Depression

Many clients seek counselling for help with depression.

Symptoms of Depression

Whilst symptoms may vary depending on the individual, many clients report symptoms including:-

• Decreased enjoyment of previously enjoyed activities
• Low energy
• Sleep disturbance including over-sleeping or not getting enough sleep
• Feeling worthless or hopeless
• Changes to appetite including increased comfort eating or losing interest in food.

Clients describe feeling like this most of the time for more than 2 weeks (ie the symptoms don’t seem to improve even after a good weekend), and they interfere with their daily life (ie makes it harder to go to work, maintain personal grooming or manage household tasks).

How can counselling help?

Many clients with depression report feeling isolated. Counselling is an opportunity to discuss your concerns in a safe place, free from judgement.

It’s important to understand what’s causing the depressive symptoms.

Over the years I have found that many clients present to counselling for assistance with depression, however often underlying this is unresolved grief, loss and trauma issues or untreated stress. I am experienced in working with these clients. For more information about those issues please see the relevant section on this page.

What can I learn in counselling?

I provide counselling that is tailored to the individual client and their specific needs. When working with clients with depression I provide psycho-education about what depression is, and depending on the cause of a client’s depressive symptoms I might teach clients Cognitive Behavioural Therapy skills (CBT) so they can identify their unhelpful thinking styles and know how to change them, some clients benefit from learning about structured problem-solving, relaxation skills, assertiveness skills and in some situations Acceptance and Commitment Therapy skills (ACT) are appropriate.

Medication for Depression

Not all clients with depression take medication such as anti-depressants.

Some clients have just been given a script for an anti-depressant and understandably, many clients often express concerns about starting mental health medications.

Other clients have had their dose changed, and they too can be worried about how this will impact them.

There are also clients who have been taking anti-depressants for years and are experiencing side effects or feel that the medications aren’t helping or seem to be making their condition worse.

These are all valid concerns.

I can explore these concerns further with you and talk to you about the role of anti-depressant medications. I’ll also encourage you to speak to your GP or Psychiatrist about any questions or concerns that you may have about taking medications.

I have extensive experience in recognising when clients may benefit from seeing a Psychiatrist for assessment or review, including when a medication review may be required, and I can help you with organising a referral if needed.

Anxiety and Stress

Many clients seek counselling for help with anxiety and / or stress.

Symptoms of Anxiety and Stress

Anxiety and Stress can seem similar. Both can trigger the “fight or flight” response and can lead to physical symptoms such as:-

• Racing heart and faster breathing
• Feeling over-whelmed
• Feeling irritable or a sense of dread
• Increased worrying
• Trouble sleeping
• Feeling tense

Causes of Anxiety and Stress

Anxiety can be long-lasting and is related to an internal cause, even if there isn’t always an obvious reason for it.

Stress is often related to an external cause such as having difficulties at work, conflict in relationships or financial concerns. Sometimes stress is short-term and resolves when the issue improves (ie the project at work is completed or our relationship has improved). At other times stress can be due to long-term concerns such as unemployment or chronic health conditions. It is important to address ongoing stress as it can lead to, or exacerbate, depression and anxiety, as well as increase our risk for other illnesses and health conditions such as digestive problems or heart disease.

How can counselling help?

For clients with anxiety who don’t know why they’re feeling anxious, counselling can help them to identify what might be causing or contributing to their anxiety.

For clients presenting with stress, counselling can help with structured problem-solving and relaxation skills.

Over the years I have found that many clients present to counselling for assistance with anxiety and stress, however often underlying this is unresolved grief, loss and trauma issues. I am experienced in working with these clients. For more information about those issues please see the relevant section on this page.

What can I learn in counselling?

When working with anxious and stressed clients, I provide psycho-education about what anxiety and stress is (including the difference between helpful and unhelpful anxiety and stress), I teach Cognitive Behavioural Therapy skills (CBT) so clients can learn how to identify their unhelpful thinking styles and how to change them and I provide psycho-education about the importance of living a healthy lifestyle which includes exercise, relaxation skills such as calming breathing, enjoying a healthy diet and getting enough sleep.

Some clients will also benefit from learning structured problem-solving, assertiveness skills and in many cases Acceptance and Commitment Therapy skills (ACT) are also appropriate.

Medication for Anxiety / Stress

Not all clients with anxiety and stress take medication.

Many people prefer to use natural therapies such as exercise, massage, meditation, yoga or herbal supplements.

However sometimes clients require medication. Some clients have been taking medications but are struggling with side effects or feeling that the medications aren’t helping or seem to be making their condition worse. In these instances I’ll encourage you to speak to your GP or Psychiatrist, and I can help you with organising a referral if needed.

Childhood Issues

I have worked with many clients who have grief, loss and trauma issues that have often gone unrecognised and therefore untreated since childhood.

We often think of child neglect as the cases we see on the news. However, it’s a sad reality that many adults grew up in environments that were not supportive and nurturing, and some have grown up in homes that were outright abusive and neglectful. Over the years I have worked with many adults who are still struggling with unresolved issues from childhood. For some people this might be grief such as when a family member has died and the child was never supported to grieve the loss; growing up in a home where a caregiver had alcohol or drug addiction and / or there was violence in their home which left the child feeling terrified and helpless, and many children grew up in homes where although they were well-fed and had lovely holidays etcetera, deep-down they felt unseen, uncared for and lonely – like they didn’t really belong in their own family.

Adults who have unresolved grief, loss and trauma issues from childhood often report feeling that deep down inside something is missing – no matter how good their life might be they never feel truly loved or accepted and they often go on to choose romantic partners who are also unwilling or unable to meet their deep need to be loved and cared for. Deep down they wonder if they will ever feel loved, cherished and ultimately safe.

The Impact of our Childhood on our Adult Life

Many clients are surprised that “childhood issues” don’t simply go away as they get older, in fact without treatment they can often get worse. Sometimes our pain causes us to make unhelpful choices to cope, such as using alcohol or drugs to numb ourselves or choosing partners that aren’t good for us because deep down we think we don’t deserve better. Those choices often leave us feeling even worse about ourselves, and there may be other consequences such as dealing with addiction or finding ourselves in an unhealthy relationship.

The Impact of our Childhood on our Relationships

When we have deeply entrenched beliefs that there is something wrong with us, we tend to sabotage relationships that would actually be good for us. This is often because we don’t feel worthy of love, or we think our partner will “realise” that we aren’t good enough for them and they’ll eventually reject us, so we behave in self-sabotaging ways and scare them off before they can break up with us. This cycle validates our faulty thinking “See? I knew they wouldn’t stay. That’ll teach me for trying to rely on someone else. I’m better off on my own anyway.” When secretly what we really want is a nurturing, long-lasting relationship, but we doubt that we will ever be able to have one.

It doesn’t have to be this way.

Working With Unhelpful Beliefs from Childhood

I have worked with many adults who have benefited from addressing unhelpful beliefs they gained from their childhood. I use a variety of evidence-based treatments, including psycho-education to help clients understand and make sense of what happened to them in childhood and why it still affects them so greatly today; cognitive behavioural therapy to help clients to identify and challenge unhelpful thinking patterns; grief and loss counselling to mourn the childhood they had as well as grieving the loss of not having the childhood they deserved; attachment-based and schema-based treatments including imagery exercises to heal the wounded inner child; psycho-education regarding healthy vs unhealthy relationships and self-compassion techniques for clients to learn how to identify and respond to their needs as an adult today, essentially “re-parenting” themselves.

Grief and Loss

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however often underlying this is unresolved grief, loss and trauma issues.

Grief and loss can come in many forms. Many people often think of “grief and loss” as surviving the death of a loved one, and sometimes this is the reason people seek counselling. But grief and loss could also mean the loss of a job, loss of a relationship, deteriorating health of yourself or a loved one or the loss of a dream.

Grief and Loss After Positive Life Changes

Some people are surprised to feel a sense of loss after positive changes, such as feeling a sense of loss after moving home - even though you love your new location you might still miss your old house and neighbourhood. Or maybe you needed to end a toxic relationship with someone but you still miss them at times. Or maybe your friends are getting married and you feel like everyone around you is moving on and you feel stuck.

Although it’s unpleasant, grief and loss is a normal part of life and we will all go through it, many of us at several times in our lives.

Working with Grief and Loss

I’ve worked with many clients experiencing different types of grief and loss. When working with bereaved clients I use compassion-based approaches and techniques including educating clients about the stages of grief, giving clients a safe space to express themselves openly about the impact of the loss on their life and encouraging regular self-care. While we never “get over” grief, counselling can help us to process our grief and learn to live with the loss in our lives.

Loss of a Job or Relationship

Many people seek counselling after the loss of a job or a relationship. I help these clients to process the loss, help them to identify and change any unhelpful thinking styles that are keeping them “stuck” and help them to set new goals and move forward with their lives. Some clients may want to attempt to get their job back or return to the previous relationship. In some cases this may be possible, such as after learning communication skills, but for others it may require healing before moving on to a new job or relationship.

Illness and Injury

Illness and injury are a part of life, and they can leave us feeling like our life has been turned upside down. Counselling is helpful for clients who are facing health challenges of their own or their loved ones. Many clients report feeling a sense of grief and loss after a serious illness or injury. I’ve worked with clients and / or their loved ones who are coming to terms with living with a life-impacting injury or illness by helping them to come to terms with their new reality, linking them in with appropriate resources where desired and supporting them to plan for the future.

Loss of a Dream

Another form of grief and loss relates to the loss of a dream, such as realising that we will not have the career we always wanted, going through an unwanted divorce, seeing our business fail or not being able to have children. As with many other types of grief and loss, I work with these clients by helping them to come to terms with this unwanted reality and then helping them to find a new purpose in life.

Post-Traumatic Stress Disorder ("PTSD")

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however often underlying this is untreated trauma, and without intervention this can develop into Post-Traumatic Stress Disorder or “PTSD”.

PTSD can result from various types of trauma. Some of these include:-

• Experiencing sexual abuse and assault;
• Bystanders who experience or witness traumatic events such as an armed robbery or accident and
• Certain occupations such as members of the Australian Defence Force and first responders such as Police Officers who regularly attend crime scenes.

PTSD Symptoms and Their Impact on a Survivor’s Life

Symptoms of PTSD include having flashbacks, nightmares and trouble sleeping, loss of appetite or increased comfort eating, feeling “on edge”, being easily startled or agitated, having difficulty concentrating due to thinking about the trauma(s), avoiding the place where the incident occurred or avoiding people who are reminders of the event. To cope with these symptoms some people might turn to alcohol, drugs or gambling to cope, and this can bring other consequences such as health or financial issues.

PTSD can lead to increased conflict in relationships, it might affect work performance and many survivors no longer enjoy hobbies or interests that they enjoyed before the trauma(s).

Survivor Guilt

Many survivors also blame themselves, thinking that if they’d said or done something different then they could’ve stopped the event from happening. They may also feel guilty if they survived but someone else was seriously injured or died during the trauma (survivor’s guilt).

Treatment for PTSD

It is crucial that people with PTSD get help as soon as possible. Counselling provides a safe space to talk about what happened and how it is impacting your life. When counselling people with PTSD, I provide education about how the brain processes trauma, help people to identify and challenge unhelpful thinking, teach grounding techniques to help individuals to feel safe again, teach relaxation skills including calming breathing and help to connect individuals with other relevant resources as desired.

Relationships

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however often underlying this is some sort of relationship issue.

Over the years I’ve worked with many clients who are feeling frustrated and disconnected in their relationship, are dealing with betrayal in their relationships such as affairs, have experienced unwanted break-ups or divorce and clients who are single and seeking a healthy relationship.

Unfortunately we don’t learn much about relationships at school, and we often rely on what we’ve learnt from our caregivers growing up or from what we can google. If we were lucky we had healthy role models growing up, and we learnt healthy relationship skills from them, such as effective communication, problem-solving and conflict resolution skills. Sometimes we’re able to find good websites, books or YouTube videos which can teach us about healthy relationships. However, sometimes it’s helpful to have counselling to learn these skills, where you can actually have a tailored conversation with a counsellor, rather than watching someone talking “at you” about general topics.

For Couples Wanting to Improve Their Relationship

I use Gottman-based techniques to help clients improve their communication, increase intimacy and manage conflict in their relationships.

For Clients Following Break-Ups or Divorce

Some clients seek counselling after experiencing break-ups or divorce. I help these clients to process the complicated mixture of feelings most people experience after relationships end, such as shock, anger, fear and grief. They may also need assistance processing guilt or shame. I then help clients to come to terms with the reality of the loss and adapting to life without their partner. Following break-ups or divorce some people don’t want to have another relationship, preferring to stay single, however eventually some clients may want to start dating again.

For Single Clients Looking for Love

I help single clients who are looking for love identify what values they are seeking in a partner and relationship. We also explore what issues the individual may need to address before dating, such as a deep-rooted fear of intimacy or low self-worth, as without first addressing their own issues many people find that they are unable to find or maintain the healthy relationships they are seeking. I also provide education about attachment styles and why these are so important in our relationships.

Non-Romantic Relationships

Many clients report having difficulties in their relationships with friends, family or at work. I help clients learn assertiveness skills including how to set and maintain boundaries with “difficult” people, how to have realistic expectations of the other person’s ability to meet our needs in a relationship, encourage clients to limit contact with “toxic” people (as much as possible) and when necessary support clients who need to end “toxic” relationships. Some clients report feeling guilty when they end relationships (even unhealthy relationships). Counselling can help clients to process these emotions and learn how to seek and then maintain healthy relationships.

Issues in the Workplace

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however sometimes this is related to an issue in the workplace.

Sometimes workplace issues might be due to conflict with our colleagues or boss, feeling that our contributions go unnoticed or unappreciated, feeling that we are being over-worked or feeling that we’re being unfairly over-looked for promotions or other opportunities.

In some instances talking to our boss or Human Resources may be all that is needed to successfully address our concern. Sometimes accessing an Employee Assistance Program may help. However sometimes even after trying these options it becomes necessary to seek assistance elsewhere.

I’ve worked with clients who are experiencing various workplace issues. Some clients report that they just want to be heard and understood, but many clients also need help to actually take action and address their problems.

Addressing Work-Related Stress

When we’re under stress it can be difficult to think of possible appropriate solutions to our problems. I use structured problem-solving to help clients to focus, generate possible options to address their specific issue including identifying potential consequences, then take action to address the issue. After experiencing workplace difficulties some clients will find that they no longer want to work in their current workplace. This may be due to burn-out, in which case a holiday or break from work might be needed to feel refreshed and ready to return to work. However for some clients it will be necessary to leave their job. I help those clients to identify their personal values and career goals to help them leave their job and pursue new interests.

Unfair Dismissal / Legal Action

In some cases clients have been unfairly dismissed or are facing legal action at work. These clients often require legal assistance. You might find it helpful to contact your Union or look at the website for the Fair Work Ombudsman fairwork.gov.au

(Please note that I do not provide medico-legal reports)

Untreated Underlying Health Issues

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however sometimes there are underlying untreated health issues.

Some clients are referred for counselling who have diagnosed health concerns - those clients are already aware of their condition and usually already have a management plan. However, some clients are referred with symptoms of depression, anxiety or stress who are unaware that they have underlying health issues such as low vitamin B12, low vitamin D, undiagnosed thyroid conditions, low testosterone levels in men or low magnesium. Sometimes treating these (and other) conditions can help improve the symptoms of depression, anxiety and stress.

“Natural” Health Remedies and Treatments

Many clients find “natural” remedies and treatments helpful, such as taking specific herbs and supplements, regularly engaging in relaxation skills such as calming breathing techniques and progressive muscle relaxation, using mindfulness techniques, enjoying a healthy diet, practicing good sleep hygiene, exercising, listening to music and doing yoga.

However in some cases clients will benefit from medication.

Mental Health Medications

Some clients will be new to medication such as anti-depressant or anti-anxiety medications, and others may have been taking them for many years. Understandably, many clients often express concerns about starting or changing the dose of mental health medications. I can explore these concerns further with you and talk to you about the role of anti-depressants or anti-anxiety medications. I’ll also encourage you to speak to your GP or Psychiatrist about any questions or concerns that you may have about taking medications.

Some clients might have already been taking mental health medications for years, such as anti-depressant or anti-anxiety medications, and are experiencing side effects or feel that the medications aren’t helping or seem to be making their condition worse. I am experienced in recognising when clients may benefit from seeing a Psychiatrist for assessment or review, including when a medication review may be required, and I can help you with organising a referral if needed.

Financial Stress

Many clients present to counselling with a diagnosis of “Depression and Anxiety” or “stress”, however sometimes this is related to finances.

The Importance of Addressing Financial Stress

Financial stress is a major concern for many Australians. Sometimes clients benefit from learning budgeting skills or referral to a financial counsellor or advisor. It’s important to address financial stress as early as possible as it often leads to other problems such as conflict in relationships and depression and anxiety. Untreated stress can also lead to other health problems when we use unhelpful coping strategies such as smoking, alcohol, drugs, gambling or comfort eating.

Underlying Issues Related to Financial Stress and Spending Habits

Clients may also benefit from addressing other issues that may be contributing to ongoing financial stress, such as deeply-rooted unhelpful thinking about how to manage money or low self-esteem contributing to clients trying to live a lifestyle that is beyond their financial capacity. This is something I can help you with using evidence-based treatments such as Cognitive Behavioural Therapy.