Season 3, Episode 17: What Help Actually Looks Like – Starting Counselling for Depression
Depression is one of the most common mental health concerns — and also one of the most treatable. In this episode, we talk with psychologist Long Zhou about what depression really feels like, the signs it may be time to seek help, and how counselling can make a difference. We explore what to expect when starting counselling, why early support matters, and the small but powerful changes that can help people move forward.
From October 6–12, you can also take the free, confidential depression screening quiz at areyoufeelingok.com.
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Katherine Hurtig
Welcome to Living Fully. Each episode is a chance to talk about mental health in a way that's simple, honest, and helpful. We'll share stories, tips, and tools to help you feel supported and feel your best. I'm your host, Katherine Hurtig.
Depression. It's one of the most common mental health concerns, but the good news is it's very treatable. Today, we're talking about what depression actually feels like when it's time to reach out for help and what counselling for depression really looks like. I'm joined by psychologist Long Zhou to walk us through what support can look like and why reaching out sooner makes a difference.
From October 6th to 12th, take the free depression screening quiz at areyoufeelingok.com.
Okay today I’m here with Long Zhou a counsellor with Calgary Counselling Centre. Hi Long thanks so much for being here.
Long Zhou
Hi Katherine. Yeah glad to be here.
Katherine Hurtig
And you haven't been on the podcast before so tell our listeners who are you?
Long Zhou
Yeah my name is Long. I'm a registered psychologist and I’m a staff here at CCC I also did my residency here prior in 2023 and I’ve been staff for about a year.
Katherine Hurtig
Excellent. So we're talking about depression and what getting help for depression looks like. So very basic question, how would you describe what depression actually feels like day to day?
Long Zhou
First of all, depression can manifest differently for everyone due to its type, severity, and also a complex interplay of biological, emotional, psychological, and social factors.
Katherine Hurtig
Right.
Long Zhou
But in general, people with depression often experience persistent feelings of sadness, loss of interest, or fatigue. So those are common symptoms, but also there's also ranges of other emotional, psychological, and physical symptoms.
Katherine Hurtig
And when you say persistent, is that just a few days? Is it like, what's that time frame look like?
Long Zhou
To be diagnosed with a major depressive disorder, which is the most severe and common type of depression, the persistent feeling of sadness need to last for at least like two weeks' time.
Katherine Hurtig
Are there some more maybe subtle signs of depression that people might overlook, brush off, not really think that they have to do with depression?
Long Zhou
Some subtle signs would be, you know, social withdrawal, changes in their sleep. Either they'll sleep a lot or sleep less. Their appetite can also be affected. Other things would be like unexplained pains. There's other subtle signs, but those are the ones I can think of right now.
Katherine Hurtig
And I guess you really have to look at the whole picture because one of those things on their own doesn't necessarily mean, oh, I'm depressed. Like if my appetite changes, you kind of got to look at everything going on, right?
Long Zhou
Yeah, for sure. There's a diagnostic manuals, right, to assess whether you qualify for the diagnostic criteria for depression.
Katherine Hurtig
Yeah. And how does depression, you know, how would it affect my motivation, energy, ability to function, that kind of thing?
Long Zhou
Depression can really zap people's, you know, motivation, energy. So it's very common people feel less motivated to do things and also find things that normally enjoyable. And also because their sleep is also affected, that further affects their energy level.
Katherine Hurtig
For sure. Yeah. So if someone's experiencing these things, you know, been feeling sad for a while, sleeping a lot more, kind of withdrawing from friends. When would it be time to reach out for help?
Long Zhou
Okay. Like mentioned earlier, if the symptom lasts more than two weeks and it's not getting better, that means that, you know, help is needed. If you can't do it, it's not improving on its own or if you have tried. It's always a good idea to reach out for support, to find out like the underlying causes. The first step is visit your doctor and explain your symptoms to see if there's any underlying medical conditions that may contribute to the depression.
Katherine Hurtig
Yeah, that's a good point.
Long Zhou
And when you're in counselling, we'll figure out what are some contributing factors, underlying issues. And also we're going to learn coping strategies to help the symptoms.
Katherine Hurtig
What would you say to someone who's unsure if what they're feeling is, quote unquote, serious enough to need counselling?
Long Zhou
You know, counselling is not just for a crisis, right? Even when you feel off, you're not like yourself, counselling is always there to support. it's actually recommended to reach out sooner than delaying because symptoms can get worse over time. It's just like you're having an illness. You don't want to wait until symptoms get a lot worse before you visit the doctor.
Katherine Hurtig
Right, yeah.
Long Zhou
So that early detection and intervention is always recommended.
Katherine Hurtig
In your work with clients, what have you found are some common thoughts or fears that might keep people from seeking support if they're struggling?
Long Zhou
Some common barriers would be the social stigma, right? The fear of being stigmatized as being weak, right? Also, there can be financial barriers as well. Not everyone can afford counselling. That's why actually at our centre, we're providing that sliding scale for people who have financial difficulties. Also, there are people think that they can tough it out. Or for some people, they don't know their help is available. Maybe they don't know what counselling entails.
Katherine Hurtig
And so let's talk about what this help actually looks like. So what happens when someone starts counselling for depression? What kinds of things are covered? What kinds of tools are used? That kind of thing.
Long Zhou
So at start, we usually have like initial assessment to understand, to explore what contributes to depression, right? The case, the perpetuating factors. And after getting to know your history, your medical conditions, family history, then we'll come up with a treatment plan.
Katherine Hurtig
Okay.
Long Zhou
That is tailored to your individual circumstances. Then in the first session, we'll come up with a goal for you to work towards.
Katherine Hurtig
Okay. In my own experience, because I've had counselling before, how specific does that goal need to be? Like, is the goal of I just want to feel better? Is that enough? Or do we need to dive a little deeper?
Long Zhou
We want to be very specific, right? With depression, people want to feel better, right? Feel happier. But how can we operationalize that? And what does it look like, right? When you feel better, what will we be doing differently? So we want to make sure the goal is very specific, measurable, and achievable.
Katherine Hurtig
Okay. So if a client doesn't know the goal beyond that feeling better, you're able to work with them to help flesh that out a bit?
Long Zhou
Definitely. Well, first find out, you know, what depression looks like for you. For example, how your life day-to-day functioning has been negatively impacted.
Katherine Hurtig
Okay.
Long Zhou
And when you're not depressed, what does your day look like? And we try to, you know, bring you back to that baseline functioning.
Katherine Hurtig
Yeah. And you had mentioned earlier, like coping skills. What kinds of skills are you helping clients build up and add to their toolbox?
Long Zhou
It really depends on the therapeutic models that a counsellor is practiced. Like for me, my main modality is Cognitive Behavioural Therapy. So we would use techniques such as behavioral activation.
Katherine Hurtig
What is that?
Long Zhou
That is, you know, when people feel depressed, they usually don't want to do things, right? The less they do, the more depressed they feel. So they got themselves into that vicious cycle. So behavioural activation is actually to break that cycle. So start to do more things. Do things that you find meaningful, you find enjoyable, and the more you do, the better you will feel and you get that slow rolling.
Katherine Hurtig
And you mentioned counselling modalities. I'm aware of CBT, Cognitive Behavioural Therapy. Are there other modalities that are effective in helping with depression?
Long Zhou
Oh, for sure. There's many, many modalities out there. For example, there's DBT, Dialectic Behavioural Therapy. There's ACT, stands for Acceptance and Commitment Therapy. There's a brief Solution Focused Therapy.
Katherine Hurtig
And so how does as a counsellor, how do you go about which of these modalities is going to be right for each particular client?
Long Zhou
That's why it's important to understand clients history and also what has worked or hasn't worked for them before. And then we're going to create that treatment plan collaboratively. And we're going to check with the client whether you find that helpful or not. For example, if some strategies from CBT that clients find not very useful, then we may pull from other therapeutic models to try. So it's really individualized plan in the end.
Katherine Hurtig
I know. I think it's easy to kind of think it's a one size fits all. You come in, you get the same kind of therapy as the next person, but we are so different. So it's got to be kind of tailored.
Long Zhou
For sure. That's why like at CCC, we have many staffs and students right they practice various therapeutic models and sometimes if we find we're struggling we're not making any progress we'll ask clients permission to make a video recording so we can present it to our team and create a and have a consult and come up with a more effective treatment plan for them.
Katherine Hurtig
Yeah that's good to know that could be really helpful like there's a whole team that can be helping
Long Zhou
Definitely.
Katherine Hurtig
Yeah. So if I’ve never been to counselling before if I’m dealing with depression, what would you say to me in terms of the question of like, how does talking to a counsellor help?
Long Zhou
When you talk to a counsellor, you know, first of all, this is going to be a very safe, non-judgmental, and supportive environment for you to share your struggles, right, your challenges. And the counsellor can offer that guidance, help you to identify triggers, and also learn helpful emotional regulation skills or coping strategies. It's not just a talk. We also try the skills that we learned or concepts you find helpful so you can actually practice in your in real life to find if it's helpful. So there's usually a homework assigned at the end, homework that we created together that you're willing to give a try. See if that makes any make a real difference in your day-to-day life.
Katherine Hurtig
Right. That's a big part of it, hey, because like it's not just a conversation in the room, it's practices that you have to build into your life.
Long Zhou
For sure, because the time we spend together is really short, just 50 minutes, right? The hard work and effort is actually on you, on the client, to really give a try and save that, make differences. If not, then we'll come back and we'll revise or try different strategies until we find the right one for you.
Katherine Hurtig
And this homework, you know, what might be a few examples of homework that might be given to someone dealing with depression?
Long Zhou
For example, we made activity scheduling. So we can figure out typical day going to be like, what do you think might be helpful if you do that in a day? Things like what time you're going to get up, what are you going to eat, then what are you going to do afterwards to really try to get you become active. So we're going to schedule out the day so you can try that out, see if that's going to change how you feel and how you think about yourself.
Katherine Hurtig
Does that routine, kind of knowing what to expect, can that be helpful?
Long Zhou
Yeah, for sure. As a human being, actually, we function best when there is a routine. And usually when we feel depressed, we're out of the routine and we just become almost like immobilized. That's why we want to get back to the routine and do the things that once actually worked for you.
Katherine Hurtig
And what role does the relationship with your counsellor play? So a client coming in, that connection between them and the counsellor, how does that help?
Long Zhou
Actually, that therapeutic relationship, we call it the alliance, plays a huge role. Actually, studies have shown that therapeutic alliance, that relationship plays a bigger role than specific techniques.
Katherine Hurtig
Really?
Long Zhou
Yes. Having that trust. And when clients feel heard, understood, seen, and safe, they'll be more open to share and more willing to try. So that relationship is really fundamental.
Katherine Hurtig
So as a counsellor, how do you build that relationship and that trust and that comfortableness for someone to be vulnerable with you like that?
Long Zhou
Usually while we explain to clients, this is a safe and non-judgmental space. And also it's confidential. And we do it through active listening and really put ourselves into clients' situation and see from their perspective where they're struggling. So that active listening and perspective taking is the key to build that relationship.
Katherine Hurtig
Yeah. Could you give some examples of maybe some small changes people might start to notice once they've begun counselling?
Long Zhou
Yeah, some small changes is that we feel a little more motivated to do things, to reach out for support. And they may feel just a little more hopeful, which is very important.
Katherine Hurtig
That's huge, yeah.
Long Zhou
Other things, maybe if they really work on building that routine and being more behaviorally active, let's say if they engage in some exercise or even small movement, just go out for a walk, and that can have a huge health implication. They may have a better sleep at night, and that kind leads to other positive changes in life.
Katherine Hurtig
Yeah, how do those basic aspects of our health, like sleep and exercise and eating right, how does that impact depression?
Long Zhou
Right, definitely can help very much with depression because when we have a quality sleep, we feel less irritable. For some people, depression can show up as feel irritable and more anxious, right? But having a better sleep that can help regulate anxiety and the mood. Also improve our concentration and memory as well. And eating, same thing if we eat balanced, nutritious meal. It gives us the energy and also makes us feel better when we eat well. Same with exercise. When we exercise, our body produces that natural feeling better chemical, the dopamine, the endorphins. So those are naturally painkiller and actually makes us improve our mood as well.
Katherine Hurtig
Like, would you say that that's where someone should start? If they're feeling depressed, kind of go back to the basics and kind of assess, like, how am I sleeping? You know, and making sure that's in check and making time for exercise and that kind of thing.
Long Zhou
Yeah, definitely. That's actually during the first session when we do that initial assessment, understanding client situation. Those are the areas that we actually assess is how is your sleep quality, your eating, any physical exercises, activities, or their social life as well. So those basics, we want to make sure they're in check because they play a huge role in terms of the emotion regulation.
Katherine Hurtig
In your experience working with clients struggling with depression, what are the things they typically feel the hardest things to overcome? Is it, you know, getting out and being social? Is it changing how they feel about themselves? I mean, that's a really broad question, I know. But what are some trends that you see?
Long Zhou
Right, right. Usually people with depression, they have negative thought patterns. So one of the things we're doing in counselling actually is to try to identify and also modify those negative that may perpetuate depression.
Katherine Hurtig
Okay.
Long Zhou
And try to think more positively, more healthily. Another thing would be sometimes that sense of a hopelessness. That's a thing because when people are severely depressed, not only they have a sense of like low self-esteem, worthlessness, but also thoughts of self-harm and suicide. So I would say instilling that hope in clients is very important, knowing that depression is very normal. A lot of people experience that at some point of their life. Not only it's normal, but also it is treatable.
Katherine Hurtig
Yeah, it's temporary. It's temporary. Yeah, that was something huge that really that helped me is that is really hanging on to that perspective. Like this feeling, even if it doesn't seem that way right now, it is temporary and it will pass.
Long Zhou
Yeah, usually a metaphor I use with my client is the weather, right? You know, sometimes it's sunny, sometimes it's cloudy, but it's just like our emotion. It changes over time. Sometimes even within a day, you'll see the weather shift, right? But with the depression, it's actually a little different. But depression is different from sadness. Sadness is actually a very normal emotion, right? Depression is actually a clinical diagnosed as a mood disorder. So that actually needs medication or therapy intervention in order for you to overcome it. But that being said, it is treatable, right? Even we have a storm for, let's say, it's snowing for two weeks or more, or even for six months. But eventually the sun will come out.
Katherine Hurtig
That's right.
Long Zhou
We have a summer time.
Katherine Hurtig
And I can imagine, you know, anyone coming in dealing with depression, they want to feel better immediately. So how do you how do you go about working with clients when the progress kind of feels slow for them? You know, how do people stay hopeful and motivated in those moments?
Long Zhou
Yeah, it's important to have to set a realistic expectation, knowing that improvement, that progress is not linear. It takes time. It's important to be patient and be consistent. Really working on the things that you know will be helpful. Another thing earlier you mentioned about, oh, I just don't feel like doing it. But if you know logically, if you know if I get up, go out for a walk, reach out to friends, eat healthy, improve my sleep, things will get better and have that belief and really practice it. Over time, you should see the improvement.
Katherine Hurtig
Yeah, it's a hard thing, that patience, but it's important to keep going. One last question, Long. What's just one thing that you wish everyone knew about getting help for depression?
Long Zhou
So really, like I mentioned earlier, depression, it is normal and it is treatable and it's nothing to be ashamed of. Like we all get to experience at some point of our life. So when you feel like you're off and really reach out for help and the earlier, the better. If you have any medical conditions, as soon as you see the symptoms, you want to visit a doctor and prevent it from getting worse. Same thing with our mental health.
Katherine Hurtig
Yeah, for sure. we really need to start thinking of it that way. Thank you so much Long.
Long Zhou
You're welcome.
Katherine Hurtig
If you've been feeling low tired or just not like yourself you're not alone from October 6th to 12th head to areyoufeelingok.com and take a free confidential quiz it's a simple way to check in on your mental health it only takes a few minutes and can help point you toward the support you need brought to you by Calgary Counselling Centre and Counselling Alberta.
Tune in on October 10 for our next episode. We're re-releasing a conversation we had last year with Calgary Counselling Centre's Associate Director of Counselling, Sarah Rosenfeld. She talks about one of the key factors to overcoming depression, social connection. You'll also hear from one of Calgary Counselling Centre's clients and learn how counselling helped her manage her depression.
Katherine Hurtig
Yeah, let’s talk about group. What was the name of it?
Maddi
Take Charge of Your Life.
Katherine Hurtig
And how did you find that? What was helpful?
Maddi
Honestly, it was just being in that group environment and just being with a bunch of other people that were so vulnerable and willing to get down to the root of their issues and be able to discuss and I really connected with a lot of other people who are kind of going through the same thing or having some of the same issues like borderline personality disorder is also related to attachment issues.
Katherine Hurtig
You've been listening to Living Fully, a Calgary Counselling Centre podcast. Thank you for tuning in. This episode was produced by Luiza Campos, Manuel Montano, Jenna Forbes, and by me, Katherine Hurtig. A special thanks to Long Zhou. To stay up to date on our latest episodes, be sure to subscribe. We're available in your favourite podcast app. Living Fully is a production of Calgary Counselling Centre and recorded in Calgary on Treaty 7 territory. Living Fully podcast is not a substitute or alternative for professional care or treatment. Calgary Counselling Center and Counselling Alberta provide effective counselling to anyone in Alberta with no wait list and no financial barriers. Find us online at calgarycounselling.com and counsellingalberta.com. For help across Canada and the United States, call 211. If you are outside of Canada and the U.S., seek help from your general medical practitioner.