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Some illnesses are easy for outsiders to see. People with allergies might sneeze, wheeze and develop angry, red rashes. People with arthritis might display bent, red joints or puffy, swollen fingers. Those with heart disease might gasp for air after walking just a few short steps. These conditions are serious, and outsiders often rush to provide support when they see people struggling with these conditions.

There are some other conditions that are just as serious, but they might be harder for outsiders to spot. Persistent depression is one of these conditions, and it can be treated with interpersonal therapy. While people who don’t know you might think you’re fine and healthy upon first glance, deep down you know that something isn’t quite right, and you might be at a loss to figure out how to handle it on your own.

If this sounds familiar, you’re not alone. According to the National Alliance on Mental Illness (NAMI), about five to eight percent of American adults have major depression in a given year. While these people may certainly struggle with their conditions, there is reason to be hopeful. According to NAMI, 80 to 90 percent of people with depression can be effectively treated and return to normal life once more. Many of these people do so by using interpersonal therapy.

*Spotting Signs of Depression

It can be hard to separate feelings of depression from negative feelings caused by addiction. The two conditions have symptoms that can overlap to a large degree. When you begin your therapy program for addiction, your doctor will provide you with a series of tests that can help to isolate depression or other mental illnesses you might have. This test might include questions such as:

  • Do you have little interest in things you once enjoyed?
  • Do you feel hopeless or helpless?
  • Are you sleeping too much or too little?
  • Do you feel bad about yourself?
  • Are you having difficulty with concentration?
  • Have you experienced suicidal thoughts?

Answering “yes” to questions like this might indicate that depression is an issue for you, and you might benefit from therapies designed to assist with depression as well as addiction.

The Root Causes

Interpersonal therapy revolves around the idea that while depression can be a chemical issue, and things like substance abuse can certainly have a role to play in the development of depression, a serious case of depression is also usually linked to some sort of change in your life. These changes are usually placed in one of four categories:

  • Unresolved grief. When someone dies, people may feel incredibly sad and lost for weeks or even months. Unresolved grief occurs when those feelings of sadness are delayed or distorted in some way. You might not feel grief at all in the moment, or your grief might manifest in physical symptoms such as backaches or headaches.
  • Role disputes. Here, two people have differing expectations of their relationship. You might feel as though you’re an equal with your parents when you reach adulthood, for example, but your parents might continue to think of you as a needy child. This push and pull between two roles you’re expected to play can be very depressing.
  • Role transitions. Major life changes such as getting married, getting divorced, moving to a new house or retiring can cause you to mourn the loss of what once was, and the role you used to play. While some of these changes might even be positive, they can cause a sense of loss and depression.
  • Interpersonal deficits. People with communication difficulties may be socially isolated, with few social supports or friends. You might find it hard to talk to others, or you might feel chronically misunderstood. This can also lead to depression and yet more isolation.

During your first few sessions with a therapist, you’ll discuss what has happened in your life and what you think might have contributed to your depression. Your therapist might ask you to answer questions or fill out paperwork to help you think of these root causes. Then, your therapist will provide you with a summation of the findings, and give you an idea of how long the therapy might last. According to the University of Michigan Depression Center, interpersonal therapy typically involves 20 sessions, one each week, but your therapy might differ depending on the issues you’re facing.

*Preparing for Therapy

While you won’t need to skip breakfast or do other physical preparations for your therapy sessions, there are some promises you can make to yourself that can help ensure that your therapy will be as productive as it can possibly be:

  1. Trust your therapist. You’ll work as a team, coming up with solutions and testing theories. This works best when you’re honest, and when you go to each session with an open mind, ready to work.
  2. Don’t skip appointments. Your therapy is important to your long-term success, and you’ll need to stay committed to the process.
  3. Take your medication, as needed. Sometimes, you’re given medication to help with your depression and addiction. These medications might help your therapy sessions, as you’ll be able to focus and think clearly. Don’t stop taking medications without talking with your doctor first.
  4. Keep thinking, even outside of therapy. It’s best to think of your therapy appointments as touch-up sessions for the hard work you’re doing 24/7. You’ll get the most out of therapy if you’re always thinking and always working.

Dealing With the Issue

The “meat” of interpersonal therapy occurs in the middle of your treatment program. Here, you and your therapist will tackle the specific issue you’ve identified as the root cause of your depression. If you’re struggling with grief, for example, you might role-play and speak some of the words you’d love to say to the person who died. If you’re dealing with social isolation, you might focus on communication skills. In each session, you’ll also provide an overview what happened in the previous week. You’ll outline the challenges you faced, how you attempted to deal with those challenges, and how they might be addressed differently in the future.

In these sessions, the therapist takes a relaxed and supportive stance. The therapist works as your coach and cheerleader, listening to your descriptions and providing you with praise or feedback as the situation dictates. The therapist never tries to punish you for failures, but the therapist will try to push you to take risks and make needed changes in your life.

Your therapist might also provide you with the opportunity to talk specifically about your substance abuse issue. You might be asked to set a goal of sobriety, and then discuss any temptations you might face in the following week. Then, you’ll outline how you might avoid those temptations and report back in the next session with the results of the methods you tried. According to the Encyclopedia of Mental Disorders, this form of therapy has not been proven effective in people who have substance abuse disorders, but it might be helpful for you.

*Revising Standard Care

While interpersonal therapy was originally designed just for depression, it has been modified to help people with other disorders as well. For example, according to the National Institute of Mental Health, people with bipolar disorder sometimes benefit from a form of interpersonal therapy that also includes education on bipolar disorder. Patients are asked to create daily routines, take medication regularly and work on their communication skills. They then use standard interpersonal therapy techniques to help assist them with the other aspects of their mental illness.

Studying the Studies

Understanding what the therapy is designed to do might be helpful, but you might be most interested in hearing the answer to one basic question: Will this therapy help me with the problem I’m facing? The answer is a bit less straightforward than you might like.

According to a review of research published in the journal World Psychiatry, two studies that provided interpersonal therapy to people with addiction disorders showed no benefit to this particular form of therapy. It’s possible that the participants did receive some benefit, but this finding seems to indicate that the benefit they felt wasn’t better than the benefit they felt from some other form of treatment.

People who have depression, on the other hand, do experience a clear benefit from the therapy. According to a study published in the journal European Archives of Psychiatry and Clinical Neuroscience, interpersonal therapy was proven superior to placebo in the treatment of depression. In other words, when it comes to depression, it does seem to be the best way to tackle the problem.

*When Is Therapy Over?

Interpersonal therapy is designed to be quick, with the entire course of treatment lasting just a few weeks. You’ll know how long the therapy might take when your sessions begin, and over time, you’ll work with your therapist to revise that estimate up or down, depending on the progress you’re making. There is no gold standard for length of care. It will depend purely on your progress and how you and your therapist feel about the steps you’re taking.

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