His book, Marriage Rescue is due out in spring 2013. Gary maintains a private practice in Dundas Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America.




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Gary Direnfeld, MSW, RSW
(905) 628-4847  


Gary Direnfeld is a social worker in private practice. Courts in Ontario, Canada, consider Gary an expert on child development, parent-child relations, marital and family therapy, custody and access recommendations, social work and an expert for the purpose of giving a critique on a Section 112 (social work) report.


Call Gary for your next conference and for expert opinion on family matters. Services include counselling, mediation, assessment, assessment critiques and workshops.


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For information on Direnfeld's book, Raising Kids Without Raising Cane, click here.


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27 Sina Street, Georgina, ON, Canada L4P 3E9 Tel: (905) 628-4847 Email: gary@yoursocialworker.com