Depression Treatment Options

However the client should be aware of the treatment options so that he /she can discuss with the consultant. Broadly speaking, the treatment of depression rests on two factors Medication, and Psychotherapy or Counselling.

  • Medication is required for moderate and severe depressive disorder cases.
  • Counseling and psychotherapy serves as an edge in treating depression and need to be started simultaneously along with medicines.
  • You should continue the full course of psychotherapy even if you are feeling better to prevent a relapse.
  • Suddenly stopping antidepressants can precipitate a relapse. Medication needs be tapered gradually under your doctor’s supervision.




Fear of commitment? Why am I still single? You are doing the work that you love for a good salary. Your career is on track. Now, you’ve decided that you’d like to do something about your personal life. You are thinking about a committed relationship or marriage and maybe children. You are accustomed to articulating your goals and achieving them. You take personal stock. You have a lot going for you. You are attractive, personable, fun, smart and outgoing. You think that you have met Mr. or Ms. Right. You share common interests, common friends and common ideas and, you believe, common goals. Then somehow, much to your dismay, things go awry. You learn that your partner isn’t interested in marital vows. Or worse still I notice that I am getting involved in relationships where the only common thread is that I am being ditched / cheated by my partner, basically my partner is unable to remain committed to me.
Whether you were several months into the relationship or several years, that kind of disappointment is truly hurtful. Its worse, if this is not the first time. This is not something that you want to repeat. So, you talk it over with your closest friends, the ones who you really trust. And, to your surprise, many of them admit that they saw the warning signs but “didn’t think that it was their place to say anything”, especially because it seemed so trivial incident or because you were so strong on the relationship and didn’t want to hurt you.
You’re a little miffed because you wish they would have said something. But, you can understand why they might feel that that would backfire. And too, you wonder, why didn’t you see those elusive warning signs. After all, they were apparently obvious to everyone else. You note that you are generally a perceptive person — can readily see the foibles in the relationships of others. So, what has happened here? And, how can you prevent it from, ever, happening again.
As you talk it over with your friends they each give you a list of “warning signs”. “Don’t date anyone over 35 who has never been married,” one cautions. Don’t date anyone who hasn’t had a previous long-term relationship another warns. As well intended as they may be, the lists may lead to a mis-focus. Because the real thing to consider here is probably not the “mate-selection” process that is important, rather, it is: why have you, although probably unconsciously, been drawn to someone who is unavailable. Assuming that you are a bright, competent person, this is probably not a problem of the “wrong list”. You might think of the problem with “mate-selection” as a symptom of something else that has gone awry. Think of it as the tip of the iceberg. That is, there is more to it than meets the eye.
Fear of commitment lies beneath the surface
If you have chosen a partner who turns out to be unavailable more than once, chances are there’s a reason why you chose someone who is unavailable. It’s painful to think about. The good news is as painful thinking about it can be: thinking about it, rather than sweeping it under the rug and going blithely along to the next relationship can allow you to understand it. And, understanding it can allow you not to repeat it. You can address and/or overcome it, and truly move toward the kind of relationship that you seek.
So, why are you, in effect, playing tricks on yourself? Although each individual and each situation is unique, odds are, as strange as it sounds, there may be a part of you who truly wants a relationship and another part of you, a less conscious part, who does not. That is, there may very well be a part of you who has a fear of commitment. As a starting point to your self-discovery process, ask yourself a difficult question, “what are the advantages to NOT being in a relationship?” And, in what ways do you have fear of commitment? At first blush, most people see these as ludicrous questions. If the answers were immediately apparent, you would have already dealt with them. Why aren’t you in a committed relationship and what can you do to overcome your fears. These reasons may include:
1. You are terrified of intimacy.
People who are terrified of intimacy may not always be, consciously, aware of it. If you grew up in a household in which your parents behaved in ways that were hurtful to each other, to you or to a brother or sister than you may be more afraid of intimacy than you realize. This is an extremely common problem among successful young professionals who often become quite successful in their careers. Without realizing it, they allow their careers to take precedence over their lives. Work becomes to the worker as alcohol is to the alcoholic; balm to soothe the anxiety and fear. Of course, this sort of “workaholism”, quite common here in Washington, is highly rewarded. Workaholism can be a cover for a fear of commitment.
2. You don’t feel that you deserve a relationship.
This is a close cousin to the fear of intimacy. Many people, who are otherwise successful in life, do not feel that they deserve a relationship. Unfortunately, most of the time, though not always, this belief is unconscious. Thus, it is difficult to learn more about it and to resolve it. Often this type of belief comes from experiences in childhood. The person may feel responsible for something bad that happened in the family such as the death of a parent or a sibling, or the illness or drug or alcohol problem of a parent. Alternatively, the basis for the guilt might be far more subtle such as guilt for resenting a needy or vulnerable parent or sibling. Similarly, individual may feel guilty over outstripping a parent or sibling.
3. You fear that any relationship is destined to end in hurt or failure.
Another cousin to the first two apprehensions is the belief, again unconscious, that any relationship will end in failure or loss. This is a common concern among people who moved around a lot as children, such as those with parents in the military or in an industry where such moves were required. These people often report that every time they began to make friends and become emotionally invested they were, often over their strenuous objections, forced to uproot themselves. For some these moves were so painful that they learned to make only superficial attachments. Also, this is a common problem among individuals who had significant early losses such as a loss of a parent through death or divorce. It is important to note that the loss does not necessarily entail an actual separation, it could entail a loss of a role or status. It’s understandable that individuals with this tyoe of experience have a fear of intimacy.
4. You don’t know much about what you think and feel. Consequently, you are unable to use your reactions as a guide.
Often times people who come for psychotherapy or counseling know little about what they think and feel. People with this difficulty typically report, “I don’t know why I have these problems. I had a very happy childhood”. They may have had a stressful childhood but they have denied that to themselves. Such individuals became proficient, at an early age, at turning off painful feelings. They may avoid painful feelings by throwing themselves into activities in which they are busy and successful such as work and sports. Unfortunately, not knowing much about what you think and/or feel has serious drawbacks inasmuch as feelings and thoughts often inform and guide important decisions.
5. You are frightened by the prospect of learning more about some aspect of your sexuality.
Another reason why an individual might select unavailable partners is to avoid learning more about some aspect of their sexuality. An intimate relationship holds the possibility of self-discovery and this can be frightening to many people.
So if you are afraid of a committed relationship, if you recognize yourself in one of the descriptions what steps might you take? How do you go about teasing apart the nature of your fear of intimacy?
Ask yourself the following questions:
1. What about an intimate relationship do you feel might be hurtful?
2. What is your worst fear?
3. How did your parent’s relationship work? In what ways was it successful? In what ways was it hurtful?
4. What were your relationships with your parents like when you were a small child? In what ways were they loving and supportive? In what ways were they hurtful?
5. Are you, in some way, repeating a script of what you observed with your parents? For example, do you find yourself doing everything and feeling “walked on” like your mother?
The answers to these questions may give you some insight into your fear of commitment. Talk them over with a trusted friend. Sometimes talking with a friend can help us to learn more about ourselves. However, if selecting unavailable people as prospective partners has been a recurring problem for you, seriously consider seeking an consultation with a therapist. These intensive treatments allow individuals to develop the requisite trust to deepen their understanding of themselves so that they can make real and enduring changes.
Why do some people have profound difficulties with commitment while others seem to embrace it? True commitment can come about only when one has a clear sense of oneself. That is, a person knows who they are and what they want and need is more available for a committed relationship. Many single people intuitively recognize this and choose to work on themselves prior to entering into a committed relationship. Also, a committed relationship isn’t for everyone. Some who know themselves well find it deeply enriching to take a solo flight. The key here is: just as individuals can remain unpartnered as a way of avoiding a host of painful experiences, they can marry or partner for a host of defensive reasons, such as avoiding aloneness or self-discovery. Self-understanding can help one to recognize when marriage or partnering is a growing experience and when it is a way of avoiding knowing oneself.


Every human being wishes to be eternally connected with a person. This connection is established or expected to be fulfilled in a love / marital relationship. Infidelity in the relationship causes severing of this connection and also the hope of it in future. Too often, the numbness and confusion, the pain and anger of uncovering the infidelity is intensified by the myths and half-truths about affairs and inability to share the wound, that makes surviving infidelity that much more draining and difficult – both mentally and emotionally.
Emotions in infidelity mimic that of death of a person, only more difficult to deal with because it is not an actual physical death. The partner is not only mourning the loss of the relationship but also the eternal wish to be connected with a human being. It stirs up deep infantile feelings of insecurity and leaves the person feeling unloved and abandoned.
Compounding the issue, infidelity is often kept under wraps as it is shrouded by societal humiliation, shame, guilt and lowered self worth. The partner goes through various stages such as denial/ disbelief, anger, apathy and then grief. This mourning can last up to a year, or even more. Each occasion/ incident is mourned individually till the person is ready to let go and forgive. Often, during this phase of grieving the wounded person, although aware of the practical approach to deal with the situation, is unable to do so due to intense emotions. Family and friends out of their concern and not wanting them to be in pain provide with logical/ practical solutions and try to cover the wound quickly. This only further complicates the problem and the person further withdraws into his/ her shell. Now, not only he /s he is wounded but is also expected to wear a smile on his/ her face and move on in life. To forgive, and forget. But the wound festers within, causing more damage.
Each affair is unique. Each different type of affair serves a unique purpose to the cheating husband or wife. Here are areas of knowledge that, once studied, generate tremendous relief and hope.
There are different TYPES of INFIDELITY.
I came up with 7 types of affairs in my work with couples over the last 15 years:
1. My Marriage Made Me Do It
2. I Can’t Say No
3. I Don’t Want to Say No
4. I Fell Out of Love…and just love being in love
5. I Want to Get Back at Him/Her
6. I Need to Prove my Desirability
7. I Want to be Close to Someone…but can’t stand Intimacy
The reasons behind the varying types of affairs are distinctive. One may be motivated by compulsion, another by strong personal needs for excitement, another for revenge, another to maintain distance in all relationships, and another to project blame onto someone or something else.
These motives derive not from the marital relationship or the wounded spouse, but from the personal coping patterns of the cheating spouse. Additionally, these characteristics, motives, and patterns were already set well before the marital couple even met. At some level, it was necessary for the cheating spouse to “play out” these patterns. Unsurprisingly, most of this acting out (if not all of it), or at least the motivation behind the acting out, are well outside the consciousness of the cheating wife or husband.
Once the wounded spouse becomes aware of these patterns, the complexity of the infidelity and the motives for the cheating spouse – and other person as well – a flood of relief flows. The more one can make distinctions in a situation, the more refined those distinctions become, the less power that situation has to control the feelings and behavior of a person. Knowledge is power because it comes with options.
Overcoming infidelity requires a lot of space for the hurt and anger to be vented out. It is important that this venting out is listened to without any evaluation. This process along with challenging the beliefs about marriage and extramarital affairs helps the individual to cope with infidelity in an appropriate manner. It is difficult for the near and dear ones to do so because of their emotional attachment and involvement and often requires professional psychotherapeutic help for healing the individual/ s and their relationship. Working on these beliefs will provide the grieving person with clarity of thought and thereby the ability to choose his /her future actions. Knowledge about infidelity and self awareness becomes power with which one can heal oneself.
Look at the following false beliefs for example:
1. LOVE IS MAGICAL & SACRED: Coping with infidelity for the wounded spouse may mean dealing with the seeming fact that s/he is no longer “loved” and in reality that “love,” which was so sacred, is given to someone else and one has no control over it/ the ability to regain it. And, honestly, what is more emotionally devastating than to feel unloved?

2. POOR MARRIAGE LEADS TO INFEDILITY: Another common misconception is that someone jumped into the arms of someone else because the marriage was awful. Quite often, this means that the sex was awful, or even nonexistent. The wounded spouse is left lamenting the arguments and the points of differences with his/her spouse as if those differences tainted the marriage or relationship or worse what could they have done to avoid the infidelity.

3. Everybody is unfaithful; it is normal, expectable behavior: Seeking solace in commonality of the problem can bring about temporary relief, but along with it it brings about disillusionment and hopelessness about life in general and relationships in particular.

4. Affairs are good for you; an affair may even revive a dull marriage: Back at the height of the sexual revolution. This is an ineffective way to pacify oneself as jt leads to further damage in a relationship and more so to ones own self esteem.

5. People have affairs because they are oversexed: Affairs are about secrets. The infidelity is not necessarily in the sex, but in the dishonesty.

6. People have affairs because they aren’t in love with their marriage partner: On closer examination it routinely turns out that the marriage was fine before the affair happened, and the decision that they were not in love with their marriage partner was an effort to explain and justify the affair. Being in love does not protect people from lust. Infidelity with your loved one is not a very loving thing to do, and it may be downright hostile. If people are experiencing a deficiency in their ability to love their partner, it is not clear how something so hateful as betraying him or her would restore it.

7. TIME WILL HEAL THE WOUNDS: The wounded person is wounded because he/ she was unconsciously attracted to a person with particular traits. If these motives are not uncovered, he / she is likely to fall into a similar trap once again. So in a way they are responsible, albeit unconsciously. If these wounds are not opened, aired and well looked at, they are likely to remain infested and the infection likely to reappear at a later date, and often more damaging. Hence often we find the person saying that my partners often have uncannily similar personalities. Time does not help in protecting oneself in the future. One needs to work not only with ones emotions but also take professional psychotherapeutic help to figure out what about them drew them to such a person.
Such knowledge about infidelity brings great relief, quite often right then and there. Knowledge about infidelity gives options to act, feel and think differently, which gives one a tremendous feeling of personal power. The “wounded spouse” moves beyond playing the victim, and now recognizes that he or she is not at fault for the affair taking place. S/he is not defective. She or he can confront him or her with a basic educated guess as to the end result of that confrontation. There is nothing s/he could have done to avoid infidelity in the spouse. It also brings in awareness about ones own mental makeup protecting the person from future hurts.

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