What is depression?

There are many ways to define and describe depression. Fighting an invisible enemy, living with a ‘black-dog’*, walking through thick fog, wearing a lead suit, trapped with a critical gremlin. What would your word or image be? (Visit the fab online community,, for more metaphors for depression.)

To show this in body language we might gesture with our hands, palms down, to mimic an act of pressing down. Imagine squashing a balloon down onto the floor, or placing a heavy weight on top of a packed suitcase to keep the lid shut.

Thinking about the balloon about to pop and the squeezed contents of the case evokes compassion in me. As a therapist I cares about the things in the case, the things that depression weighs down, traps and compresses. In a therapy session I might acknowledge the bits of my client which have been repressed and I might tentatively try to give them attention.

One theory is that, horrible though it is to be ‘depressed’, our system is trying to protect us from letting out or expressing things that might take us out of our comfort zone or conflict with the deep-seated scripts and rules for life which we live by but were set in childhood. ‘Don’t go there,’ says depression. ‘Don’t believe you can do/be/have/say/feel that.’

Good therapy respects the depressive tendency but does not believe it has to have the last word. Depression may have developed as a response to having had parts of us depressed – or repressed or suppressed. If we can listen to those disallowed parts of ourselves we might begin to experience life differently.

To use body language again, we might turn our palms upwards and let them face towards the ceiling. We might visualise the balloon free to expand and float upwards, and the lid of the case opening to reveal the colourful contents of the case.

*Winston Churchill used to refer to his depression as ‘the black dog  Watch ‘black dog’ videos made by the author, Matthew Johnstone, about living with depression.
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Un-shaming ourselves about climate change

I’ve been thinking about Greta Thunberg over the summer. The Swedish teenager and climate campaigner has been travelling by boat across the Atlantic to the US to attend a climate conference. I thought about this particularly hard as I sat in my seat waiting to take off from Gatwick for a trip to France. A quick visit to enabled me to pay around £25 to offset the carbon emissions of the trip but this didn’t really salve my conscience. Greta is putting her money where her mouth is. I, currently, am not.

Thanks to colleagues, clients, and the News, I’ve been prompted to reflect more deeply about the whole issue of climate change and anxiety about the planet, and I’m wondering how to respond from a therapeutic perspective.

My initial question is around shame. As soon as we start talking about climate change we very quickly feel the weight of guilt and shame descending as we face our part in messing up the planet. But how useful is this? In therapy we discover that shame often leads to negative outcomes. When we feel shame we may engage in avoidance activities like drinking, shopping or playing on our phones, we may overly blame others and justify ourselves, and we may feel crippled and unable to take positive actions because we have lost faith in ourselves and our own worth.

Nature doesn’t shame us. It continues to include us in its natural processes and cycles, and to hold us in being, growing and dieing. If I shame myself around taking my flight this summer do I empower myself to live more responsibly? Or do I simply lose hope in the face of the problem and give up? Perhaps a more empowering and kinder way forward is to forgive myself and allow a place on my mental bookshelf for the future possibility that I might just ‘do a Greta’ and take a boat next time?

If therapy is anything it’s a process of un-shaming. Perhaps by un-shaming ourselves and our clients we can all become compassionate humans who accept our precious smallness and its limits and, from that kind place, extend kindness to others and to the planet.

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Summer self-help

As I take my summer break I thought I’d highlight some great sources of online help and inspiration for our mental health.

WEBSITE: has a directory of therapists and also lots of accessible articles about all aspects of therapy. Recent posts include: ‘What’s wrong with being a perfectionist’ and ‘Is it time to quit social media?’

BLOG: This excellent health, disability and mental health blog covers a huge range of issues in a down to earth and humane way. Here’s their advice on helping someone who is suicidal or otherwise hurting:
You don’t have to have all the answers or make them happy. Here’s what you can do:
1. Let them lead the conversation.
2. Listen. Really listen.
3. Let them know you’re there for them and want to help.
4. Offer to connect them with any additional support they might need

VLOG: vlogbrothers Search for this on YouTube and you’ll find a shared video blog (vlog) hosted by the American author John Green (as in ‘The Fault in our Stars’) where he aims to“raise nerdy to the power of awesome”. Green has Obsessive Compulsive Disorder (OCD) and has a compassionate, humorous approach focusing on celebrating small successes and being kind to your unwell self.

Happy reading/watching and see you in September!

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Loose language around mental health

Donald Trump has decided to brand recent mass shootings in America as a ‘mental health’ problem. Whatever your views on US politics it’s concerning for mental health professionals to hear mental illness casually associated with violence. Negative stereotyping fuels misunderstanding and fear and glosses over the fact that people with a mental illness are much more likely to be victims of crime than perpetrators.

Why does society sometimes demonise the mentally ill? Is it because we struggle to understand ‘difference’? Are we still influenced by the past when the depressed and anxious were called ‘hysterical’ and ‘mad’? Or are we in denial about the vulnerable parts of our own psyche that we prefer not to think about? It’s always easier to see the problem as being ‘out there’ in someone else, rather than looking at our own part in things.

Where there is mental illness there will be social as well as individual factors. Poverty, discrimination and powerlessness provide a fertile soil for feelings of alienation and disturbing thoughts to flourish. So what can we do? As therapists we start from a place of compassionate attention to troubled states of mind and body. Sometimes our politicians will voice this compassion and sometimes they won’t. But each of us has the power to speak from a place of understanding rather than fear.


Facing up to Fortnite

British 15 year-old, Jaden Ashman, this week won nearly a million pounds playing ‘Fortnite’, a fast and furious online game where 100 players battle to be the last one standing. “I’ve thrown out an Xbox and snapped a headset because I’ve got calls from school saying he is falling asleep in class,” said his mum, though she now accepts he’s going to have a career as a professional gamer.

At this point we could rehearse well-worn concerns about excessive screen time. Competitors in the Fortnite ‘World Cup’ are routinely spending eight to ten hours a day gaming, and, unchecked, this kind of excessive usage by an ordinary teenager could lead to isolation and poor physical and mental health. We could also focus on the potential risks of meeting strangers online. However, coverage of the Fortnite fixture this week showed a vibrant, social gathering, not unlike a more traditional sports event, with the big personalities, competitive tension and sheer exhilaration that we might get watching football or Formula One. Far from encountering dangerous strangers, players had made team-mates, rivals and friends.

Professional gamers, and the teenagers who love and play video games, have got amazing skills. Fine motor control, strategizing, creative world-building and teamwork (many online games are played in groups) to name but a few. Kids who struggle to fit in with the sporty in-crowd at school may find a sense of belonging through gaming with peers around the world who aren’t judging eachother on looks or ‘likes’. It’s an oddly democratic zone where everyone is welcome and anyone can play. And so video games now rival ‘playing out’. Rather than hanging out in the park kids – particularly boys – are just as likely to hurry home from school and meet up with their friends online over a game of Fortnite.

It’s different to what we’ve been used to, and, like all change, it has positives and negatives, risks and opportunities. We don’t know the effects gaming will have on long-term mental health. But we do know that Jaden and his peers will have to navigate an increasingly technological future that will leave a generation of parents like me behind. Perhaps they need as much practice as they can get!

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Self-help for the heat wave

As temperatures hit 35 degrees this week here are some top tips for staying sane in the sunshine:

  1. Hydrate. What’s good for the body is good for the mind and water is essential for well-being. Keeping well-hydrated guards against tiredness and irritability.
  2. Take more time. In really hot weather we can’t expect ourselves to achieve as much as quickly as we might normally do. Build in an extra 10 minutes to get somewhere so that you can stroll rather than power-walk.
  3. Be patient. No one is at their best in the heat. Others may move slower, take longer to do things or be more snappy and tense. Getting annoyed or angry will only make us all feel worse so we could consider extending compassionate sympathy to others as well as to ourselves.
  4. Listen to your body. The way our body reacts to stimuli like light or temperature is a good indication of what we need. If we are feeling tired or stressed out in the heat then our body is saying it needs to shelter in the shade and rest. Work and childcare demands may make this difficult but try to put your own needs on the agenda as well.
  5. Consider SAD. Seasonal Affective Disorder is usually associated with depression during the darker, winter months. However, some of us experience increased sadness or lowness when the sun is at it’s brightest, feeling exposed, overwhelmed and unprotected. If this is you, consider getting some extra support to get you through the heat wave.
  6. Use the season. Ancient civilisations worshipped the sun because it brought light, heat and growth. Consider what aspects of your life you want to grow and be nourished. Then, as the sun shines on you, allow your own inner wisdom to shine on your wishes and dreams and make them grow.


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Fly me to the Moon

It’s fifty years ago today since the Apollo 11 space mission put a human on the Moon. Two years before I was born, this event captivated the baby boomer generation. Suddenly, shockingly, we could now look down at the Earth from space, “hidden behind my thumb,” said Apollo’s pilot, Michael Collins, later.

Viewed from the Moon the Earth appears luminously beautiful and terrifyingly fragile. It is our home, and yet, being human, we still want to flee the nest and make it back to the Moon and on to Mars.

Why? What is it about humans that pushes us always onward and upward? It’s the source of psychological strength, and also psychological pain. Striving for better for ourselves and our loved ones easily morphs into driving ourselves into the ground.

Of course we don’t have to see the Moon as another piece of land to be conquered. Glimpsing that sliver disc drooping in the night sky can help keep our lives in perspective. We belong to a world where we don’t control the tides, the time or the space around us but where we are nonetheless perfectly adapted to be. Viewed from the Moon there are no nations or races or genders, just a single, unified planet. “For one priceless moment in the whole history of man, all the people on this Earth are truly one,” said  President Richard Nixon, in a telephone call to Neil Armstrong and Buzz Aldrin while they were on the Moon’s surface.

Full moon, half moon, crescent moon, blood moon, blue moon, gibeous moon, it waxes and wanes, tugging the ocean around the globe, and getting infinitesimally further away with every rotation of the Earth. We belong to it and it belongs to us all.