Acceptance and Commitment Therapy, or ACT, is a ‘new wave’ approach to working with a variety of psychological difficulties, including depression treatment. Although ACT is relatively new compared with more widely used therapies, it has been used and tested by psychologists for a number of decades and there is a great deal of empirical evidence to suggest that it is effective for producing positive changes in the lives of clients.
What is depression?
A person may be depressed if they experience five or more of the following difficulties over a two-week period that significantly impairs daily functioning:
- Low mood for most of the day, every day
- Significantly less interest or pleasure in most or all activities he or she usually enjoys
- Significant weight or appetite change
- Sleeping significantly more or less than usual
- Recurrent thoughts of death or suicide
- Physical agitation and slowing of physical movements
- Fatigue
- Feelings or worthlessness or guilt almost daily
- Decreased concentration or decisiveness almost daily
How common is depression?
According to Beyond Blue, 20% of Australian women and around 13% of Australian men will experience depression during their lifetime.
How is depression diagnosed?
If you believe you may be experiencing depression, it is important to talk to your GP about your difficulties. Your GP should conduct a comprehensive medical examination to ensure that another health problem is not causing your symptoms. The doctor may refer you to a mental health specialist, such as a psychologist, for further assessment and treatment.
What is ACT?
ACT involves the practice of mindful awareness of positive, neutral and negative experiences, both internal (thoughts and feelings) and external (behaviours and environmental stimuli).
This awareness is used to facilitate ‘defusion’ – the practice of creating space between the self and these experiences. Often depressed clients ‘fuse’ with upsetting thoughts (e.g. ‘I am a failure’) and feelings (e.g. hopelessness), which then prevents them from engaging in activities they usually enjoy or that lead to a valued life (e.g. seeing friends regularly, exercising).
The creation of space enables clients to place less importance on upsetting thoughts, feelings and situations, which facilitates engagement in more valued living. When a depressed client can see that they are not their thoughts and feelings, they are more able to choose to act in accordance with their values, rather than what their mind or body is telling them.
How is ACT different to other approaches to treating depression?
Some other psychological therapy styles involve training in skills to evaluate the rationality of negative thoughts and feelings, and the development of more realistic thinking styles. Whilst these skills can also be very helpful, it is unrealistic to expect humans to be able to think rationally at all times, and sometimes the negative thoughts and feelings humans have are perfectly realistic and appropriate for the given circumstances.
For instance, a depressed client who has chronic pain may think ‘I’ll never be well again’ – this may in fact be a realistic thought. Evaluating it logically is unlikely to assist a client in feeling more positive and having a richer and more meaningful life. However, enabling the client to realise that they can have that thought and still engage in meaningful and rich activities (e.g. visiting a friend) is often more empowering.
Another common approach to treating depression is medication. In many cases this is appropriate, as some people experience such low mood that they are incapable of motivating themselves to do almost anything. Medication can be a helpful first step in facilitating treatment engagement in more severe cases. However, depression almost always develops through a combination of biological, psychological and social factors. Unless medication is used in conjunction with psychological therapies, only part of the problem is being addressed and full remission is unlikely to occur.
Finding assistance
If you live in Canberra and feel that you may be suffering from problems with depression, you can contact Strategic Psychology to arrange to see one of our psychologists. We can assist you in identifying the issues that are causing and maintaining your difficulties and recommend strategies that draw on your strengths to achieve optimal social, emotional and academic functioning.
No referral is required in order to see one of our psychologists, however, you can contact your GP for a referral under Medicare (if eligible) to receive a rebate on services provided.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C.: American Psychiatric Association.
Beyond Blue. (2015). Anxiety and depression: An information booklet. Retrieved from the Beyond Blue website: http://resources.beyondblue.org.au/prism/file?token=BL/0885
Hayes, S. (2005). Get Out of Your Mind and Into Your Life. USA: New Harbinger Publications.