Barriers to Overcoming Depression

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It would be wonderful if everyone who came to therapy got the help they needed and after a couple of months of working through difficult things were all better and resumed a wonderful happy life.

This doesn't happen very often and the reasons why vary from person to person.

Sometimes a person doesn't mesh well with the therapist, sometimes more life events come up and therapy takes a backseat, and sometimes there's just bad luck with scheduling appointments.

Certainly, these barriers exist for a number of people seeking mental health services.

However, these barriers can usually be overcome through diligence and cooperation.

They also tend to be pretty rare cases that any one of these prevents someone from getting help for very long.

The reality is, the most common barriers for people overcoming depression, anxiety, trauma, or other mental health issues are internal barriers.

By that, what I mean is, there are certain preconditions for any person to overcome obstacles (including overcoming depression), and those preconditions have nothing to do with scheduling, finding time, or any other external circumstances.

Instead, those preconditions are the individual's readiness for change, willingness to work, and willingness to be honest with themselves.

These are all things that exist internally for every person, and if any of these aren't ready in the person, then they aren't going to get better (at least not in a couple of months).

Therapists can help client's improve their readiness to change, but ultimately it's the individual who makes the real difference.

Today we're going to break down these internal barriers and explore why they matter when overcoming depression.

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Readiness to Change

The first of the 3 internal barriers to change that are most responsible for preventing people from overcoming depression is their readiness to change.

A well-accepted model of behavior change is called the Stages of Change Model and is comprised of 5 stages: pre-contemplation, contemplation, preparation, action, and maintenance.

For so many clients struggling with depression coming into therapy is very difficult.

Depression robs everyone of optimism, and belief that they can get better, so people with depression often come into therapy without believing it will truly help.

So, mentally, these people are at the pre-contemplation stage.

Physically they're taking action, but mentally there's a disconnect.

Therapists help clients see that change is possible and that positive change is realistic thus shifting them into the contemplation stage.

Tools like challenging negative thoughts, journaling, and being open continue to help the client prepare and take action a little bit at a time until their confidence begins to grow.

Once the client is feeling strong and optimistic, they enter the maintenance stage where they no longer need therapy but need to continue using their tools to avoid sliding backward.

It would be nice if the process was always this straightforward.

The reality is depressive thoughts keep the clients in the pre-contemplation or contemplation stage for a very long time.

Clients who can't get to the preparation and action stage carry doubts that prevent them from even trying to make changes.

For this reason, readiness to change is essential in overcoming depression.

You must believe that you can change, that you don't have to be depressed, and then be willing to make helpful changes.

Willingness to Work

This brings us to the next barrier that often gets in the way of overcoming depression; willingness to work.

Overcoming depression takes a lot of effort, more so than other disorders because depression steals energy and motivation.

The good news is the more actions you take, the more energy and motivation you create.

You can think of depression as an hourglass-shaped cycle with the top half circling upward and the bottom half circling down.

The less you do, the further down you go, but the more you do the higher up you get.

I've met a lot of people who get to the contemplation stage of change and want to feel better and even believe they can, but they don't do the work.

This can make depression worse because seeing a way to feel better but failing to do so can reinforce negative thinking and depression.

This is where small goals are crucial.

You don't have to overcome depression in a single bond with major lifestyle changes.

Start with small goals, like REALLY small goals that you know you'll actually do.

Cleaning your room, making your bed, washing the dishes, checking your email; the goal itself doesn't matter, your willingness to accomplish the goal does.

Accomplishing small goals builds confidence, motivation, and energy that allows you to slowly seek larger goals, which then produce more energy and motivation, and so on and so forth.

Small steps make monumental changes in mental health, as long as you are willing to do the work.

Overcoming depression can be as simple as keeping your room clean one day at a time.

Willingness to Be Honest

The third barrier that prevents people from overcoming depression is the inability to be honest with themselves.

You can make great strides in mental health by being ready to change and willing to work.

But, if you can't be honest with yourself then you may not be as ready to change as you think.

For instance, if you think you're ready to change but can't be honest about what went wrong, then how are you ever going to prevent that from happening again?

It's the therapist's job to notice discrepancies in the client's statements and beliefs to check the person on how aware they are of the underlying cause of their struggles.

I've said to many of my clients that it makes no difference if they lie to me because I go home to my life, with my own thoughts and my own feelings- and it's them who go home with their own thoughts and feelings.

All I can do is point out what I hear, and the truth is only ever going to be known by the person speaking.

Honesty is the key to making lasting progress.

You can have all the tools in the world but if you can't be honest with yourself, then you're preventing yourself from addressing the real issues and will never be able to fully heal.

Overcoming depression means being honest with yourself.


Today we have looked at 3 barriers to overcoming depression (and plenty of other mental health issues).

Those barriers are readiness to change, willingness to work, and willingness to be honest with yourself.

Depression makes it very difficult to believe that positive change is possible; it steals motivation and energy to do the work; and prevents you from seeing the objective truth about yourself.

The therapist can help you proceed through the necessary stages of change, but only you can take the steps to heal yourself.

Depression is not a permanent state of being.

It takes courage, but overcoming depression is a very real possibility if you are ready to change, willing to work, and willing to be honest. 

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May 28th, 2023

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