The Impact of Depression on the Client Carer Relationship

Depression is so often a term thrown around, it has somehow crept its way into our everyday vernacular yet it still remains so stigmatised in our society. We so flippantly throw around the term but yet do we ever stop to think about what it actually means for a number of people with depression? Not only as members of society but as carers, can we truly comprehend the impact that a client’s depression may have on the rapport and relationship we are able to develop.

I hadn’t really devoted a lot of thought into this unique client carer paradigm - that was until I was able to reflect on my own experience with a client. As a student social worker, I had never truly encountered depression or observed depression from a carer’s perspective. Is there a difference? Did my observations and behaviour somehow shift because I was more conscious of my social work lens and the inherent power social workers possess?

From my experience working with an elderly client who has depression, I was truly awoken to the complexity of late life depression.  What I found complex, which is so common with late-life depression is that the depression itself was located and compounded within a web of additional physical and medical illnesses. Which ultimately made it more difficult for me to assess the reasoning behind some of my client’s actions. For instance, whilst their limited physical mobility was the consequence of several factors, I felt as though it was only truly intensified by their depression. Thus a crucial component of our relationship was nurturing their confidence and self-esteem.

This proposed ‘idea’ or rather assumption of how their depression manifested without a doubt impacted on not only the way I responded and interacted with the client, but how we developed a rapport and a relationship. Upon reflecting on my role as their support worker, I can say that their depression impacted on the way I interacted with them, in the sense that it meant:

• I spent a lot of time trying to decipher what impacted upon each decision and behaviour.

• It took a lot more encouragement, reassurance and positive reinforcement.

• I was more conscious of how I asked the client to do things, reframing and changing the extent of what I was asking.  

• Just sitting, talking and being there. Even if it was talking about something that may seem so insignificant, in a way providing that form of distraction.

• But also sitting in silence and tackling my own un-comfortability with silence and recognising the importance of being present with the client in those moments.

• Actively listening. To what was and also what wasn’t being said.

• Being mindful of what was said, being there to listen when more intimate feelings and thoughts were disclosed that may relate to the clients depression, validating those feelings and thoughts as something which are very real for the client without perpetuating them.

• Delving deeper but being aware of boundaries. Seeking out what lies behind those depressive thoughts, whilst navigating that relationship of give and take.

Whilst these were all aspects that played a major role within our relationship as client and carer, I recognise this relationship as unique. However, the importance lies in recognising that depression can have a major impact on the ability to build rapport and the nature of the relationship that develops. Personally my takeaway from this initial experience has been that it’s the little, sometimes insignificant seeming things that can make all the difference. As well as cementing for me that distraction is not lost on someone with depression. I can only hope as a student that my thoughts and knowledge around the impact of depression on the client carer relationship will continue to develop with the more experience I gain.