This in-depth article is dedicated to thoroughly explore and define the question of what is depression?
- Some say depression is an illness.
- Some say it is an emotion.
- Others believe it is merely an attitude or life view.
- Some doctors say medications are the only true cure.
- Some say psychotherapy that teaches you to adjust your self-perceptions is the best solution.
- Others believe that there is really no cure at all.
So, is depression actually a game of multiple choice where you pick the definition that best suits your purposes?
Sometimes it would seem that way: scientists, doctors, counsellors, and even a few self-declared experts are all promoting their ideas and claiming them to be fact.
However, despite these challenges to verbally capture what is depression we will make a concerted here to give you:
- A definition of depression that distinguishes ‘normal’ depression from clinical depression.
- A list of 8 types of depression.
- A list of depression symptoms.
- Information on depression symptoms within certain groups of people: women and depression, depression in men, depression in children, depression in teens and depression in the elderly.
- A scientifically based discussion of what causes depression.
- Information on diagnosing depression along with a list of potential treatments and cures for depression.
- A list of self help advice of how you can help yourself in the everyday battle with depression.
The Truth Is, Depression Is Very Complex
In fact, no one really completely understands how depression works or why it causes particular symptoms.
A treatment that is effective for one person may not necessarily work for another, and that can be very frustrating to the clinically depressed.
And, although several causes have been proposed, there is no definitive proof.
For every study that supports a particular theory of what is depression, there seems to be one that refutes its findings.
Some arguments are just plain silly and obviously come from the uneducated ramblings of someone whose life has never been touched by depression. However, others seem to have enough scientific backing to at least deserve some consideration.
Depression is Difficult to Box
- Symptoms Vary From Person to Person
But, I suppose that a diversity of ideas as to what is depression is not really surprising considering that depression includes such symptoms as ‘difficulty sleeping’ or ‘sleeping too much’, ‘weight loss’ or ‘weight gain’, ‘agitation’ or ‘lethargy’.
It would be difficult to hypothesize that the same chemical, environmental, or genetic factors that cause someone to be jittery also contribute to a lack of energy.
Thus, the dichotomy of depression!
Depression often makes no sense – yet it is, it clearly exists.
And, for those suffering from it, it can be powerful, controlling, and overwhelming.
Depression Is Like Being in a Dark Tunnel
- But Without the Light at the End of It!
Holding your head up high, putting on a happy face, and pretending all is right in the world will not send it running.
It is not about keeping the right attitude so you can get through a bad day, or even a challenging period – depression is about surviving in a darkness that completely changes your reality.
So what is depression? Well, depression is about finding ways to fight that darkness, and win!
Elizabeth Wurtzel, author of Prozac Nation, states, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key.”
So, telling a clinically depressed person to “shake it off”, “press on”, and keep a “the sun will come up tomorrow” attitude is like telling someone with pneumonia that they can clear their lungs by imagining themselves well, or asking a blind person to drive a car by pretending they can see.
Major depression is not a sign of weakness, it is not a ploy for attention or sympathy, it is not an act of self pity, and you cannot simply “will” it away.
What is depression then? How can we define it?
First of all, it is important to understand that depression is a very serious illness – one that usually requires professional or medical intervention.
Without some sort of treatment, most people will not recover.
Some people resist labelling it a “mental disorder” because there are so many physiological factors involved.
Similarly, others do not like referring to it as a “medical condition” since there seems to be both psychological and emotional underpinnings.
Perhaps the most accurate description would be to call depression an “affective disorder”, a definition that allows for the combination of biological, behavioral, social, and psychological factors.
Characteristics of Major Depression
- Natural Depression Is Caused by Events, Clinical Depression Becomes a Way of Life
Major depression is characterized by a combination of symptoms that adversely impact a person’s ability to work, sleep, eat, enjoy once-pleasurable activities, and carry out the functions of everyday life.
In some cases, it can be continuous, but most of the time it comes in episodes. Some people may only ever experience one episode, while others can battle the condition their entire lives.
Unless major depression has touched your life, or your home, in some way, it can be really difficult to understand that the depressed person sees the world differently from the healthy person.
Neil R. Carlson, in his book Foundations of Physiological Psychology describes the condition as follows:
“The emotional state of most of us reflects what is happening to us: Our feelings are tied to events in the real world, and they are usually the result of reasonable assessments of the importance these events have for our lives. But for some people affect becomes divorced from reality. These people have feelings of extreme elation (mania) or despair (depression) that are not justified by events in their lives. For example, depression that accompanies the loss of a loved one is normal, but depression that becomes a way of life that will not respond to the sympathetic effort of friends or relatives or even to psychotherapy, is pathological. Almost everyone experiences some depression from time to time, mostly caused by events that sadden us. Occasionally, these periods of depression become severe enough that the person can profit from professional assistance. [But] the major affective disorders are quite different.” (page 477).
Global Demographic Facts about Depression
So what is depression on a seen through a global lens?
According to the World Health Organization, depression affects about 121 million people worldwide and contributes to approximately 850,000 deaths by suicide each year.
Depression is one of the leading causes of disability and the “fourth leading contributor to the global burden of disease” (WHO).
Additionally, the World Health Organization projects that, by the year 2020, depression will be second in the rankings of Disability Adjusted Life Years (DALYs). In fact, it has already reached this ranking in the 15-44 age group for both men and women.
Recent medical studies have shown that depression has a greater affect on normal functioning than conditions such as arthritis, hypertension, or lung disease.
Depression is often difficult to diagnose, and even treat, because there are so many different types with a variety of symptoms.
And, often one type of depression can evolve into another, especially if treatment is not received.
1. Major Depression.
Also known as major depressive disorder, this is the most common type of depressive illness. Major depression is characterized by extreme sadness, a loss of interest in once-pleasurable activities, and an inability to carry out day-to-day tasks due to a combination of other symptoms.
2. Psychotic Depression.
A person is diagnosed with psychotic depression when they experience symptoms of major depression accompanied by some form of psychosis such as hallucinations or delusions.
3. Postpartum Depression.
This is much more serious than the common “baby blues” and is estimated to affect 10-15% of women following the birth of a child.
Since it is marked by the same symptoms as major depression, many doctors and researchers believe that it may actually be a variant of major depression.
If untreated, postpartum depression can last for several months, or even years, and may occasionally develop into a condition referred to as postpartum psychosis, which includes hallucinations, delusions, and suicidal thoughts. “….yet many women fail to seek help. Instead, they typically blame themselves for feeling sad at at time when they are expected to be happy” (American Medical Association, Essential Guide to Depresssion, page 36).
4. Dysthymic Disorder or Dysthymia.
This type of depression is characterized by long-term chronic symptoms (typically lasting 2 years or longer) that may not be severe enough to be completely disabling, but can prevent a person from feeling well or functioning normally.
Those with dysthymia may also experience episodes of major depression. The combination of the two types of depression is sometimes referred to as Double Depression.
5. Premenstrual Dysphoric Disorder.
This is a cyclic illness that affects 3-5% of menstruating women.
Typically, a woman will feel deep depression or irritability for a couple of weeks before or during menstruation, with these symptoms being much too severe to be mistaken for normal PMS.
6. Seasonal Affective Disorder.
This type of depression occurs only at certain times of year, usually appearing with the onset of winter; although, some people experience summer depression.
Since the symptoms are typically milder, it can usually be treated with short term antidepressants or Light Therapy.
However, seasonal affective disorder can sometimes be very serious, especially in northern communities with long winters and shorter days.
7. Minor Depression.
Minor depression is characterized by symptoms that last for two weeks or longer but do not meet all the criteria of major depression.
Without treatment, minor depression can evolve into major depressive disorder.
8. Bipolar Depression.
Although this is often considered a separate disorder, the depressive state experienced by bipolar patients has many of the same symptoms as unipolar disorder – or depression.
Rather than remaining at one pole (depression), patients will alternate between moods of depression and mania, although some types of bipolar disorder involve only the mania phase.
A Diagnosis Is Often a Combination of Symptoms
Depression is not always easy to diagnose accurately, in part because it has so many symptoms – often conflicting – that can range in severity, making it difficult to create a profile of the ‘typical’ depressive.
In fact, to make matters even more confusing, some people are even said to have ‘atypical’ depression.
In other words, researchers are often as confused as patients as to what is depression.
They provide a list of symptoms and then qualify this list by saying that a person who experiences some of these symptoms does not necessarily have depression, and the absence of these symptoms – at least in a severe or obvious way – does not mean that depression doesn’t exist.
A diagnosis of depression really comes down to a combination of the following symptoms as well as how they affect an individual’s life and overall well-being.
Remember, major depression affects a person’s family, relationships, work/school life, and physical health.
Here is a list of depression symptoms:
1. Prevailing feelings of sadness, anxiety, or a general “emptiness”.
No joy, no purpose, and no vision for the future. These feelings may also be interspersed with irritability.
2. Pessimistic attitude.
The depressed person may seem jaded, or express feelings of hopelessness. Why try, because it doesn’t make a difference.
3. Strong feelings of guilt, worthlessness, helplessness, or self-loathing.
Depressed people often blame themselves for the negative things in their lives or the lives of others. They believe that they cannot attain the favor or approval of others.
Some even view depression as a form of punishment for their inability to bring happiness to the important people in their lives.
Psychiatrist, Dr. David D. Burns, states, “Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem.”
Elizabeth Wurtzel wrote, “I thought depression was the part of my character that made me worthwhile. I thought so little of myself, felt that I had such scant offerings to give the world, that the one thing that justified my existence at all was my agony.”
4. Lack of energy and fatigue.
The depressed person may walk and talk slowly, or have an overall feeling of lethargy.
Even mental functioning may slow down, making it difficult to process thoughts or follow a conversation.
Novelist and essayist, William Styron, who battled depression much of his life, wrote, “The madness of depression is the antithesis of violence. It is a storm, indeed, but a storm of murk. Soon evident are the slowed down responses, near paralysis, psychic energy throttled back close to zero. Ultimately, the body is affected and feels sapped, drained.”
Some depressed patients will experience periods of restlessness or agitation, or may pace around aimlessly in an inability to relax or be still.
6. Disrupted sleeping patterns.
At least 80% of depressed people experience insomnia.
Although they may have difficulty falling asleep, more typically they will awaken early, or after only a few hours, and be unable to get back to sleep.
About 15% of patients suffer hypersomnia, or oversleeping.
7. Disrupted eating patterns.
Again, this is another dichotomy of the disease. Some people experience a loss of appetite with resulting weight loss, while in other cases, overeating and weight gain may occur.
8. Loss of interest in activities or hobbies that were once enjoyed.
9. Difficulty concentrating, focusing on or completing tasks, remembering details, and making decisions.
This is compounded even more by a sense of worthlessness and prevailing fatigue.
10. Increased crying.
A depressed person may cry more frequently, and episodes could last several hours.
11. Reduced sex drive.
Several people report a decreased sexual desire and a lack of energy, but some patients also report an aversion to being touched.
12. Thoughts of suicide and / or suicide attempts.
Up to 60% of people who committed suicide had a history of depression or other mood disorders.
Studies show that most people will not make an attempt on their own lives when in the deepest stages of depression because they simply cannot muster the effort to do so.
However, the risk increases significantly during the period just before or immediately after – on their way into deep depression or on their way out.
It is during these times that suicide watch should be most diligent.
13. Withdrawal from social situations.
Those with depression typically avoid being around other people. They often withdraw from their own family, and even when they are in the same room, they will sometimes appear comatose or disengaged.
14. Physical symptoms.
Depressed people often complain of headaches, digestive problems, cramps, and a dry mouth due to reduced saliva production.
Also, they usually have a shorter life expectancy because they have a much higher risk of developing other serious illnesses.
American novelist, William Styron, wrote of his condition, “Mysteriously, and in ways that are totally remote from natural experience, the gray drizzle of horror induced by depression takes on a quality of physical pain.”
15. Altered mental states.
In severe cases, depressed people may experience delusions or hallucinations. In most instances, these are very unpleasant, and contribute to irrational fear, anxiety, panic attacks, and erratic behavior.
Recongnized Some of Those Symptoms in Yourself or Others?
- Don’t Hesitate to Seek Help!
As mentioned, although the above depression symptoms are the ‘typical’ symptoms, depression can present itself very uniquely depending on the person and their life circumstances.
If you think that you, or someone you love, may be suffering depression, you should seek medical help immediately.
Remember, it is not something you should be ashamed of. You are not crazy. And, like any other illness, admitting that there is something wrong and that you need help, is the first step to recovery.
Although depression most commonly develops between the ages of 20-30, it is still quite prevalent in other age groups as well.
It is important to note that the symptoms sometimes vary, especially in young children. As a result, much depression remains undiagnosed.
By being aware of how the disease manifests itself in the various age and gender groups, you will be better able to identify a need for concern.
Keeping in mind the unbelievable suicide statistics that have already been mentioned, your knowledge could save someone’s life – maybe even your own!
- Depression Seems to Strike Women More Than Men
Depression rates are fairly equal in boys and girls until about the age of 15, where it begins to become more prevalent in females. Some researchers argue the possibility that this equality still exists; however, women are more likely to seek treatment, whereas men are less willing to admit their struggles.
Again, this theory can’t be proven, but it is something to consider if you have a man in your life that may be experiencing some of the classic symptoms.
Depression in Women Might Be Related to Hormonal Cycles
Doctors are not entirely sure why depression in women rates so high, but they do think that it is largely connected to the hormone cycles.
After all, men are typically not going to experience postpartum depression because they don’t have babies (however, brand new research does seem to suggest that men can suffer from this as well.)
Men don’t have to be concerned about developing premenstrual dysphoric disorder, because they don’t menstruate.
Men don’t have to endure menopause, a highly susceptible time for the onset of depression.
And, men have a lower rate of osteoporosis, which is also considered to be a risk factor.
Plus, many researchers hold to the theory that women have a much higher stress level due to conflicting societal roles and their demanding schedules, both at home and work.
Researchers also believe that young girls are often instilled with the idea that they should put the needs of others before their own, and this desire to please everyone makes them more prone to depression.
Women tend to develop depression at an earlier age than men, have longer and more frequently occurring episodes, and are more likely to have Seasonal Affective Disorder.
Also, women often show atypical symptoms such as excessive eating or sleeping, weight gain, heavy feeling in limbs, trouble getting to sleep, and a significant worsening of mood in the evening.
- Men and Women Show Depression Differently
Well, first of all, men exhibit depression differently than women!
Women are more likely to experience sadness, worthlessness, and guilt; whereas men more commonly feel very tired or irritable, lose interest in hobbies and enjoyable activities, and have difficulty sleeping.
They also experience frustration, discouragement, and anger – sometimes to the point of being abusive.
Often, they will work excessively to avoid dealing with their feelings, and are more likely to engage in reckless or risky behavior.
Also, men more commonly turn to alcohol or drugs during depression.
Although more women attempt suicide, many more men actually die by suicide. In fact, men commit suicide four times as often as women. They are also far less likely to seek or receive treatment.
Other symptoms may vary depending on the age of the child and the specific situation. A child may pretend to be sick, refuse to go to school, become withdrawn, clingy, or demanding.
They may also try to compensate for their low self-esteem by trying to please others, often creating a great deal of anxiety.
Sleeping patterns may be disturbed and children may have difficulty paying attention or focusing, even on activities that they enjoy such as watching television or playing games.
As a child gets older, they may begin to sulk, get into trouble at school or with other authority figures, develop a negative attitude, and claim to be misunderstood.
Depression in children often co-exists with Attention Deficit Hyperactivity Disorder (ADHD), which makes both diagnosis and treatment much more difficult.
Before puberty, boys and girls are at an equal risk of developing depression.
However, by age 15, girls are almost twice as likely to develop the disease.
Depressed teens often show little concern for their safety, engage in risky behavior, and think a lot about death. In fact, depressed teens are more likely than younger children to commit suicide.
Teenage depression is also connected to (or co-exists with) other conditions such as anxiety and eating disorders.
Unfortunately, signs are often mistaken as normal teenage mood swings and, therefore, many youth are not diagnosed until early adulthood.
- Depression in the Elderly Is Often Overlooked
Depression in the elderly is very difficult to recognize and diagnose because it co-occurs with so many other serious physical disorders such as stroke, cardiovascular disease, and Parkinson’s disease.
Depression is often overlooked in seniors because symptoms are commonly less obvious or they mimic the side effects of other conditions and medications.
White males over the age of 85 have the highest rate of suicide, so recognizing the signs of depression in the elderly is very important.
- Is It Genetic, Biological, Environmental or Psychological?
Like every other aspect of depression, the cause is relatively unknown.
Although it is constantly being researched, findings are often conflicting or inconclusive. And, since so many factors play a role in the development of the illness, it is difficult to pinpoint an actual cause.
Really, it is the age-old question, “What came first, the chicken or the egg?”
Does a chemical imbalance cause depression or does depression lead to a chemical imbalance.
Similarly, do stressful relationships contribute to the disease or does depression result in stressful relationships?
Most people have come to the conclusion that depression is caused by a combination of genetic, biological, environmental, and psychological factors. This is often referred to as the Biopsychosocial Model.
Yes, the name is a blend of all possible causes. I guess scientists figured that the one sure way to avoid being wrong would be to construct a theory that included everything.
Despite the constant confusion, researchers still keep working at it. And, over the years, a few findings have been discovered that seem to give certain theories some credence.
Here is a list of possible causes of depression:
1. Is Depression inherited? (What is depression and What Causes Depression #1)
Although people with no family history of depression can develop the illness, much research has shown that the disorder does seem to travel through the generations. While scientists are hesitant to say that depression is heritable, they have found enough evidence to suggest that genetics at least plays a role in the tendency or vulnerability to develop affective disorders.
Research Study 1 of Depression and Inheritance
One early study found that close relatives of people who suffer from depression are ten times more likely to develop an affective disorder themselves, than those who have no afflicted relatives (Rosenthal, 1971).
Research Study 2 of Depression and Inheritance
Another study found that if one member of a set of identical twins had an affective disorder, then the other twin had a 69% chance of also developing the disease. In the case of fraternal twins, the figure went down to 13%. Perhaps the most interesting finding was that these rates did not change, whether the twins were raised together or apart (Gershon, Bunney, Leckman, VanEerdewegh, and DeBauche, 1976).
The Typical Discussion: Is It Nature of Nurture
Some say that this confirms that a vulnerability to depression can be inherited. But, others argue that the inherited factors do not necessarily play as large a role as many would like to imply.
While it cannot be denied that a pattern of affective disorders seems to develop in families, it is still questionable as to whether this is due solely to genetics or can attributed to the fact that relatives often have similar environments.
In other words, did a person inherit depression from her mother, or is she depressed because she was raised by a depressive parent? After all, doesn’t a child learn their attitudes and responses to life events from parents? Could it be that social and environmental factors are just as powerful as genetic factors?
Have you heard the theory that a girl will likely marry someone exactly like her father or completely opposite? So, if she is raised by a man who drank too much, she will either marry an alcoholic or a teetotaller.
Some personalities are drawn to the familiar, while others will refuse to follow the destructive pattern.
Some people hypothesize that the same principal may apply with depression, and use this idea to explain why one child raised by a depressive parent will experience depression themselves while another child is not afflicted. It comes from a decision to either follow family history or break the cycle.
Nature Lays the Foundation, But Nurture Triggers It
This is not minimizing the seriousness of depression, but simply suggesting that genetic factors may need to be triggered by social or external factors – and not merely the factors themselves, but an individual’s perception or interpretation of these factors.
Foundations and perceptions established in childhood play a large role in adulthood problems. The success of the psychiatric field is proof of this fact. So, do these principles come into play with regards to depression?
Can a person overcome their own genetic propensity by being aware of this vulnerability and taking proactive steps to stay healthy?
This often applies to other conditions such as cancer or diabetes, so if depression is an illness with physiological basis, could life choices trump genetics?
The Diathesis-Stress Model
The Diathesis-Stress Model is based on the idea that everyone has a different level of vulnerability to developing depression and that it can actually be activated by stressful events that play to the specific vulnerability.
Based on this theory, genetic factors may play a role, but they can lay dormant until social, environmental, or chemical stresses trigger its appearance.
So, is depression inherited? Well, the jury is still out on that one. But, interesting evidence certainly makes it an area worth further study.
2. Is Depression Caused by External Events? (What is depression and What Causes Depression #2)
There seems to be a connection between the development of depression and certain traumatic events such as loss of a loved one, chronic illness, financial problems, or broken relationships.
Again, the question is whether or not these events are causes or triggers.
Not everyone who experiences challenging circumstances will develop depression, so do these things simply awaken the illness in those already genetically vulnerable, or do they actually change the physiological make-up of the body to cause the onset of depression?
3. Is Depression Caused by Biological Factors? (What is depression and What Causes Depression #3)
Most biological research has focused on neurochemicals and neurotransmitters.
Many studies have shown that depression may be connected to an overabundance or lack of the key chemicals serotonin, norepinephrine, and dopamine.
Although using medications that alter these levels have been successful in managing symptoms, it is still unclear as to whether lower levels of neurotransmitters cause depression or if depression results in decreased levels of neurotransmitters.
- The Step by Step Process of Diagnosing a Depression
Many medications or medical conditions can mimic the symptoms of depression, so it is important to rule these out before making a diagnosis.
If no other medical causes can be found, the next step would likely be a psychological evaluation. Your doctor may refer you to a mental health professional for this examination.
You may be required to complete screening questionnaires, and will also be asked about your family history of depression or other mental disorders. They will want to know if these family members received treatment for their illnesses, and which treatments were effective.
Next, you will be asked about your symptoms: what they are, how long you have been experiencing them, how severe they have been, if they have occurred before, and if so, what treatment was received.
Your doctor may also perform a mental health exam to determine if your speech, thought, or memory patterns have been affected, which frequently happens with depressive disorders.
Unfortunately, many sufferers never seek treatment for depression; although, most people can get better with proper medications and therapies.
- Antidepressants as Cures for Depression
Most antidepressant medications increase the levels of the neurotransmitters serotonin, norepinephrine, and dopamine in the brain.
It is theorized that depression results when there are low levels of these chemicals, and that certain antidepressants can correct these levels, thereby diminishing symptoms.
Scientists have found that each of these substances plays an important role in mood:
- Serotonin is associated with anxiety, obsessions, and compulsions.
- Norepinephrine may be related to energy level, alertness and concentration, anxiety, and interest in life.
- Dopamine is a factor in attention, motivation, pleasure, and reward.
Proponents of the Monoamine Hypothesis believe that medications should be given that address the most prominent area of symptoms.
Here is a list of antidepressants that are being used as Cures for Depression:
1. SSRIs and SNRIs: (What is depression and Antidepressant Drug Cures for Depression #1)
Some of the most popular antidepressant drugs are called Selective Serotonin Reuptake Inhibitors (SSRIs) which increase the amount of serotonin in the brain by blocking its uptake.
Examples of these drugs are Prozac, Zoloft, Lexapro, Paxil, and Celexa.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are very similar to SSRIs and include such drugs as Effexor and Cymbalta.
Both SSRIs and SNRIs have fewer side effects than some of the older antidepressants but can still cause headaches, nausea, jitters, and insomnia when first taken. Many of these side effects diminish or cease with time.
Wellbutrin is the most common drug to address dopamine levels. It has similar side effects to SSRIs and SNRIs but it can increase the risk of seizures.
2. Tricyclic Antidepressants: (What is depression and Antidepressant Drug Cures for Depression #2)
These are an older class of antidepressant drugs that are not used very much anymore due to the fact that they have more serious side effects than the newer SSRIs.
Developed in the 1950s and 60s, these medications are designed to increase levels of norepinephrine in the brain.
3. Monoamine Oxidase Inhibitors (MAOIs): (What is depression and Antidepressant Drug Cures for Depression #3)
These are the oldest group of antidepressants and work by inhibiting monoamine oxidase, an enzyme that breaks down neurochemicals. When this breakdown is prevented, neurotransmitter levels in the brain increase.
MAOIs are especially effective in treating the symptoms of atypical depression such as increased appetite and the need for more sleep rather than the more common symptoms of decreased appetite and insomnia. They may also help with feelings of anxiety and panic.
MAOIs impair the break down of tyramine, a chemical found in certain foods such as red wine and cheese, that is connected to the elevation of blood pressure. If this substance is not broken down, blood pressure can rise so high that cranial bleeding can result.
If you are taking MAOIs, make sure that you ask your doctor for a complete list of foods to avoid.
The Process of Taking Antidepressants
Antidepressants must be taken for 4-6 weeks before the full benefits are realized. Do not stop taking them unless your doctor has approved this decision.
Once medications begin working and patients feel better, many people with depression often believe that they are cured, or can manage the situation on their own, and no longer need to continue taking the drugs.
Stopping treatment suddenly can cause a relapse and the re-appearance of depressive symptoms. Unfortunately, this is a cycle that many sufferers of affective disorders seem trapped in, and is a significant hindrance to complete recovery.
Cognitive Behavioral Therapy and Interpersonal Therapy
There are two basic types of psychotherapy most effective for treating depression: Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT).
Cognitive Behavioral Therapy What is depression and psychotherapy as cures for depression #1
Cognitive behavioral therapy helps patients restructure their thought patterns and works on the way they see themselves and the world around them.
Its main focus is to create positive, realistic life views and to help people identify those triggers that may be making their depression worse.
By dealing with attitude, perceptions, and behavior, it is theorized that those with depression are better able to manage their condition.
Psychologist Dorothy Rowe says, “Depression is a prison where you are the suffering prisoner and the cruel jailer.”
Her belief is that “it is not what happens to us that determines our behavior but how we interpret what happens to us.”
This brings us back to a point previously mentioned – many people have “punitive consciences” and believe that their depression is something they deserve – in fact, it may even define them.
Dorothy Rowe proposes that many people build a prison called depression and the only way out is to change the way they see or interpret their experiences.
Interpersonal Therapy What is depression and psychotherapy as cures for depression #2
Interpersonal therapy helps people deal with troubled relationships and work on rebuilding some of the key relationships that the illness may have damaged. It also focuses on the development of good relationships and communication skills.
Those with depression have often shut themselves off (both emotionally and physically) from others for so long that they need to re-learn how to have healthy interactions.
Elizabeth Wurtzel wrote, “What I need, what I’m really looking for is not something I can articulate. It’s nonverbal: I need love. I need the thing that happens when your brain shuts off and your heart turns on. And I know it’s around me somewhere, but I just can’t feel it.”
- An Apparently Successful But Controversial Method
This is most often used for treatment-resistant depression or in cases when medications and psychotherapy have been ineffective.
Patients typically undergo several treatments, although some people may only need a few. Sometimes, maintenance treatments are required, usually once a month.
ECT has been the topic of much controversy and criticism, mostly from the popular media. However, to many of those battling major depression, it is a miracle cure. Some doctors believe that many critics are making uneducated accusations, and do not understand the desperation treatment-resistant patients experience.
Although ECT treatments may cause temporary memory loss, confusion, and disorientation, research has proven that there are no long term adverse cognitive effects.
REM Sleep Treatments
- Restoring Sleeping Patterns
Depressed people tend to experience REM sleep out of sync, or at a different time, than healthy people. It is proposed that initiating treatment to restore proper sleep patterns may be very helpful in treating depression.
When it comes to treatment for depression, it may take time to figure out what works for each individual.
Different combinations and dosages are often tried and medications may change as symptoms change.
While psychotherapy alone may be effective for mild or moderate cases, it may not be enough for more severe depression. Most patients find that the best treatment is a combination of both antidepressant drugs and psychotherapy that works to address the individual’s specific situation.
According to the World Health Organization, antidepressant medications combined with psychotherapy is effective 60-80% of the time; however, less than 25% of those suffering from depression actually receive treatment. In fact, this number is suspected to be as low as 10% in some countries.
If you are suffering from clinical depression, it is important that you follow your doctor’s instructions carefully and continue to take your medications.
There are also several other things you can do to help you deal with your condition, facilitate your healing, and make life seem just a little bit more manageable.
1. Find someone you trust to confide in.
You may also benefit from keeping a journal or chronicling your feelings and emotions.
2. Set realistic goals for yourself and don’t take on more than you can handle.
Break large tasks into smaller ones and set priorities so the most important things get done first.
3. Eat healthy and take the time to exercise, even if it is simply a walk outdoors.
Taking care of yourself is a way of declaring that you are worth the effort, which will make you feel better.
4. Avoid being alone.
Try to spend time with other people rather than isolating yourself. Do something that you used to enjoy with people that you love.
5. Don’t expect immediate change.
Treatments take time to work, and the process will usually be slow and gradual.
6. Don’t make important or life-changing decisions until you feel better.
If these decisions cannot wait, then discuss them with someone you trust to gain an objective perspective.
7. Try to keep your thinking positive rather than negative.
8. Continue to learn about depression in general.
And keep track of your experiences so you can better understand what is happening in your specific situation.
Hope and Help Is There!
It can be consuming.
It can make you feel like you are drowning in darkness.
But, there is hope. With proper treatment, most people can fight their way back to the surface and live an enjoyable, satisfying life.
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