Cure or Control?


Cure or Control?

Depression as a Chronic Condition

By Margaret Wehrenberg

November/December 2014


Martha is terminating therapy again. This woman, who’s dealt with depression throughout her life, has been my client on and off for 10 years. Her pattern has been to work with me for a year or more and then take a break as she feels better. Then life will throw something at her that she can’t quite manage without despair—her beloved dog dies, her spouse is diagnosed with cancer, her finances take a plunge—and she’ll be back to find ways to get out of the pit she’s fallen into.

She’s not the only one with this pattern. Ric has been back three times. He has generalized anxiety disorder, and over the course of seven years he’s returned to therapy as life has hit him with overwhelming changes. The first time was when he and his new wife had bought a house and he was frantic that he’d made an irreparable mistake. Then they had a baby. Then the boss at his new job started asking him to cut corners in ways that Ric thought were unethical. The worry that plagued him would be unmanageable, but each time in therapy he learned more about how to make it abate.

As they return for another round of couples counseling, Jill and Mike tell people that working with me keeps them “maintaining.” But they’ve been in and out of treatment about four times since Mike needed help with addiction eight years ago. This time, they’re back because they can’t resolve their conflicts parenting their first adolescent. But they believe that together we’ll chart a course that will put them back…

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