Using the DSM manual, a combination of symptoms are traditionally used to determine whether you have a mental health disorder, including anxiety and depression disorders. The intention is to classify your responses so as to determine how best to be helpful with what is wrong and to determine what type of expertise will be most helpful. The use of the DSM to classify and treat individuals is so ingrained in the mental health field that no other option is considered.
Nevertheless, serious concerns with the traditional approach have been expressed over many years. One such criticism is that the context in which these symptoms are felt is largely ignored, or only used to confirm the conclusions already reached. Those so called anxiety and depression symptoms can be seen as responses to a variety of challenges individuals experience in their day to day life. Shouting at the top of your lungs in the middle of a war zone is very different from the same response while relaxing at a pool. Allan Wade and his collaborators have written extensively about the use of traditional therapy and contrasting assumptions in cases of violence against women (See the Centre for Response-Based Practice).
In my experience, one of the overarching feelings of anxious or depressed individuals is their feeling of powerlessness to do something about what they are feeling, and the strong suspicion that nobody else except other sufferers can possibly understand what they are going through. Even if they have a healthy fear of strong medications, pharmaceutical solutions often seem the only reasonable option. Unfortunately, for many the relief experienced is temporary because the body adjusts to the medication and the side effects of these strong drugs become major additional impediments.
Because Individuals with severe anxiety and depression responses often have little hope that anything can be of help to them, they are very reluctant to believe the information that might be useful to them. My approach is to clarify their perception of their current situation and their expectations of their future in terms of the time it will take for the anxiety or depression to lift, and how this can be brought about. In this process, many aspects of what is going on are clarified, major influences and their power are revealed, and alternative ways of seeing become available.
Difficulties can be classified as follows:
MAJOR LIFE CRISES
Loss and Grief
Divorce or separation
Unexpected life changes
Abuse
Trauma
Anxiety and Depression
Sleeplessness
DIFFICULTIES AT HOME
Anger/Aggression
Rejection
Arguing with a loved one
Parenting Challenges
Child and Youth counselling
Substance abuse issues
Non-drug related addictions
DIFFICULTIES AT WORK
Employee/Supervision conflict
Job instability
Work related stress
Critical incident debriefing