Depression: Like Walking Through Setting Concrete

I still remember my naivety when asking a client, “Does depression feel like walking through treacle?” With a look of slight weariness, he replied “No, it doesn’t. It feels like walking through setting concrete.” The analogy he used captures the essence of depression - an overwhelming sense of heaviness and resistance that makes even the simplest of tasks feel impossible. Understanding the nature of this struggle – and the need to fight against it - is central to effective therapy.

Understanding the Symptoms of Depression

Depression is condition that can show itself in various ways - from decompensated, sad presentations - to excessive irritability - to those who put on a good mask but feel more and more distanced from others as they build a fort around themselves, to the extent that no one can see the struggle going on behind. Recognising the different symptoms of depression and the way in which they can present is crucial for recognising the condition and seeking help. Key symptoms of depression can include:

• Persistent feelings of sadness, helplessness and hopelessness

• Loss of interest or pleasure in activities that you once enjoyed – including socialising

• Fatigue and decreased energy levels

• Difficulty concentrating or making decisions

• Changes in appetite or weight (either loss or gain)

• Sleep disturbances, such as insomnia or excessive sleeping

• Irritability or restlessness; or increasing discontentedness and judgementalness

• Physical symptoms, such as headaches or digestive problems

• Suicidal thoughts or self-harm 

Each individual’s experience of depression is unique, which is why a tailored approach to treatment is essential.

Therapies That Can Help

As therapists, we often draw on techniques from different therapeutic models to help clients manage and overcome depression. These approaches include:

1. Schema-Focused Therapy

Schema-focused therapy focuses on deep-rooted beliefs that contribute to depression, that are formed in childhood. Like the foundations of a house, they cause problems if they’re wonky. So, for example, if we’re bullied as a child, we tend to believe that we’re “not good enough”, rather than that the bullies lack empathy. By understanding these negative schemas,  we can begin to understand why we behave as we do when our core beliefs are activated. From there, we can learn alternative ways to function and feel.

2. Compassion-Focused Therapy (CFT) 

Compassion-focused therapy focuses on way to combat harsh self-criticism and feelings of shame. For many, depression is compounded by an internal voice that criticises and judges. CFT teaches clients to nurture a kinder, more supportive inner dialogue. This approach is especially effective for those who struggle with self-esteem and self-acceptance.

3. Acceptance and Commitment Therapy (ACT) 

ACT encourages individuals to accept their thoughts and feelings, rather than fighting them. By doing this, clients can learn to live with painful emotions while pursuing values-driven actions. ACT helps allow clients to acknowledge their struggles without being overwhelmed by them. This can be especially helpful when depression feels like an immovable force. 

4. Cognitive Behavioural Therapy (CBT)

CBT is one of the most widely used and evidence-based treatments for depression. It involves identifying and challenging automatic negative thought patterns that contribute to depressive symptoms. By challenging these thoughts and developing more helping ways of thinking, we can feel and behave very differently.

The Benefits of a Balanced Lifestyle

While therapy is central to managing depression, lifestyle changes play a central role in improving mood. So:

• Sleep: Establishing a consistent sleep schedule can reduce fatigue, improving both mood and cognitive function.

• Diet: A balanced diet inevitably contributes to stable energy levels and that helps our mood.

• Exercise: Physical activity stimulates the production of endorphins, the brain’s natural mood lifters. Even short walks can make a significant difference, gradually chipping away at the metaphorical concrete of depression.

Learning from Depression

While depression is undeniably painful, it can also be a teacher. As described in Sunbathing in the Rain, the book by Gwyneth Lewis, depression often reveals uncomfortable truths about how we live our lives. For instance, chronic overworking can mask deeper issues of inadequacy, leading to burnout and eventual depression. Recognising these patterns is essential for preventing future episodes.

By understanding the roots of our depression, we can change our relationship with work, relationships, and with our own expectations - helping to ensure that we do not slip back into the concrete.

Conclusion

Depression can feel like you’re walking through setting concrete, leaving you feeling both helpless and hopeless. Unfortunately, the sensation of walking through setting concrete does not dissipate overnight. However, by combining therapy, lifestyle adjustments, and self-awareness, step by step, it is possible to walk out of the concrete and into a life where you can walk more freely  again.