Counseling for Depression

BEFORE APPOINTMENT

Print out: Beck's Depression Inventory (found free online)

Print out: Zung Self-Rating Depression Scale (found free online)

print out : Hamilton Depression Rating Scale (HDRS) (found free online)

^^^^^ they all are the same so look up which one would be most appropriate for patient.... the last one is for counsellor to fill out, the first 2 is for patient to do.

Introduction

this first session is going to me getting to understand you better

so I will be listening and asking a lot of questions.

Facts about Depression:

Today 1 in 5 woman will suffer major depression

1 in 8 men will suffer major depression

Depression differs slightly in its symptoms, severity, and duration

Lesser forms of depression is

Grief which can last beyond a year, but usually doesnt affect work, friendships, family, and physical health.

Even less is a bad mood which can last to up to a couple days.

My goal is to better understand what you are going through

The more open and honest you are the better I can help.

Getting to Know the Patient

1. Do you know when what your feeling started?

2. Do you know or have any ideas to what started it?

3. How did that make you feel? or How do you feel when depression hits?

Types of Depression/ Understanding Patients Symptoms

say yes or no to any of these symptoms

Please focus only on the symptoms and not what is part of your regular personalilty.

Please remember during this to focus on the sympomss

If you have to say “this might be part of my regular personality”

It will help me

(Counsellor: try to understand the frequency of the symptoms/depression esp for Dysthymia, and SAD))

MAJOR DEPRESSION/ UNIPOLAR DEPRESSION

*approx 4 months at a time

Symptoms:

affects your work, relational life affected, affected physical health sad, empty, hopeless, slowed physical behavior, slowed cognitive behavior, disorientation, changes in weight, changes in appetite(THIS CAN BE MORE TEN A SYMPTOM BUT THE PROBLEM), changes in sleeping patterns (SAME), loss of interest in hobbies, less interest/less pleasure in spending time with friends, thoughts of death, thoughts of suicide,

Psychotic Symptoms:

delusions & hallucinations

Facts:

the average major depression lasts 4 months

50% of people that get it once will get it again

80% of people that get it twice will get it a 3rd time

MANIC DEPRESSION / BIPOLAR DISORDER

*random

Symptoms:

increased energy, inappropriate excitement, irritability, increased talking, constant moving, promiscuous behavior, racing thoughts, impulsiveness, poor judgement, spending sprees, unrealistic plans, unrealistic goals, exaggerated thoughts, inflated self-esteem.

Extreme Symptoms:

Resembling schizophrenia

DYSTHYMIA/CYCLOTHYMIA

*(long lasting, less intense), no breaks, 24/7

Symptoms:

All of the above, but some symptoms more and some less. (never is it all symptoms of one, its some of each), is less intense, symptoms last for at least 2 years

never feel good, going through the motions, experiencing very little pleasure and enthusiasm, always feeling it,

SEASONAL AFFECT DISORDER (SAD)

*pretty predictable with time of day or season

Symptoms:

All of the above, but occurs in certain seasons, or times in the day (esp lack of light).

SEVERITY OF DEPRESSION

Fill out 1 of the 3 Scales

remember to answer according to symptoms not personality.

After knowing they are saved, determine if Biblical counsel is best option or if they need clinical treatment

Biblical Counsel

Questions to ask

How strong is your walk with God?

Have you seeked out God’s help in these times? Did it help?

Have you reached out for prayer advice when going through it? Did it help?

How well do you think you have applied Biblical practices to treat your depression?

Homework

When the symptoms hit write down how you feel and why, then Read through verses put a check mark to the ones that minister to you, and afterwards write your thoughts, bring it back.

The 3 CLINICAL Treatments For Depression:

1. Psychotherapy

Part science part art.

Theres no set method.

2. Medication (antidepressants)

Tricyclics (TCA’s) - increase the availability of norepinephrine and serotonin at the neuron synapse.

Nomoamine Oxidase Inhibitors (MAOIs) : increase transmitter norepinephrine and dopamine; and the most recent addition,

Selective serotonin reuptake inhibitors (SSRIs), (Prozac, Zoloft, and Paxil): which increase the availability of serotonin at nerve endings.

while these three have seen much success they all have its side effects: for example (MAOIs) may dangerously increase blood pressure), TCAS as overdose can kill,. which is why SSRIS are mostly used (they still have side effects but less intense)

THese three are NOT habit forming, will not cause euphoria

medication is given from 4-6 months to a year at a time and will try others if one does not work.

3. Ectroconvulsive therepy (ECT) (shock therapy)

passing an electric current through the brain to create an artificial epileptic seizure (the rapid firing of neurons throughout the brain)

ECT is most often used for severely depressed patients who do not respond to other forms of treatment.

Since it is painful they do have drugs to give ECT which is painless

However this is a treatment for those that cant take medications

VERSES FOR VARIOUS SYMPTOMS

Psalm 34:17-18

When the righteous cry for help, the Lord hears and delivers them out of all their troubles. The Lord is near to the brokenhearted and saves the crushed in spirit.

Isaiah 41:10

Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.

1 Peter 5:7

Casting all your anxieties on him, because he cares for you.

Matthew 11:28

Come to me, all who labor and are heavy laden, and I will give you rest.

Jeremiah 29:11

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.

Proverbs 3:5-6

Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.

Psalm 143:7-8

Answer me quickly, O Lord! My spirit fails! Hide not your face from me, lest I be like those who go down to the pit. Let me hear in the morning of your steadfast love, for in you I trust. Make me know the way I should go, for to you I lift up my soul.

Psalm 30:5

For his anger is but for a moment, and his favor is for a lifetime. Weeping may tarry for the night, but joy comes with the morning.

Philippians 4:6-7

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

Psalm 23:4

Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.

Proverbs 12:25

Anxiety in a man's heart weighs him down, but a good word makes him glad.

Psalm 9:9

The Lord is a stronghold for the oppressed, a stronghold in times of trouble.

Psalm 34:18

The Lord is near to the brokenhearted and saves the crushed in spirit.

Romans 12:2

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

2 Timothy 1:7

For God gave us a spirit not of fear but of power and love and self-control.

Revelation 21:4

He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.”

John 10:10

The thief comes only to steal and kill and destroy. I came that they may have life and have it abundantly.

Deuteronomy 31:8

It is the Lord who goes before you. He will be with you; he will not leave you or forsake you. Do not fear or be dismayed.”

Isaiah 40:31

But they who wait for the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint.

Psalm 3:3

But you, O Lord, are a shield about me, my glory, and the lifter of my head.

Psalm 102:1-11

A Prayer of one afflicted, when he is faint and pours out his complaint before the Lord. Hear my prayer, O Lord; let my cry come to you! Do not hide your face from me in the day of my distress! Incline your ear to me; answer me speedily in the day when I call! For my days pass away like smoke, and my bones burn like a furnace. My heart is struck down like grass and has withered; I forget to eat my bread. Because of my loud groaning my bones cling to my flesh. ...

Isaiah 26:3

You keep him in perfect peace whose mind is stayed on you, because he trusts in you.

Psalm 30:11

You have turned for me my mourning into dancing; you have loosed my sackcloth and clothed me with gladness,

Philippians 4:8

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Matthew 6:33

But seek first the kingdom of God and his righteousness, and all these things will be added to you.

Psalm 40:1-3

To the choirmaster. A Psalm of David. I waited patiently for the Lord; he inclined to me and heard my cry. He drew me up from the pit of destruction, out of the miry bog, and set my feet upon a rock, making my steps secure. He put a new song in my mouth, a song of praise to our God. Many will see and fear, and put their trust in the Lord.

John 16:33

I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.”

Romans 15:13

May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.

Philippians 4:13

I can do all things through him who strengthens me.

Romans 8:38-39

For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.

Matthew 11:28-30

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

Psalm 23:1-6

A Psalm of David. The Lord is my shepherd; I shall not want. He makes me lie down in green pastures. He leads me beside still waters. He restores my soul. He leads me in paths of righteousness for his name's sake. Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me. You prepare a table before me in the presence of my enemies; you anoint my head with oil; my cup overflows. ...

Philippians 4:4

Rejoice in the Lord always; again I will say, Rejoice.

Psalm 139:1-24

To the choirmaster. A Psalm of David. O Lord, you have searched me and known me! You know when I sit down and when I rise up; you discern my thoughts from afar. You search out my path and my lying down and are acquainted with all my ways. Even before a word is on my tongue, behold, O Lord, you know it altogether. You hem me in, behind and before, and lay your hand upon me. ...

Jeremiah 1:19

They will fight against you, but they shall not prevail against you, for I am with you, declares the Lord, to deliver you.”

Joshua 1:9

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.”

Psalm 77:4

You hold my eyelids open; I am so troubled that I cannot speak.

Psalm 42:11

Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation and my God.

1 Peter 1:13-16

Therefore, preparing your minds for action, and being sober-minded, set your hope fully on the grace that will be brought to you at the revelation of Jesus Christ. As obedient children, do not be conformed to the passions of your former ignorance, but as he who called you is holy, you also be holy in all your conduct, since it is written, “You shall be holy, for I am holy.”

1 Corinthians 10:13

No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.

Psalm 103:1-5

Of David. Bless the Lord, O my soul, and all that is within me, bless his holy name! Bless the Lord, O my soul, and forget not all his benefits, who forgives all your iniquity, who heals all your diseases, who redeems your life from the pit, who crowns you with steadfast love and mercy, who satisfies you with good so that your youth is renewed like the eagle's.

Romans 8:28

And we know that for those who love God all things work together for good, for those who are called according to his purpose.

Psalm 40:2

He drew me up from the pit of destruction, out of the miry bog, and set my feet upon a rock, making my steps secure.

John 14:18

“I will not leave you as orphans; I will come to you.

Matthew 28:20

Teaching them to observe all that I have commanded you. And behold, I am with you always, to the end of the age.”

1 Peter 5:6-7

Humble yourselves, therefore, under the mighty hand of God so that at the proper time he may exalt you, casting all your anxieties on him, because he cares for you.

Psalm 37:23-24

The steps of a man are established by the Lord, when he delights in his way; though he fall, he shall not be cast headlong, for the Lord upholds his hand.

2 Corinthians 7:10

For godly grief produces a repentance that leads to salvation without regret, whereas worldly grief produces death.

Proverbs 15:13

A glad heart makes a cheerful face, but by sorrow of heart the spirit is crushed.

2 Samuel 22:29

For you are my lamp, O Lord, and my God lightens my darkness.

Habakkuk 3:16-19

I hear, and my body trembles; my lips quiver at the sound; rottenness enters into my bones; my legs tremble beneath me. Yet I will quietly wait for the day of trouble to come upon people who invade us. Though the fig tree should not blossom, nor fruit be on the vines, the produce of the olive fail and the fields yield no food, the flock be cut off from the fold and there be no herd in the stalls, yet I will rejoice in the Lord; I will take joy in the God of my salvation. God, the Lord, is my strength; he makes my feet like the deer's; he makes me tread on my high places. To the choirmaster: with stringed instruments.

Psalm 34:17

When the righteous cry for help, the Lord hears and delivers them out of all their troubles.

2 Corinthians 10:4-6

For the weapons of our warfare are not of the flesh but have divine power to destroy strongholds. We destroy arguments and every lofty opinion raised against the knowledge of God, and take every thought captive to obey Christ, being ready to punish every disobedience, when your obedience is complete.

1 Corinthians 6:19-20

Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.

Psalm 27:1-14

Of David. The Lord is my light and my salvation; whom shall I fear? The Lord is the stronghold of my life; of whom shall I be afraid? When evildoers assail me to eat up my flesh, my adversaries and foes, it is they who stumble and fall. Though an army encamp against me, my heart shall not fear; though war arise against me, yet I will be confident. One thing have I asked of the Lord, that will I seek after: that I may dwell in the house of the Lord all the days of my life, to gaze upon the beauty of the Lord and to inquire in his temple. For he will hide me in his shelter in the day of trouble; he will conceal me under the cover of his tent; he will lift me high upon a rock. ...

Psalm 32:10

Many are the sorrows of the wicked, but steadfast love surrounds the one who trusts in the Lord.

2 Corinthians 1:4-6

Who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. For as we share abundantly in Christ's sufferings, so through Christ we share abundantly in comfort too. If we are afflicted, it is for your comfort and salvation; and if we are comforted, it is for your comfort, which you experience when you patiently endure the same sufferings that we suffer.

Psalm 94:18-19

When I thought, “My foot slips,” your steadfast love, O Lord, held me up. When the cares of my heart are many, your consolations cheer my soul.

John 10:27-31

My sheep hear my voice, and I know them, and they follow me. I give them eternal life, and they will never perish, and no one will snatch them out of my hand. My Father, who has given them to me, is greater than all, and no one is able to snatch them out of the Father's hand. I and the Father are one.” The Jews picked up stones again to stone him.

Psalm 34:18-19

The Lord is near to the brokenhearted and saves the crushed in spirit. Many are the afflictions of the righteous, but the Lord delivers him out of them all.

Psalm 112:4

Light dawns in the darkness for the upright; he is gracious, merciful, and righteous.

2 Samuel 22:2

He said, “The Lord is my rock and my fortress and my deliverer,

Psalm 42:5

Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation

1 Peter 4:12-13 ESV /

Beloved, do not be surprised at the fiery trial when it comes upon you to test you, as though something strange were happening to you. But rejoice insofar as you share Christ's sufferings, that you may also rejoice and be glad when his glory is revealed.

Lamentations 3:22-26

The steadfast love of the Lord never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness. “The Lord is my portion,” says my soul, “therefore I will hope in him.” The Lord is good to those who wait for him, to the soul who seeks him. It is good that one should wait quietly for the salvation of the Lord.

Isaiah 60:1

Arise, shine, for your light has come, and the glory of the Lord has risen upon you.

Psalm 147:3

He heals the brokenhearted and binds up their wounds.

2 Corinthians 1:3-4

Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God.

Romans 12:12

Rejoice in hope, be patient in tribulation, be constant in prayer.

Romans 13:14

But put on the Lord Jesus Christ, and make no provision for the flesh, to gratify its desires.

Matthew 6:27

And which of you by being anxious can add a single hour to his span of life?

Ecclesiastes 7:3-4

Sorrow is better than laughter, for by sadness of face the heart is made glad. The heart of the wise is in the house of mourning, but the heart of fools is in the house of mirth.

Ecclesiastes 9:4

But he who is joined with all the living has hope, for a living dog is better than a dead lion.

Psalm 55:22

Cast your burden on the Lord, and he will sustain you; he will never permit the righteous to be moved.

Psalm 43:4-5

Then I will go to the altar of God, to God my exceeding joy, and I will praise you with the lyre, O God, my God. Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation and my God.

Lamentations 3:31-33

For the Lord will not cast off forever, but, though he cause grief, he will have compassion according to the abundance of his steadfast love; for he does not willingly afflict or grieve the children of men.

Psalm 37:3-4

Trust in the Lord, and do good; dwell in the land and befriend faithfulness. Delight yourself in the Lord, and he will give you the desires of your heart.

Romans 8:26

Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words.

Psalm 42:3-5

My tears have been my food day and night, while they say to me all the day long, “Where is your God?” These things I remember, as I pour out my soul: how I would go with the throng and lead them in procession to the house of God with glad shouts and songs of praise, a multitude keeping festival. Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation

Matthew 6:34

“Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.

Hebrews 4:12

For the word of God is living and active, sharper than any two-edged sword, piercing to the division of soul and of spirit, of joints and of marrow, and discerning the thoughts and intentions of the heart.

Psalm 43:5

Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation and my God.

Psalm 94:19

When the cares of my heart are many, your consolations cheer my soul.

1 John 2:16

For all that is in the world—the desires of the flesh and the desires of the eyes and pride in possessions—is not from the Father but is from the world.

Psalm 31:21

Blessed be the Lord, for he has wondrously shown his steadfast love to me when I was in a besieged city.

2 Peter 2:9

Then the Lord knows how to rescue the godly from trials, and to keep the unrighteous under punishment until the day of judgment,

Luke 10:27

And he answered, “You shall love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind, and your neighbor as yourself.”

Deuteronomy 33:27

The eternal God is your dwelling place, and underneath are the everlasting arms. And he thrust out the enemy before you and said, Destroy.

Romans 8:1-39

There is therefore now no condemnation for those who are in Christ Jesus. For the law of the Spirit of life has set you free in Christ Jesus from the law of sin and death. For God has done what the law, weakened by the flesh, could not do. By sending his own Son in the likeness of sinful flesh and for sin, he condemned sin in the flesh, in order that the righteous requirement of the law might be fulfilled in us, who walk not according to the flesh but according to the Spirit. For those who live according to the flesh set their minds on the things of the flesh, but those who live according to the Spirit set their minds on the things of the Spirit. ...

John 1:1-51

In the beginning was the Word, and the Word was with God, and the Word was God. He was in the beginning with God. All things were made through him, and without him was not any thing made that was made. In him was life, and the life was the light of men. The light shines in the darkness, and the darkness has not overcome it. ...

Hebrews 11:1

Now faith is the assurance of things hoped for, the conviction of things not seen.

Isaiah 40:30-31

Even youths shall faint and be weary, and young men shall fall exhausted; but they who wait for the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint.

Song of Solomon 2:11-12

For behold, the winter is past; the rain is over and gone. The flowers appear on the earth, the time of singing has come, and the voice of the turtledove is heard in our land.

Psalm 31:1-24

To the choirmaster. A Psalm of David. In you, O Lord, do I take refuge; let me never be put to shame; in your righteousness deliver me! Incline your ear to me; rescue me speedily! Be a rock of refuge for me, a strong fortress to save me! For you are my rock and my fortress; and for your name's sake you lead me and guide me; you take me out of the net they have hidden for me, for you are my refuge. Into your hand I commit my spirit; you have redeemed me, O Lord, faithful God. ...

1 Kings 19:1-21

Ahab told Jezebel all that Elijah had done, and how he had killed all the prophets with the sword. Then Jezebel sent a messenger to Elijah, saying, “So may the gods do to me and more also, if I do not make your life as the life of one of them by this time tomorrow.” Then he was afraid, and he arose and ran for his life and came to Beersheba, which belongs to Judah, and left his servant there. But he himself went a day's journey into the wilderness and came and sat down under a broom tree. And he asked that he might die, saying, “It is enough; now, O Lord, take away my life, for I am no better than my fathers.” And he lay down and slept under a broom tree. And behold, an angel touched him and said to him, “Arise and eat.” ...

Ephesians 2:6

And raised us up with him and seated us with him in the heavenly places in Christ Jesus,

Isaiah 9:1

But there will be no gloom for her who was in anguish. In the former time he brought into contempt the land of Zebulun and the land of Naphtali, but in the latter time he has made glorious the way of the sea, the land beyond the Jordan, Galilee of the nations.

Psalm 46:10

“Be still, and know that I am God. I will be exalted among the nations, I will be exalted in the earth!”

Proverbs 17:9

Whoever covers an offense seeks love, but he who repeats a matter separates close friends.

Mark 5:28

For she said, “If I touch even his garments, I will be made well.”