The Best Questions Therapists Ask Clients

2023 Therapist Guide | What Questions Do Therapists Ask?

Top 2023 Guide on the Best Counselling Questions to Ask Client During Therapy

Disclaimer

Getting clients to open up and be their true selves is one of the greatest challenges that therapists face. Whether it’s in-person one-on-one therapy or group therapy, therapists and mental health professionals may find it challenging to come up with counseling questions that will make the clients comfortable and also keep the conversation naturally flowing.

It’s essential to know what questions do therapists ask to help clients feel at ease and open up without resistance in order to make therapy and counseling sessions as productive as possible.

Therapy Questions to Ask Clients

This Social Work Portal article will cover different types of approaches and psychological questions to ask clients during counselling sessions.

Would you like to share counselling question examples used by your organization? Do you have clinical interview questions that work best for you that you’ll like to share with other therapists, counselors, and mental health professionals? If so, contact the Social Work Portal Team.

See Also: How to Become a Family Social Worker

Table of Contents: Best Counselling Questions Therapists Ask Clients

Keep on scrolling down this page to read each section or click any link below to go directly to that section.

1. What’s the Importance of Questions in Counselling?
2. Types of Counselling Questions
   1. Open Ended Questions in Counseling
   2. Closed Questions in Counselling
3. Counselling Questions Examples
   1. Questions to Ask on the Phone
   2. First Therapy Session Questions to Ask Clients
   3. Therapeutic Questions to Ask Clients
   4. Group Therapy Questions
   5. Family Therapy Questions to Ask Clients
   6. Cognitive Behavioral Therapy Questions to Ask Clients
   7. Gestalt Therapy Questions to Ask Clients
   8. Questions Therapists Ask Depressed Patients
   9. Questions to Ask a Resistant Client
   10. Miracle Question – What is Solution Focused Brief Therapy?
4. Download Free Slides – Questions Therapists and Counselors Ask Clients PPT & PDF
5. Conclusion | Best Questions Therapists Ask in Counselling
6. FAQ | Questions Counselors Ask

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Would you like to share feedback on best counselling questions to ask client used by your organization? Is there a counseling questions to ask clients PDF that has provided great value to you that we can include in this guide for other therapists and counselors to leverage? If so, contact the Social Work Portal Team.

Counselling Questions and Answers | The Importance of Questions In Counselling

Asking the right questions in counselling is considered to be one of the basic counselling and therapy skills.

Well-thought-out, mindful counselling questions allow counsellors and therapists to learn more about their clients which is of great importance in the information gathering stage of counselling.

Furthermore, good therapy questions help with guiding the counselling conversation which may enhance client’s opening up and speaking their truth.

Questions counselors ask will vary depending on the scope of therapy, but regardless of the situation, they will allow you to learn more about your clients and set the tone for subsequent therapy sessions.

If you’re looking for a powerful client & case management tool to streamline your therapy and counselling practice, subscribe to our case management software to see how it can help you take your counseling to the next level.

Related: Guide on How to Get Started As a Social Worker Child Welfare Specialist

Types of Counselling Questions | Open and Closed Questions in Counselling

So, what questions do therapists ask? There are two main types of counseling questions to ask clients in therapy:

1. Open Ended Questions in Counseling
2. Closed Questions in Counselling

While both types of questions are valuable, there is a big difference between open and closed questions in counselling.

What Questions Do Therapists Ask? | Open Ended Questions in Counseling

Open ended questions in counseling cannot be answered with a simple “Yes” or “No”. This type of therapy question to ask clients will encourage them to pause, think, and reflect before they answer.

Open ended questions in counseling begin the exchange between the counselor and the client and shift the control of the conversation from the therapist to the client. If the therapist is the only one in control of the conversation, it means they’re asking closed questions in counseling.

Open ended therapeutic questions to ask clients typically begin with:

• Who
• Why
• How
• What
• Where
• When

These are essential therapy questions to ask patients as they have no set or predetermined answers and they require a full response from the client.

Open and Closed Questions in Counselling

What Questions Do Therapists Ask? | Closed Questions in Counseling

Closed questions in counseling are questions that lead to “Yes” or “No” answers or questions that have only one correct answer.

While closed questions can be used to clarify on certain aspects of conversation if therapist or counselor asks a lot of these questions, client can quickly start feeling like they’re being interrogated rather than leading a constructive conversation.

It’s up to the therapist to recognize and best determine when to use open and closed questions in counselling. However, therapists are more likely to get the constructive conversation going if they’re asking open ended questions in counselling.

Even if a therapist or counselor has a closed question in mind, they can rearrange it into a more open ended one. See the below table with some examples of open and closed questions in counselling, and how counselors can rearrange them to make the questions in counselling more engaging.

Popular Article: Psychosocial Questions & Examples of Psychosocial Evaluation

Do you have any questions about what questions do therapists ask or information on the best counseling questions to ask clients PDF? Do you have feedback on key questions to ask a client in a first therapy session? If so, contact the Social Work Portal Team.

Questions Therapists Asks | Counselling Questions Examples

With so many psychological questions to ask clients, we’ve divided this section into different categories so it’s easier for you to find the exact type of therapy questions to ask clients.

1. Questions to Ask on the Phone | Counselling Questions to Ask Clients

Most counsellors and therapists will offer clients a complimentary phone call so they can get a sense of each other before the first therapy session.

Here are some questions to ask on the phone:

• What made you consider therapy now?
• Have you been in therapy or counselling before?
• What has worked/not worked for you in the past counselling sessions?
• What are you looking for in a counselor or therapist?
• Do you have any questions for me?
• Do you want to schedule an in-person appointment?

Incorporating a reliable case management software can further enhance the efficiency of your therapy and counseling practice. Why not join our Case Management Hub and see it in action? 

Read More: What Does a Social Worker Substance Abuse Job Description Look Like?

2. First Therapy Session Questions to Ask | Counselling Questions Examples

While every therapist and counselor has their own unique approach, there are some common questions to ask client in first therapy as an introduction.

Typically, the majority of the first therapy session will be dedicated to clinical interview questions or therapy intake session questions to gather pertinent information about the client. Below are some of the most common questions to ask client in first counseling session:

• Why made you seek therapy/counselling now?
• What do you expect from therapy/counselling?
• How have you been coping with problems that made you seek counseling?
• Have you been in therapy/counselling ever before? What was that experience like?
• What do you hope to accomplish in therapy/counselling?
• How is your relationship with your family?
• How do you cope with stress?
• What are some of your strengths?

3. Group Therapy Questions | Counselling Questions Examples

Group therapy is a form of therapy where one or more counselors or therapists will be working with several different people at the same time.

Group therapy questions will vary based on the type of group (i.e., Psychoeducational groups, Cognitive-behavioral/problem-solving groups, Support groups, etc.)

Therapy Session Questions

Keeping track of therapy session questions and answers can get quite messy without the proper therapy tools.

Whether you’re managing individual, couple, or group therapy sessions, Social Work Portal Client and Case Management Hub platform can provide a streamlined solution to help manage your practice. Subscribe to All-in-One Case Management Hub today!

Regardless of the main focus of the group, majority will revolve around discussion type of group therapy questions such as:

• Is it your personal decision to come here, or did someone else encourage or force you to do so?
• What do you like best about group therapy session?
• What coping strategies are you using to cope with and manage your addiction/behavior triggers?
• What are you grateful for in life and why?
• What are some things that make you feel stressed? How are you coping with stress?
• What are 3 things you like about yourself? Explain why.
• Discuss goals you want to achieve in group therapy.
• What are three bad habits that you’d like to replace with good ones?
• What are the good habits you can replace the bad ones with?

Related: Everything You Need to Know About Using the CRAFFT Questionnaire

Are you looking for psychological questions to ask the clients and patients? Do you have any questions about therapeutic questions to ask clients or best therapy session questions in general? Click here to contact the Social Work Portal Team.

4. Family Therapy Questions to Ask Clients | Counselling Questions Examples

As the name itself suggests, family therapy is a type of counselling that helps families address and solve conflicts and improve communication.

While family therapy questions will vary based on each family’s history and issues, we have prepared some of the family therapy questions that therapists and counselors ask:

• Why are you seeking family therapy?
• What changes do you want to see within your family?
• What do you expect from the family therapy?
• What are you willing to do to make the changes happen?
• What have you done as a family so far to improve the situation?
• Does everyone in the family therapy session agree that changes need to happen?
• What will be different if the family decides to make the changes?
• What do you want to see improved for each family member?
• How is each family member progressing?
• How do you think you can rebuild the relationship?

These are just basic family therapy questions and the list will grow as the family progresses through counseling. Based on specific reasons the family is in counselling, therapist will determine what other family therapy questions need to be asked. 

If you’re looking for a HIPAA, PIPEDA, Privacy Act, and GDPR compliant software to manage your clients and cases, sign up for Case Management Hub today and take your practice to the next level.

5. Cognitive Behavioral Therapy Questions to Ask Clients | Counseling Questions to Ask Examples

Cognitive behavioral therapy is a type of therapy where therapist or counselor works on producing change by helping unlearn behaviors that don’t serve them and helping them relearn specific behaviors. 

There are 3 most commonly asked cognitive behavioral therapy questions to ask clients are also known as the “Three Rational Questions” technique.

Therapist instructs the client to ask themselves the following 3 cognitive behavioral therapy questions:

1. Is the thought I’m having based on fact?
2. Does that thought help me achieve my goals?
3. Does that thought help me feel the way I want to feel?

If the client’s response is a “No” to at least two out of these three cognitive behavioral therapy questions to ask clients, then they know the thought they’re having is irrational.

CBT counselling questions and answers examples:

Thought: I am going to lose my job if my boss finds out about my anxiety.

1. Is this thought based on fact?
   Answer: No.
2. Does this thought help me achieve my workplace goals?
   Answer: No. (This way of thinking won’t help me become a better colleague or employee.)
3. Does this thought help me feel the way I want to feel?
   Answer: No. (This way of thinking makes me feel insecure and incompetent.)

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6. Gestalt Therapy Questions to Ask Clients | Counseling Interview Questions For Clients Examples

Gestalt therapy is a humanistic, individual-centered type of therapy that focuses on person’s present issues vs digging into their history of issues and experiences.

Gestalt therapy questions to ask clients will be focusing on what is currently going on in client’s life.

The point in Gestalt therapy questions to ask clients is for therapist to guide them toward better understanding of the life they’re currently living. Since this type of therapy focuses on “right now” vs “past”, Gestalt therapy questions to ask clients are “what” and “how” types.

Here are some of the best Gestalt therapy questions to ask clients:

• How are you feeling now?
• What are you thinking right now?
• How does your body feel at the present moment?
• What mood is evoked now?
• How should I support you?
• What are your body language and facial expressions saying right now?

7. Therapeutic Questions for Depression | Questions Therapists Ask Depressed Patients

There are many different types of therapist questions for depression that therapist or counselor may ask their clients.

Questions therapists ask depressed patients will vary but some of the most common therapeutic questions for depression are:

• What are the issues or problems that brought you to therapy?
• What’s your family history?
• Have you attempted harming yourself?
• How is your relationship with others around you?
• Therapeutic questions for depression revolving around client’s medical history and mental state

These are just some of questions therapists ask depressed patients. Most counselors, therapists, and mental health practitioners will conduct one of many types of depression screening questionnaires to best determine what depression symptoms client has been experiencing.

Looking for software that comes equipped with pre-made assessment, screening, intake, and letter templates?

Our case management software is a comprehensive solution for psychologists, therapists, counselors, and other mental health professionals that helps you manage clients while saving you time and money. Subscribe to All-in-One Case Management Hub Platform and see for yourself how our software can benefit your practice.

Do you have any questions about therapist questions for depression described above? Click here to contact the Social Work Portal Team.

8. Questions to Ask a Resistant Client | Examples of Questions Counselors Ask

Client-counselor relationship is all about collaboration, but even the best counselors will encounter a resistant client.

Resistance usually comes when a particularly distressing and uncomfortable issue is brought up during a therapy or counselling session.

When such issue arises, what questions to ask a resistant client? Or what not to ask?

It is widely recommended that instead of thinking about what questions to ask a resistant client, therapists and counselors should aim to use statements that encourage clients to open up.

Guiding clients to explore their own ability reason, desire, and need to change is far more effective in reaching resistant client than pondering on what question to ask a resistant client (and potentially causing even more distress).

9. Miracle Questions | What is Solution Focused Brief Therapy?

Solution focused brief therapy (SFBT) is a type of therapy based on building solutions rather than problem solving.

So, what is solution focused brief therapy in practice?

In practice, SFBT therapist serves as a skilled conversation facilitator that approaches the sessions from the position of “not knowing” rather than presenting themselves as an expert.

SFBT therapist will use the so-called “Miracle Questions Technique” to help clients think outside the box.

Good therapy questions using this technique will let the client imagine what things will be like once they get rid of their problems.

Here are a few examples of therapy questions to ask patients using this technique.

Imagine that one night the miracle occurs and your depression is entirely gone! When you wake up in the morning:

• How do you know that this miracle has truly happened?
• What’s different in how you feel?
• What’s different about your life?
• What will others notice about your new self?

By allowing the client to visualize themselves depression free, clients can create some space between themselves and their depression. In return, this method allows them to distance themselves from their depression and allows them to set future goals.

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Disclaimer: This web site is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with… Read our full disclaimer here: Social Work Portal Disclaimer.

Popular Article: Depression Questionnaire and Scoring Guide

Download Best Questions Therapists and Counselors Ask Clients

Below you can find free slides PPT and PDF with the best questions therapists ask clients that are designed to help therapists and counselors with basic questions relating to client needs so they can better support them. 

We have organized questions into the following categories:

• Questions to Ask on the Phone
• First Therapy Session Questions to Ask
• Group Therapy Questions
• Family Therapy Questions to Ask Clients
• Cognitive Behavioral Therapy Questions to Ask Clients
• Gestalt Therapy Questions to Ask Clients
• Therapeutic Questions for Depression
• Questions to Ask a Resistant Client
• Miracle Questions

Download Your Questions Therapists & Counselors Ask (PPT & PDF Versions)

Do you have feedback on best questions to ask client in first counseling session? If you are a Clinical Therapist, do you have a list of more questions to ask a client in therapy that you would like to share? If so, contact the Social Work Portal Team.

Conclusion | Best Questions Therapists Ask in Counselling

Best psychological questions to ask in therapy and counseling can be of enormous help when conducting your own therapy intake session questions.

As you continue to prioritize your clients’ needs, consider how our case management software can help streamline your therapy practice. To learn more about the benefits that our client and case management software for therapists and counselors can provide, join All-in-One Client & Case Management Hub Platform today.

Questions to ask a client in therapy (or not to ask) can make a huge difference in therapist-client relationship.

While not all of the questions counselors ask will apply to every therapist’s sessions, it is essential to be aware of different types of clinical interview questions as you never know where life can take you.

If you’re not a therapist yet, but you’re intending to start a career in therapy or counseling, it is essential that you develop and consistently improve your own counseling interview questions for clients.

Whatever the situation may be, if you have any feedback on clinical interview questions or questions counselors ask, don’t hesitate to get in touch with the Social Work Portal Team.

See Also: Guide: What Are the Best Screening Tools for Depression and Anxiety?

FAQ | Questions Counselors Ask

What are the main types of therapy questions to ask patients?

There are 2 main types of counseling questions:
•Open Ended Questions in Counseling
•Closed Questions in Counselling

Which are the best questions to ask client in first therapy session?

The best first therapy session questions are clinical interview questions or therapy intake session questions that gather pertinent information about the client.

What counselling questions to ask client?

It will depend on the type of counseling, but the best questions will be open-ended questions as they lead to an open conversation that strengthens the bond between the therapist and the client.

What are the most common therapist questions for depression?

The most common therapist questions for depression are:
•What are the issues or problems that brought you to therapy?
•What’s your family history?
•Have you attempted harming yourself?
•How is your relationship with others around you?
•Therapeutic questions for depression revolving around client’s medical history and mental state

Note: Content on Social Works socialworkportal.com website is copyrighted. 

Social Work Portal Disclaimer: Social Work Portal is not a social work agency and we do not refer social workers. This web site is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with … Read our full disclaimer here: Social Work Portal Disclaimer.

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How to Know if You Are Depressed? 12 Questions to Ask

By: Twitter Trends 2019

by Andrea M. Darcy

Not feeling yourself lately? Worried you might have depression? And wondering how to know if you are depressed?

Depression has a wide range of symptoms. And there are even different kinds of depression. So if you are seriously concerned, it’s of course best to see a mental health professional.

This said, there are certain questions you can ask that can give you a clearer picture over whether it’s depression, or something else entirely.

[Have you taken our ‘Stressed, Depressed, or Both?’ quiz yet? It’s free!]

How to know if you are depressed – 9 questions to ask

So what is it you need to ask?

1. How long have you been feeling low?

Is it only recently you’ve not felt yourself? Like in the last few weeks? And is this unusual for you, or are you constantly having ups and downs?


If you’ve only felt blue for a few weeks or more, it could be a bout of sadness or emotional shock.

Depression comes when we’ve not felt ourselves for around six weeks, or up to a lot longer.

Look at the big picture here if you tend to have ups and downs.  If you have two or three weeks of feeling low each month, and it’s been going on for half the year, then you are really looking at a six-month period. It’s time to reach out for help.

[Know you are depressed, but scared to go to a therapist’s office? Why not try online therapy from the comfort of your own home?]. 

2. How interested are you in your hobbies and activities? 

By: Megadeth’s Girl

Crying a lot, but still making it to the gym, and happy to get out to see friends as then you feel better? You are more likely just processing some sadness.

Depression actually affects our capacity to want to do things we usually like. Everything seems too much effort to be bothered.

3. Do you know what’s behind your moods?

Did you have a bad experience a few weeks ago, like a redundancy, a break up, or a presentation gone wrong? You might be suffering severe stress.

The good thing about stress, unlike depression, is that we can identify the issue and therefore take steps to fix it. We can get help with a new CV, spend time with friends, or take a course in public speaking.

Depression, on the other hand, can descend like a blinding fog. There were many things going on, and then suddenly we were just ‘in it’. We feel helpless against depression because we can rarely pinpoint the exact cause. So we don’t know where to start making changes (and depression robs us of the motivation to even try). 

Note that stress can, however, become depression if we don’t deal with the stressor. So do seek support to make a plan forward.

4. What tense is your mind living in?

How to know if you are depressed? Note if your thoughts are about the past, present, or future.

Are you obsessed with something in the future, and unable to stop thinking about all the things that might go wrong? You are more likely to be suffering anxiety than depression.

Depression can blot out any hope for a future. Instead we obsess on the past. All the things that went wrong in our life, that we missed out on, all the ways we failed.

5. What is the main emotion you feel lately?

By: Robert Hoge

Do you feel fear jolt through your body on a daily basis? Again, that is anxiety, a fear-based condition.

Depression is more likely to drown you in shame. Shame can manifest as waves of guilt, sadness, and even blasts of anger.

Note that sometimes, with depression, you can find you are unable to feel at all, lost in what many depression sufferers refer to as ’emotional numbness’.

6. What are your physical symptoms?

Muscle tension, churning stomach, sweaty palms, heart palpitations? These are symptoms of stress or anxiety.

So exhausted everything seems a giant effort? Does your body feel made of sand or lead? Or do you feel flu-y all the time, run down? Or even disconnected from your body entirely?  These can be the physical symptoms of depression.

7. And how is your sleep?

Are you sleeping so heavily you can’t get up when the alarm clock goes, and are suddenly prone to sleeping away your weekends? Or, are you sleeping in fits and starts, having bad dreams, waking up tired? Or unable to fall asleep at all? Depression tends to cause sleep problems.

Anxiety also affects sleep. Either you can’t sleep at all as your mind is racing, or you wake up several times with night anxiety, which feels like a half-asleep panic attack in the dark.

8. And your appetite?

Depression can mean we under or overeat.

9. What are you thinking about?

By: Ganesh Dhamodkar

If you take the time to hear your thoughts, what do you hear?

Are you going through details of everything you have to do and accomplish, and troubleshooting? It’s stress or anxiety.

Are you replaying a certain situation again and again, trying to get the facts right but feeling emotional? Might just be sadness and a bit of emotional shock.

If your thoughts are all doom and gloom, then you might have depression.

Negative thinking is always present with depression, as are ‘cognitive distortions‘, where we make things worse than reality. If you have severe depression, your negative thinking will be so bad you can even consider hurting yourself or others.

If this is you, seek help immediately – try a free help line, or, if you really are about to carry through, call emergency services. 

10. Who are you thinking about?

Are you thinking about what your boss thinks of you, and your colleagues, and your family? Wondering how they will react to what you do next? Anxiety, always looking outward, has a hold on you.

Do you think about yourself mostly, about all the things you do wrong, and the terrible things that you experienced? If you are thinking about others, is it about how you let them down, and how they can’t understand you? This could be depression talking, an inward-looking condition.

11. How’s your focus?

When you try to work, does your mind feel foggy, blank, far away? Is it hard to get simple tasks done, partly as you can’t focus, partly as you can’t find the desire to be bothered to focus? Sounds like depression.

Stress and anxiety, on the other and, put us into the fight and flight mode. Our cortisol levels surge and we can find that we are sharply over-focused, as if we are seeing in 3D.

12. Do you feel understood?

Do you feel inclined to share the way you are feeling and thinking with friends and loved ones? Even find yourself over-explaining it? Anxiety can make us babble. And we are more likely to share it, as we live in a society where anxiety and stress are fairly acceptable.

Depression can have to opposite effect. It goes back to the fact that depression is driven by shame. And when we have shame, our instinct is to hide.

Even if we do gather our courage and share how bad we are feeling with a loved one, shame can cause us to be on the lookout for the tiniest glimmer of rejection. No matter how hard the other person tries, if we are depressed, we are likely to feel misunderstood.

Will my depression just go away?

Depression doesn’t tend to vanish, even if we have a sudden change of life circumstance for the positive. This is because depression is driven by unresolved past experiences that affect our unconscious and colour our ability to enjoy good things. But trying talk therapy can mean we not only manage our depression, we are less likely to fall into it again in the future.

Time to seek help for depression and finally get your life back on track? We connect you to some of London’s top therapists. Not in London, or even the UK? Our booking platform offers registered therapists UK-wide, or Skype therapists you can talk to from anywhere. 

Andrea M. Darcy is a mental health and wellbeing expert, who has done some training in person-centred counselling and coaching. She often writes about trauma, relationships, and ADHD, and advises people on how to plan their therapy journey. Find her on Instagram @am_darcy

17 important questions about depression

Important questions for the doctor

03/15/23

How to suspect depression and why it occurs

Ekaterina Kushnir

talked about depression

Author profile

Polina Svechnikova

psychiatrist

We talked with psychiatrist and psychotherapist Polina Svechnikova.

You will learn why depression develops and whether it can be prevented, what its symptoms are, what atypical depression is, whether online tests for depression work, how it is treated, and whether this disease always increases the risk of suicide.

What will you learn

• Why does depression develop?
• Can depression be prevented?
• Are there genetic tests to determine predisposition to depression?
• Is it true that depression sometimes develops after COVID-19?
• What are the symptoms of depression? How to distinguish it from ordinary sadness, bad mood?
• Is there atypical depression? How does it differ from the classical one?
• Is it true that depression is worse in the morning than in the evening?
• The symptoms of depression often resemble physical illnesses. Should I first contact a therapist and undergo an examination?
• Do online depression tests work? Is it possible to make a diagnosis with their help?
• How is depression treated?
• Can depression be cured by psychotherapy alone, without drugs?
• Can depression go away on its own without treatment?
• Can depression be cured forever or will the disease return?
• What can people with depression not do?
• Does depression always increase the risk of suicide?
• What if a person wants to commit suicide but refuses to go to the doctor?
• What depression prevention measures do you use for yourself?

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Why does depression develop?

As a definition of depression, I like the well-known neuroscientist Robert Sapolsky: “Depression is a biological disorder with a genetic component and influence from the early childhood environment that makes it impossible for a person to now enjoy the sunset.”

The Biology of Human Behavior – Lectures by Robert Sapolsky at Stanford University in Russian

This is a somewhat ironic definition, but it well demonstrates the current understanding of the causes of depression and many other mental disorders. Such a model in psychiatry is called the biopsychosocial model.

Causes of clinical depression – NHS

The role of genes. This is the first component of the model of the modern understanding of depression, its biological component.

Some people have a predisposition to develop a depressive disorder, a so-called genetic vulnerability. A person inherits from parents a certain number – a whole group – of genes that can further contribute to the development of depression.

This genetic vulnerability determines how neurotransmitters work in the brain or how the nervous system responds to stressful stimuli.

The role of mental characteristics. This includes individual characteristics of temperament and personality. For example, there are different types of response to stress, especially attitudes towards disturbing or sad events.

Also included here are the features of children’s upbringing, for example, the collision of a child with any injuries.

The role of the environment, its influence on an already adult person, including the influence of macrosocial factors, such as events in the world.

The development of depression does not always require the influence of all three groups of factors. So, a person may not have a genetic predisposition, but such a severe psycho-traumatic event happens to him, for example, violence of any order, that depression forms in the future.

13 important questions for geneticist Irina Zhegulina

It also happens the other way around – a person has a genetic vulnerability, but his life is going well, and depression does not develop.

How to treat effectively and inexpensively

The best materials on how to check the prescription, choose a quality medicine from a dozen analogues and return money for treatment – in your mail twice a month on Thursdays. Free

Can depression be prevented?

For prevention, first of all, it is important to satisfy the basic needs of the body – in normal nutrition, healthy sleep, rest.

Modern reality greatly influences these basic needs. For example, people, for the sake of some trends, may limit themselves in food, the diet is often violated, because work processes are a priority.

8 Free Ways to Relieve Stress After a Hard Day

The same can happen with sleep patterns. And this is an important biological need, while you need to sleep at night, in the dark. Sleep disturbances, such as daily work, seriously affect health, including psychological state.

Prevention of depression – WHO

The third component is disruption of work and rest. This is both burnout and ignoring the need for rest, for getting new emotions from hobbies, meetings with loved ones, and the like. A person in working days ignores or puts into the background what energizes him, gives him energy.

Are there genetic tests to determine predisposition to depression?

It is not possible to determine the predisposition to depression with the help of genetic tests, there is currently no such diagnostic tool.

The Genetics of Depression – Stanford Medicine

Even in research, there are not yet a limited number of genes that affect the development of depression. Every year there are more of them. In addition, these are certain combinations of genes, and their presence does not mean that depression will definitely develop. Much depends on what other factors will influence a person throughout life.

Many companies offer genetic tests that allegedly determine the risk of depression. In fact, it is still impossible to reliably determine the likelihood of a disease in a particular person. Source: genotek.ru

Is it true that depression sometimes develops after COVID-19?

It’s true, there is even such a term – “post-covid depression”. Another question is that it is not yet fully understood how the coronavirus infection affects mental activity.

Depression and COVID-19 – NHS

How post-COVID depression can manifest itself – Harvard Medical School blog. According to the data collected, about 30% of people report neurological or psychiatric symptoms after illness. From the side of psychiatry, these are more often anxiety or depressive disorders.

Outpatient appointments are sometimes attended by people who say that about six months after the coronavirus infection, they developed symptoms of classic depression. We do not know why this happens, but treatment in such cases helps. If necessary, drug therapy is prescribed, supplemented with psychotherapy. Antidepressants work great here, as they do for depression that arose without suffering COVID-19.

What are the symptoms of depression? How to distinguish it from ordinary sadness, bad mood?

It is normal to be sad, worry from time to time, any person can have episodes of depressed mood for two to three days.

DSM-5 Diagnostic Criteria for Depression

Timing is very important in clinical depression. According to modern diagnostic criteria, we can speak of depression if the symptoms last at least two weeks. It is the duration of the symptoms that distinguishes depressed mood, blues, burnout from major depression, with which it is already worth contacting a specialist.

The classical school of psychiatry talked about the triad of depression. Now the ideas have changed a little, but still, three main groups of symptoms can be distinguished.

Symptoms of depression – Mayo Clinic

Emotional disorders. This is exactly what is most often mentioned when talking about depression. This includes depressed mood for a long time – at least those same two weeks, but it can be months, sometimes years.

There may also be a predominance of feelings of guilt, dissatisfaction with oneself. Such feelings will persist even in the presence of conflicting incentives, such as promotions, praise from superiors, and other positive moments. A person will still believe that he is not good enough or that something is wrong with him.

Also an important symptom is anhedonia, that is, a condition when a person loses the ability to enjoy life. This is exactly what Sapolsky was talking about when “it is impossible to enjoy this beautiful sunset.”

Here you can remember the advice that is often given to people with depression, for example: “Just smile!”, “Look what a wonderful life.” And a person at the biological level cannot experience this joy, he does not allocate fuel for it.

In addition, with depression, motivation will suffer significantly, that is, a person’s desire for something: obtaining new knowledge, work, communication. Interest disappears even in what previously seemed very attractive.

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Cognitive impairment. Concentration, attention decreases, new material is absorbed worse. Sometimes patients complain that it has become difficult to read even fiction.

The ability to choose may suffer. A person may have difficulties even when choosing products in a store, not to mention making vital decisions.

Ideas of self-blame, negative thoughts about one’s own life and future will still appear. There is such a thing as a pessimistic view of the future and the past. For example, a person devalues ​​past achievements, does not see anything good in what awaits him. This is precisely the cognitive component when this happens at the level of thoughts.

Moreover, negative thoughts often become ruminating, that is, they are constantly repeated, do not stop, a person gets stuck in them, like in quicksand. Such a thought process can take hours and days, it is impossible to distract from it.

Physical disorders. Weakness appears, there is no strength and energy. Severely depressed patients often report that it is difficult for them to even get out of bed, do normal daily activities, and maintain hygiene. This, in turn, reinforces negative thoughts about yourself. There may also be disturbances in sleep and appetite.

Is there atypical depression? How does it differ from the classical one?

In classical depression, a person’s mood is equally bad throughout the entire period of illness. Nothing ever makes him happy. The flow of negative thoughts about oneself and life is stable, despite any external events – joyful and joyless.

Atypical Depression – Cleveland Clinic

Atypical depression sometimes has flashes, that is, responses to positive stimuli. Constantly bad, but suddenly something good happened, for example, it turned out to close a complex project or they gave a bonus at work, and it became easier for a couple of hours or days. Sometimes a person even reaches a normal state.

At the same time, the symptom of reactivity to external influences also works in the opposite direction. When we talk about classic depression, a person always feels bad. Even if something bad happens, it seems to confirm the fact that something is wrong with life or a person, it does not get worse.

With atypical depression, the situation is different: a positive event can pull a person out of a depressed state, but any negative trifle can sink him down again. At the same time, it can cause such an increase in the intensity of emotions that this sometimes leads to impulsive actions.

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Another feature of atypical depression is an increase in appetite, which is uncharacteristic of typical depression. In the classic version of the disorder, appetite disappears, there may be an aversion to foods that you used to like, or food becomes the same in taste.

The same will happen with sleep: most often with atypical depression, the need for sleep is increased, during the day there may be constant sleepiness. In the classical version, on the contrary, disturbing or negative thoughts often do not let you fall asleep for a long time, and then suddenly wake up early in the morning.

Is it true that depression is worse in the morning than in the evening?

Diurnal mood swings can be seen in depression. This mainly applies to the classic version. In this case, indeed, in the morning hours, the worst is: in the morning there is no strength or energy, and by the evening it gets better.

The symptoms of depression often resemble physical illnesses. Should I first contact a therapist and undergo an examination?

On the one hand, of course, it would be good for a psychiatrist to immediately get a complete picture of a person’s state of health. Often this is what happens: patients go to him last.

On the other hand, if all people are advised to see a general practitioner or endocrinologist first, there is a high risk that the person will put off seeing a psychiatrist for a long time. And he may really need psychiatric help, including medication.

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I recommend that you first go to a psychiatrist, and if in doubt, he will send you to other specialists.

Do online depression tests work? Is it possible to diagnose yourself with their help?

Of course, it is impossible to make a diagnosis using online tests. No scale can unequivocally determine that a person has depression.

Beck Depression Scale in Russian

Psychiatrists do not just ask a person a few questions, they conduct a clinical interview, collect an anamnesis, build hypotheses about the presence of a particular disease. There is such an expression: “When a psychologist is to oneself, it is like a dentist to oneself: nothing is visible and it hurts very much. ” It’s the same with psychiatry.

The Beck Depression Scale has slightly different questions for men and women, adults and adolescents

How is depression treated?

Currently the “gold standard” of depression treatment is a combination of medication and psychotherapy.

The biological effect of drugs occurs much faster than psychotherapy begins to work. Although you need to know that antidepressants – they will be the first line of therapy – will also not begin to work in the first days. The effect will appear by the third or fourth week.

Treating depression – article for patients on Updatedate

Why then do we need psychotherapy? Here we return to the fact that there is a psychosocial component in the formation of depression, which antidepressants cannot act on.

For example, a person may have some deep negative beliefs about himself, associated with childhood or traumatic events, because of them certain thoughts appear. Psychotherapy will work both with thoughts in the here and now, and with deep problems.

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Can depression be cured with psychotherapy alone, without drugs?

It happens that depression in a person is recent, it is more caused by psychosocial causes. For example, something happened in his life here and now: he is having a hard time with problems in relationships with a loved one or negative changes in life.

Then the doctor may prescribe psychotherapy as the only treatment option, and then look at the condition over time. If after some time the situation worsens, you will have to connect medications.

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Can depression go away on its own without treatment?

Of course, there are such cases. At appointments, there are often situations when a person comes with active and intense symptoms of depression and tells that he experienced the same episode two years ago, but then it lasted two or three months, then everything went away.

There is a common misconception that it may not be worth treating if it ever goes away. But just because a depression lasted two months in the past doesn’t mean it will last that long now. In addition, this disease seriously affects the quality of life.

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Not to mention subjective experiences: being depressed is very hard. Sometimes this state deprives of work, because it is impossible to work, leads to expulsion from the university, to the loss of social contacts, because a person in depression does not want to contact anyone.

No one can guarantee that the depression will soon end on its own. Maybe in six months it will still be there, and then the person will go to the doctor. But why were these six months? When in doubt, it is better to ask for help than to wait for it to pass.

Can depression be permanently cured or will the disease return?

There are different types of depression. For example, in the International Classification of Diseases there is such a diagnosis as “single depressive episode”, and there is “recurrent depressive disorder”. In the second case, the disease returns with a certain frequency, and no one can say how many of its episodes will be in a lifetime – two or twenty-two.

Mood disorders – ICD-10

Depressive episodes can also occur within other disorders, such as bipolar affective disorder, but this is a different condition.

What can be said unambiguously? If a person has had one depressive episode in his life, most likely he has either some kind of genetic vulnerability or psychological characteristics.

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This doesn’t mean you have to sit and wait for another depressive episode to happen. It is more a question of prevention and competent treatment.

For example, there are some principles of antidepressant therapy. It does not last one or two months, usually it is prescribed for at least six months – and this period is considered starting from the moment the condition improves. This approach also reduces the likelihood of relapses of depression.

The second important point in this case is to remember the vulnerability of your psyche and think about your lifestyle: about sleep, rest, and so on. You will need to take better care of yourself.

What can people with depression not do?

Lifestyle. Here you can repeat once again about the rules of lifestyle, taking care of basic needs – all this is important even during illness.

Added to this is the abstinence from alcohol. Among the population of Russia, for a long time it was considered a kind of antidepressant, but, on the contrary, it has a depressogenic effect.

Alcohol worsens symptoms of depression, especially in the long term. In the moment, here and now, when the soul is a little lousy, something is missing, there are negative emotions that you want to muffle, the person seems to be getting better. But, firstly, the problem will not go away, and secondly, the situation will worsen in the future.

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Patients who are prescribed antidepressants often ask if it is possible to drink at least on holidays. There are different antidepressants, with some it is absolutely impossible to combine alcohol, in other cases there are reservations. But I always advise limiting it.

Even if alcohol does not enter into complex interactions with drugs or their decay products, it will in any case affect the psycho-emotional state of a person.

The same with drugs — also because addictions can be combined with depression, which always complicates the treatment process.

Self-treatment. People with depression definitely shouldn’t self-medicate – this is also very common. For example, a friend is taking certain medications, and a person gets them without a prescription to try, and suddenly it will help too.

In addition, the biological interaction of antidepressants with other drugs that a person is taking is important. The doctor also takes this into account when prescribing therapy.

Even with a number of somatic diseases, some antidepressants should be prescribed with great caution. A person without special education will not understand this. Therapy should be prescribed only by a doctor.

Does depression always increase the risk of suicide?

Depression of mild or moderate severity is more common, in which there are no suicidal tendencies. But the risk is always present, because different factors influence a person. Suicidal behavior is not always associated with depression, it does not grow only from depressive experiences.

An important role is played by a suicidal history, that is, suicide attempts in the past. The psychiatrist at the appointment always asks questions about suicidal thoughts and intentions and takes this into account when prescribing therapy.

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What if a person wants to commit suicide but refuses to go to the doctor?

Any person who does not yet want to see a psychiatrist can be gently nudged. For example, talk about the features of treatment, positive results: “My friend applied, had the same symptoms, and now everything is gone.”

Law on Psychiatric Care

You can also advise a specialist, show someone’s page on social networks or a website – many doctors now have them. So a person will understand that these are not terrible psychiatrists from the movie “Shutter Island”, that now there are other images of doctors and psychiatry in general.

I would recommend trying to insist on seeing a doctor. And when there are already suicidal actions, it is worth seeking emergency psychiatric help.

What depression prevention measures do you use for yourself?

I try to keep my sleep and wake schedule. I had sleep problems, including due to stress. And I came up with some rules: I turn off all notifications on my phone from ten o’clock in the evening, set the night mode, dim the lights in the apartment. I also try not to watch TV shows in bed and not flip through the feed, I can read a book as much as possible.

Still trying to normalize my lifestyle in terms of work-life balance. I try to visit the theater or the Philharmonic once a month, because I like it. I also have a hobby: I am fond of oil painting. This is what energizes me and brings me pleasure.

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Remember

1. The biological component, psychological characteristics and the influence of the environment contribute to the development of depression.
2. To prevent depression, first of all, it is important to satisfy the basic needs of the body – in normal nutrition, healthy sleep, rest.
3. If the symptoms of depression, bad mood, anhedonia last longer than two weeks, you can talk about depression.
4. In atypical depression, persistently feeling unwell sometimes flashes in response to positive experiences. Also, with this variant of the disease, appetite may be increased and the need for sleep increased.
5. If symptoms of depression appear, it is better to immediately go to a psychiatrist, in case of doubt, he will send you to other specialists.
6. You can use the Beck Depression Scale to confirm your intention to see a doctor, to make sure a problem is likely.
7. The “gold standard” treatment for depression is a combination of medication and psychotherapy.
8. Depression can go away on its own, but no one knows how long the next episode will last. In addition, the disease greatly reduces the quality of life.
9. There are different types of depression. It can be once in a lifetime, or it can come back again and again.
10. A healthy lifestyle and avoiding alcohol is important for people with depression.
11. You should not prescribe antidepressants yourself, as there are different variants of the course of the disease, in addition, all drugs have side effects that need to be taken into account.
12. Depression does not always increase the risk of suicide. In addition, other factors can influence suicidal behavior.
13. If a person commits suicidal acts, he needs emergency psychiatric help.

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What is depression (questions for self-diagnosis, types, how to treat it)

In the life of each of us there are black stripes. Sometimes we are sad or worried about something, sometimes we are overtaken by illness, and it happens that we lose a loved one. There are many reasons for a depressed mood, but sooner or later the black stripe is replaced by a white one. But if you feel that your white streak is not coming, then check if you have depression.

Depression Self-Questionnaire (answer YES or NO)

1. Do you experience constant sadness, anxiety, longing?
2. Do you suffer from insomnia (especially waking up early) or drowsiness?
3. Has your appetite changed?
4. Have you lost interest in activities that you used to enjoy?
5. Are you constantly restless and irritable?
6. Do you have symptoms of physical ailment that do not respond to treatment (pain, indigestion)?
7. Do you experience constant difficulties in concentrating, remembering, making decisions?
8. Do you feel constant, causeless fatigue and loss of energy?
9. Do you experience a painful sense of guilt, your own worthlessness and hopelessness?
10. Do you have obsessive thoughts about death?

If you answered “YES” to 5 or more questions and you have been experiencing these symptoms for two or more weeks, you should see a specialist – a psychotherapist or psychiatrist. He will help establish the diagnosis and prescribe the appropriate treatment.

Depression is one of the most common diseases in the world. One in five women and one in ten men have experienced symptoms of depression in their lifetime. But, unfortunately, not every sick person receives timely and high-quality assistance.

Currently, the following types of depression are distinguished:

Classical is a state of mind characterized by feelings of sadness, depression, anxiety, loss of the ability to enjoy or experience joy from anything. This disorder is accompanied by a violation of sleep, appetite, causeless fatigue.

Reactive – when the development of a depressive state occurs after psychotraumatic situations that are relevant for a person.

Seasonal – the onset of depressive symptoms is associated with the onset of a “short” day.

Somatized – when physical symptoms come to the fore that cannot be treated (frequent headaches, a feeling of interruptions in the heart, pain in the abdomen. Usually these sensations are functional in nature and do not have organic changes in their basis, often causeless irritability and anxiety .

What causes depression? It can be hereditary predisposition, chronic stress, somatic diseases. However, whatever the cause, the biological basis is the same in most cases. The fact is that in the brain there are special substances called mediators. They are responsible for our emotional sphere and mental abilities.