Steve Hammil Counseling

My Approach 

Welcome to my page on depression. You may have little hope and feel helpless at times, but I want you to know you can recover from depression, including severe depression. Wishing you hope, joy, strength and clarity - Steve

Depression in all its forms is a special interest of mine. It has been shown to be more limiting than heart disease, arthritis, diabetes and hypertension. Only arthritis involves more bodily pain and only heart disease involves more bed time. Like these conditions, it is usefully thought of as an illness not a character fault or personality defect.

There are proven methods that successfully treat clinical and milder forms of depression.  One of the first things we work on is restoring some measure of hope and a sense that you are not completely helpless in the face of this condition. You may be interested in the book Coping With Depression - catch 22 to hope. You can find it listed in the books and references section of this site.

Initial treatment is typically planned for 20 weeks. Severe depression may take longer. Some forms of depression require long term maintenance plans that involve life style changes and other elements to manage and prevent further occurrences.

My practice is located in the University District in Seattle, WA . You can reach me at 206-661-2854. I offer a no-fee get acquainted session.

The principles that guide my work can be found on the individual counseling page. As always, respect, understanding and caring support combine with research informed practices to hold and guide our work together.

Description

Clinical depression is like an intense sadness accompanied by feelings of helplessness, hopelessness and worthlessness. Nothing is fun anymore. You feel fatigued and have decreased energy. This depressed mental state interferes with your normal functioning. You have trouble remembering; your sleep is off; sexual desire is down; and formerly workable problems in your relationships become overwhelming or seem hopeless. It can make previously satisfying tasks impossible to complete, or even start.

Clinical depression can show up in moderate to severe episodes that last 2 or more weeks or as a chronic low grade depression that has lasted 2 years or more. Bipolar depression occurs in tandem with periods of mild to intense hyperactivity and feelings of super confidence and ability (mania and hypomania).

Whatever the form, clinical depression is a serious problem best thought of as an illness in the same way that you think about diabetes, hypertension, heart disease and arthritis. In fact, a significant study compared depression with these illnesses and found it to cause more impairment of daily function than any of the others. Only heart disease involved more bed time and only arthritis involved more bodily pain (Allen, Cwd, p 26.)

Treatment  

I offer several approaches to working with depression. All of them start with a deep appreciation for the difficulty of this condition; that how it affects you is unique to you; and that you are neither weak willed nor lazy nor to blame for having it. Keep in mind that you may feel depressed at times, we all do, but you have depression.

Here are two of the approaches I use for treating the symptoms of depression as well as my thoughts on medication: 

Interpersonal Psychotherapy for Depression focuses on the relief and healing of interpersonal problems. Stressful life events can trigger episodes of depression and depression can make it more difficult to deal with stressful life events. It is time limited, focused on the hear and now and views depression like a medical illness that is very treatable. This approach incorporates principles of Cognitive Therapy but is not as structured and does not require homework. This is an empirically validated approach with proven effectiveness for many people. Typical treatment programs are planned for 12 to 16 weeks with the potential for follow up visits.

Cognitive Behavioral Therapy for Depression assumes that negative ways of thinking serve to maintain depressive feelings, regardless of the original cause. This approach identifies beliefs, attitudes and automatic thoughts as critical candidates for change that lead to relief of depressive symptoms. We work in a collaborative, fairly structured way to identify, evaluate and change negative thinking. This approach involves homework that serves to generalize the learning to your daily life. This method has been researched extensively and also shown to be effective for many people.

What about medications?

Medications have an important supportive role to play for some people. I work with you to understand whether medication, in general, is something you want to use. It is always your choice. Many people do not want to take them while others prefer them. If you decide to use them then I will refer you to a qualified psychiatrist or psychiatric nurse for evaluation and choice of a specific medication. In the case of bipolar disorder, medications are strongly recommended to help control symptoms and are most usefully combined with individual and family therapy for help in coping with daily life.