In her poems Sylvia Plath talked about “a dark thing that sleeps in me”. Charles Darwin spent years wondering what evolutionary purpose his “fits”, “flurries” and “head symptoms” served. Winston Churchill referred – perhaps ironically, perhaps somewhat affectionately – to his depression as his “black dog”.
Since ancient times, and across all cultures, humans have attempted to understand the causes and research the effective treatment of depression. The ancient Greeks saw it as being linked to an imbalance of ‘black bile’ in the body, whilst in the Indian subcontinent traditional Ayurvedic medicine aims to address the “doshic aggravation” that causes depression. In our 21st century western world we remain unclear as to causes and best treatment of low mood. Indeed, the very nature of depression remains undefined with some seeing as a physical ailment brought about by chemical imbalances in the brain, others viewing it as an emotional condition caused by distressing circumstances, along with a whole spectrum of differing opinions in between. At times these opinions overlap and complement each other, and at times they conflict and directly contradict each other.
The nature of counselling is such that any practitioner is likely to come into regular contact with depressed clients. Throughout my counselling practice so far I have not yet had a client who has not experienced some form of low mood, whether medically diagnosed or not. Consequently, it seems important that practicing counsellors have an adequate understanding of the potential causes and effects of depression. However, this need for knowledge and understanding comes with a note of caution. As one of the key elements of counselling - particularly within person centred theory - is to attempt to see things from the clients frame of reference, it is important that counsellors use their understanding of depression in the service of the client, rather than wielding any ‘expertise’ at them.