Depression

Craig identified his problem areas with a therapist. These included low self esteem; difficulty with friendships and his awareness that he had always put others before himself.

Craig was also studying a topic that he did not want to which left him feeling useless as he was not passing the modules.

What was offered to Craig?

To support Craig in improving his mood, we offered Cognitive Behavioural Therapy (CBT).

The therapist discussed with Craig how CBT worked – that people’s thoughts affect their feelings, behaviour and bodily responses.

By using CBT, Craig would be supported to change the ways he thought about things, which we hoped would result in a positive change in feelings, behaviours and physical reactions.

Did the CBT work straight away?

The beginnings of the therapy focused on unpicking Craig’s belief that he was worthless which gave Craig a better understanding of his negative thinking and how it resulted in his mood spiralling down.

We used questionnaires to monitor Craig’s mood level on a regular basis and these were shared with Craig to evidence his positive progress. This gave him some encouragement as he could actually see the graph showing how the low mood was slowly lifting.

With his new understanding of himself, Craig was able to begin to think more positively, which was an important step in creating change.

What happened in the CBT sessions?

Work progressed with identifying Craig’s unhelpful thinking styles and replacing these with more helpful ones – this had a positive impact on his wellbeing.

The therapist explained that lots of research had been undertaken in relation to depression and evidence showed that achieving and enjoyment were the key elements of improving mood levels.

Together, Craig and the therapist made a plan of activities and tasks that Craig decided he could manage by setting achievable goals (with a view to building on this) to be more proactive and feel in control of his life.

Future sessions included Craig being more assertive so that he could get his own needs met. He also identified that it was making him feel disliked when his friends did not respond in the way he felt they should. Changing his thinking style and finding more assertive ways of communicating improved this aspect of life for Craig.

How else did you help Craig?

Craig’s mood did not improve dramatically so the therapist and Craig discussed medication. He was referred to one of the team psychiatrists for an assessment. It was explained to Craig that careful consideration of prescribing medication was always given and he would be free to decide for himself whether he wished to include this as another way of supporting himself through this difficult time.

Craig’s sleep and appetite were discussed and Craig was made aware of the importance of a good sleep pattern and healthy eating in maintaining a good level of mood. Although Craig ate appropriately his sleep was disrupted and a plan of introducing a stepped bedtime (bringing forward time to sleep over a few weeks) was made.

We thought together about Craig’s college course. Craig acknowledged that the course was not enjoyable and we looked at other possibilities and courses that he thought he would enjoy. Supporting Craig to make a decision to change his college course was a really important part of the work.

What were the outcomes for Craig?

This work with Craig enabled him to feel he was more in control of his future, he experienced improved relationships with friends and the use of medication gave him a lift in mood which enabled him to be assertive enough to change his course.

Craig’s low mood continued to slowly improve over time and he agreed to continue on medication until he was to review it with the psychiatrist.

Craig found a new sense of worth due to his belief that he was liked by others and could make choices for himself and feel in control. He undertook sporting activities twice a week which he enjoyed and joined a drama club.

Craig isolated himself less and ensured he had small tasks every day which gave him a feeling of worth and this resulted in improved relationships and mood and life in general became much more manageable.