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Guideposts for Depression Counseling

By Sarah Earles, MS, LPC, NCC | February 21, 2025

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Depression is an endemic issue in America. Millions of adults and youth struggle with depression each year. There are different types of depression, as well as different treatments for depression. Counseling is one recommended treatment. When pursuing counseling for depression, several guideposts may be helpful.

What type of depression is it?

There are many different types of depression. Most are evaluated in terms of the frequency intensity, and duration of symptoms (Corrandino, n.d.). Do depressive symptoms of low mood, loss on interest, weight gain or loss, insomnia or hypersomnia, slowed movement, fatigue, feelings of worthlessness, cloudy thinking, and/or suicidal ideation occur infrequently, or frequently (O’Connor, Whitlock, & Gaynes et al., 2009)? How many of these symptoms occur? How long do the symptoms last? At what times do the symptoms occur? Healthcare professionals may use all this information to determine if depression is major or minor (diagnostically speaking), or an instance of dysthymic (chronic, low-level of depression) disorder. Professionals may also diagnose depression in the context of seasons, the menstrual cycle, or the time of postpartum (Robinson, Smith, & Segal, 2024). Diagnosis will impact recommendations for counseling.

How will counseling benefit?

Counseling will almost always benefit individuals with depression. Depending on the severity of depression and the willingness of clients, depression may also require medicinal intervention (Gautam, Jain, Guatuam, Vahia, & Grover, 2017). With or without medication, counseling can help individuals examine triggers for their negative thoughts, develop coping skills, and acquire positive resources, such as relationships that can help people live fulfilling lives despite depressive symptoms (Smith, Robinson, & Segal, 2024). Counseling can also help clients determine what is in their control in life and set realistic goals for change (Mayo Clinic, 2022). It can assist individuals in learning to tolerate and accept distress. Counseling is about as effective as medication alone, and its effects last longer than medication, which is why most professionals recommend it (Rush, 2024). When dealing with depression, then, the question is not really whether an individual should pursue counseling, but rather which type of counseling the person should pursue.

Which types of counseling work best?

Many different types of counseling for depression exist. The Society of Clinical Psychologists (n.d.) lists at least 15 potentially effective treatments. Some of the most well-known treatments include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization and reprocessing (EMDR), interpersonal therapy (IPT), and psychodynamic therapy (Danish, n.d.; Gautam, Jain, Gautam, Vahia, & Grover, 2017). Cognitive behavioral therapy works to change thought patterns and behaviors to reduce depressive symptoms (National Institute of Mental Health, 2021). DBT works to develop skills to tolerate difficult emotions and reduce crisis behaviors (Guidepost, n.d.).  EMDR can help process trauma that results in depressive symptoms (Wood, Ricketts, & Parry, 2018). IPT reviews how life events impact depression and works to improve relational support (National Institute of Mental Health). Psychodynamic therapy helps individuals explore their emotions and how subconscious issues affect the conscious (Bhandari, 2022). Client preference and availability of professionals are the greatest factors in determining type of counseling received (Gautam, Jain, Gautam, Vahia, & Grover). There really is not one best type of counseling for depression. Rather, there is a best delivery of counseling for an individual based on given environment and resources.

Conclusion

Counseling benefits those struggling with depression. The type of depression, as well as client and professional resources will determine what type of counseling a person will pursue. Individuals struggling with depression can use these as guideposts in their own journey towards healing.

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Depression is an endemic issue in America. Millions of adults and youth struggle with depression each year. There are different types of depression, as well as different treatments for depression. Counseling is one recommended treatment. When pursuing counseling for depression, several guideposts may be helpful.

What type of depression is it?

There are many different types of depression. Most are evaluated in terms of the frequency intensity, and duration of symptoms (Corrandino, n.d.). Do depressive symptoms of low mood, loss on interest, weight gain or loss, insomnia or hypersomnia, slowed movement, fatigue, feelings of worthlessness, cloudy thinking, and/or suicidal ideation occur infrequently, or frequently (O’Connor, Whitlock, & Gaynes et al., 2009)? How many of these symptoms occur? How long do the symptoms last? At what times do the symptoms occur? Healthcare professionals may use all this information to determine if depression is major or minor (diagnostically speaking), or an instance of dysthymic (chronic, low-level of depression) disorder. Professionals may also diagnose depression in the context of seasons, the menstrual cycle, or the time of postpartum (Robinson, Smith, & Segal, 2024). Diagnosis will impact recommendations for counseling.

How will counseling benefit?

Counseling will almost always benefit individuals with depression. Depending on the severity of depression and the willingness of clients, depression may also require medicinal intervention (Gautam, Jain, Guatuam, Vahia, & Grover, 2017). With or without medication, counseling can help individuals examine triggers for their negative thoughts, develop coping skills, and acquire positive resources, such as relationships that can help people live fulfilling lives despite depressive symptoms (Smith, Robinson, & Segal, 2024). Counseling can also help clients determine what is in their control in life and set realistic goals for change (Mayo Clinic, 2022). It can assist individuals in learning to tolerate and accept distress. Counseling is about as effective as medication alone, and its effects last longer than medication, which is why most professionals recommend it (Rush, 2024). When dealing with depression, then, the question is not really whether an individual should pursue counseling, but rather which type of counseling the person should pursue.

Which types of counseling work best?

Many different types of counseling for depression exist. The Society of Clinical Psychologists (n.d.) lists at least 15 potentially effective treatments. Some of the most well-known treatments include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization and reprocessing (EMDR), interpersonal therapy (IPT), and psychodynamic therapy (Danish, n.d.; Gautam, Jain, Gautam, Vahia, & Grover, 2017). Cognitive behavioral therapy works to change thought patterns and behaviors to reduce depressive symptoms (National Institute of Mental Health, 2021). DBT works to develop skills to tolerate difficult emotions and reduce crisis behaviors (Guidepost, n.d.).  EMDR can help process trauma that results in depressive symptoms (Wood, Ricketts, & Parry, 2018). IPT reviews how life events impact depression and works to improve relational support (National Institute of Mental Health). Psychodynamic therapy helps individuals explore their emotions and how subconscious issues affect the conscious (Bhandari, 2022). Client preference and availability of professionals are the greatest factors in determining type of counseling received (Gautam, Jain, Gautam, Vahia, & Grover). There really is not one best type of counseling for depression. Rather, there is a best delivery of counseling for an individual based on given environment and resources.

Conclusion

Counseling benefits those struggling with depression. The type of depression, as well as client and professional resources will determine what type of counseling a person will pursue. Individuals struggling with depression can use these as guideposts in their own journey towards healing.

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References

Bhandari, S. (2022, September 28). Psychodynamic therapy for depression. WebMD. https://www.webmd.com/depression/psychodynamic-therapy-for-depression

Corrandino, G. (n.d.). When the ask for help: Frequency, intensity, and duration. Nueropsychology Rehabilitation Services. https://nrslifespan.com/posts/when-to-ask-for-help-frequency-intensity-and-duration/

Danish, D. (n.d.). Medication and more: A comprehensive guide to depression. Philadelphia Integrative Psychiatry. https://phillyintegrative.com/blog/comprehensive-guide-to-depression-treatment

Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973

Guidepost. (n.d.). DBT for depression. https://guidepostdbt.com/dbt-for-depression

National Institute of Mental Health. (2021). Depression. https://www.nimh.nih.gov/health/publications/depression

O’Connor, E.A., Whitlock, E.P, & Gaynes, B., et al. (2009 December). Screening for depression in adults and older adults in primary care: An updated systematic review. National Library of Medicine: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK36406/table/ch1

Mayo Clinic. (2022, October 14). Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

Robinson, L., Smith, M., & Segal, J. (2024, February 4). Depression types and causes: Clinical, major, and others. HelpGuide.org. https://www.helpguide.org/depression-types-causes-and-risk-factors.htm

Rush, A.J. (2024, February 2024). Patient education: Depression treatments options for adults (Beyond the Basics). UpToDate.com. https://www.uptodate.com/contents/depression-treatment-options-for-adults-beyond-the-basics

Smith, M., Robinson, L., & Segal, J. (2024, February 5). Depression treatment. HelpGuide.org. https://www.helpguide.org/articles/depression/depression-treatment.htm

Society of Clinical Psychologists. (n.d.). Treatment target: Depression. https://div12.org/diagnosis/depression/

Wood, E., Ricketts, T., & Parry, G. (2018, March). EMDR as a treatment for long-term depression: A feasibility study. Psychological Psychotherapy 91(1), 63-78. doi: 10.1111/papt.12145

References

Bhandari, S. (2022, September 28). Psychodynamic therapy for depression. WebMD. https://www.webmd.com/depression/
psychodynamic-therapy-for-depression

Corrandino, G. (n.d.). When the ask for help: Frequency, intensity, and duration. Nueropsychology Rehabilitation Services. https://nrslifespan.com/posts/when-to-ask-for-help-frequency-intensity-and-duration/

Danish, D. (n.d.). Medication and more: A comprehensive guide to depression. Philadelphia Integrative Psychiatry. https://phillyintegrative.com/blog/
comprehensive-guide-to-depression-treatment

Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973

Guidepost. (n.d.). DBT for depression. https://guidepostdbt.com/dbt-for-depression

National Institute of Mental Health. (2021). Depression. https://www.nimh.nih.gov/health/
publications/depression

O’Connor, E.A., Whitlock, E.P, & Gaynes, B., et al. (2009 December). Screening for depression in adults and older adults in primary care: An updated systematic review. National Library of Medicine: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/
NBK36406/table/ch1

Mayo Clinic. (2022, October 14). Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

Robinson, L., Smith, M., & Segal, J. (2024, February 4). Depression types and causes: Clinical, major, and others. HelpGuide.org. https://www.helpguide.org/depression-types-causes-and-risk-factors.htm

Rush, A.J. (2024, February 2024). Patient education: Depression treatments options for adults (Beyond the Basics). UpToDate.com. https://www.uptodate.com/contents/depression-treatment-options-for-adults-beyond-the-basics

Smith, M., Robinson, L., & Segal, J. (2024, February 5). Depression treatment. HelpGuide.org. https://www.helpguide.org/articles/
depression/depression-treatment.htm

Society of Clinical Psychologists. (n.d.). Treatment target: Depression. https://div12.org/diagnosis/depression/

Wood, E., Ricketts, T., & Parry, G. (2018, March). EMDR as a treatment for long-term depression: A feasibility study. Psychological Psychotherapy 91(1), 63-78. doi: 10.1111/papt.12145

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