From the author: Having fallen ill, each of us builds hypotheses - why this happened and where to look for help, how to behave in new circumstances and what the prognosis may be. Even if not always consciously, but within ourselves we decide whether to fight or give up, hope or lose faith, follow the traditional path or look for alternative methods of treatment. The internal picture of the disease is the totality of what we think, feel, know and fantasize about our illness. Even with the same diagnosis, this picture will vary from person to person depending on their life experiences, level of education, personality type, and a variety of other factors. But, what is most curious, the internal picture of the disease can help or hinder the healing process. Lately I have had quite a few clients come to me with symptoms of depression. And, despite the uniqueness of each internal picture of the disease in this disorder, for myself I identify four main options. The first is the triumph of biology. Its owners easily use the terms “serotonin”, “dopamine”, “cortisol” and are convinced that their depression has nothing to do with them personally. A psychiatrist usually sends adherents of the biological theory to a psychologist, and they come, wondering how I can influence their disturbed biochemistry with my conversations. It is not difficult to guess that in this case, at the first stage of therapy, the main task becomes “appropriating” the disease, recognizing it as a part of oneself, even if not the most desirable and rosy one. After all, we can only influence what belongs to us (and influence successfully!). And antidepressants, no matter how you look at them, stop working with the last dose, after which the carriage predictably turns into a pumpkin. The second option is full of the subjunctive mood. Nothing would have happened if my teenage son hadn’t been nervous, my husband hadn’t lost his job, and lack of money or a critical mother-in-law had gotten to him. It must be said that all of the above can indeed provoke or maintain depression: each of us has vulnerabilities, and if the stressor hits the target, then it’s hard. And, by the way, part of the therapeutic work is always aimed at solving external problems - professional, family, medical. A psychologist helps to release the necessary resources and develop suitable strategies, draw up a realistic plan and provide the necessary support. And yet, the underlying causes of most depression are not circumstances or other people, but strictly internal preconditions that accumulate over the years. Therefore, to get rid of symptoms it is not at all necessary to bend the world to you. In the third group, denial reigns. No, it’s not depression, I’m just unhinged, and I need to shake myself up well (get some sleep, take on a new project so that I don’t have time for all sorts of nonsense). Perhaps I have something wrong with my heart or a viral disease, or at worst, chronic fatigue. But mentally I’m completely fine, because depression is for weaklings, and I’m a strong person! As a rule, such people reach a psychologist when they are already on the edge. Then, when the strongest coffee does not help you get out of bed, when your memory fails, and your thinking becomes clumsy and viscous, and when a huge, suffocating fear rolls in - what has become of me? And even after turning to a psychologist, such clients resist the thought for a long time, that they have nothing to blame themselves for and that absolutely every person in this world can get sick - from the president of a transnational company to music teachers. By the way, working with them often reveals a long family trace of the extremely valuable idea “I have no right to weaknesses.” Finally, the internal picture of the fourth group is dominated by a clear understanding: I am sick, I need help and I will accept it. Who do you think I can help most quickly??