What are some considerations for massage therapists when working with clients experiencing depression?

When working with clients who experience depression, massage therapists should be mindful of the complexities involved with mood disorders. Depression is a biopsychosocial condition involving disruptions in neurotransmitters (serotonin, norepinephrine, dopamine) and an overactive hypothalamus-pituitary-adrenal (HPA) axis, resulting in a constant state of stress. Clients may exhibit symptoms such as a sad, empty feeling, loss of pleasure, irritability, changes in sleeping or eating habits, decreased concentration, and even persistent pain.

The physical risks of providing massage to clients with depression are generally low, but therapists need to be sensitive to the client’s boundaries. The therapist-client relationship may be affected by the client’s mood disorder, so maintaining clear, healthy communication and honoring client priorities is crucial. Massage therapy can help improve mood, self-efficacy, and anxiety levels. It's important, however, that therapists urge clients not to alter their prescribed medication regimen based solely on their massage experience, as changes in medication should be managed by their primary healthcare provider.