How Depression Therapy Can Help Remove the Mask

One of my jobs as a specialist in depression therapy is to help my patients make sense not only of the depression, but of the constellation of coping behaviors that have developed alongside it.

It’s not unusual for people with depression to hide their despair from friends, loved ones and family, even if the act of hiding makes the depression even worse. Interestingly, high achievers tend to be especially adept at this kind of “masking” behavior.

Why would someone hide such agonizing pain, when the benefits of reaching out and seeking help are so widely known? One case study captures the sentiments of many patients I have met:

It was clear that Jared was acutely ill with depression, but he also despaired for another reason: He blamed himself for his lack of control and for not being able to “figure it out.” He had always had a sense of interdependence, with a concern for the welfare of others. He therefore worried about how revealing his depressive state would affect his parents, concerned that they would feel responsible for his distress and, an even greater fear, that they would then castigate themselves for being ignorant of his condition.

In my experience, high achievers who suffer from clinical depression often evidence this type of social isolation, and self-punishing thoughts like these tend to be a common thread.

Any good therapy for depression must help patients contend with this masking behavior, and with the dynamics of their lives that may have inspired them to hide this pain. Often by understanding what lies behind the masking, patients can also begin to make sense of the depression itself, uncovering its roots in an overdeveloped sense of obligation to others.

Want to learn more? Contact my Philadelphia psychotherapy practice today.

When Parenting Pressure Leads to Depression

I wrote recently about the strong link between parental pressure to achieve, and a sense of emptiness that can develop in pressured children as they grow.

One consequence of a childhood spent living up to the lofty expectations of parents is that high-achieving children often internalize the idea that achievement is the lever they must press to receive a pellet of love. Here’s one account from psychologist Dale Atkins:

“[Your child] also has to want to come to you for nurturing. And, he has to know that he’s going to be good enough and wonderful enough even if he isn’t the best, even if he doesn’t succeed […] Our kids come to us to find out who they are and if we’re not letting them know they’re perfect as they are, they’re going to wonder, what do they have to do to be good enough.”

Psychodynamic therapy is the most effective way to untangle the emotional issues associated with parental pressures–no matter how well-intentioned those pressures may have been–and the scars they can leave. Often, by discussing how we understood those expectations, we can diminish their strength and help restore a more realistic internal sense of self-worth.

To learn more about how you may have been shaped and hindered by undue pressure in your youth, I invite you to contact my Philadelphia psychotherapy offices. I specialize in therapy for depression, therapy for anxiety and therapy for stress.

Why Therapy for Personal Loss Makes Sense Later in Life

It is becoming more common for people who are well into their fifties, sixties and beyond to seek out psychotherapy, even if conventional wisdom holds that their “busiest” years may be behind them. The struggles of later ages can be somewhat quieter, of course, but they are no less powerful.

One of the most common surrounds the notion of death, both as a real event and as a source of anxiety. As we age, of course, we are more likely to lose friends and loved ones, while racing inexorably toward our own sunsets. All this can take a toll, as one therapist describes:

“Part of it is existential. Most of us have had death anxiety as children, but it resurfaces when we are less distant from death.” . . .

One woman told the group of a particularly fun evening she’d had. But then when she went back to the home she’d shared with her husband and dog, who had both died, she felt the contrast even more sharply.

Getting into a good psychotherapy for grief and personal loss is one of the best ways to make sense of a loss, and to distill the elements within that grief which can be relieved and better directed over time. If you or someone you love is wrestling with the shattering effects of a personal loss at any age, please contact my Philadelphia psychotherapy practice today.