What Is Depression?
Depression is more than just feeling sad, having the blues or feeling down for a couple of days in a row. Major Depressive Disorder (MDD) is a serious mental health problem that is characterized by an extreme feeling of sadness lasting for at least two-weeks straight and is accompanied by a number of emotional, behavioural, cognitive and physiological symptoms1. The symptoms make it difficult, even impossible, for an individual to function on a personal level (e.g. engage in meaningful activities), interpersonally (e.g. being engaged with friends and loved ones) or at work (e.g. completing assigned tasks).
I frequently talk to my clients about how emotions like depression are analogous to ‘road signs’ that are communicating important information to us. So on a psychological level, feeling depressed is telling the individual that they are experiencing a significant sense of ‘loss’ or that they are ‘missing’ something in their life.
What Are The Symptoms Of Depression?
If you find yourself asking, “Am I depressed?” or “Do I need to be treated for depression?”, you should consider consulting a mental health professional such as a psychologist, who will look at whether you are experiencing significant symptoms of depression. How do you know if you are depressed? If you experience many of the following depressive symptoms most of the day for two weeks1, you may need help to treat your depression.
- A depressed mood for pretty much the whole day nearly every day.
- A diminished interest or pleasure in all or almost all your activities.
- Significant weight loss/gain or decrease/increase in appetite.
- An inability to get to sleep, insomnia or sleeping too much.
- Feeling restless, agitated or on edge or having slowed movements which is observable by others.
- You are easily fatigued and have a significant loss of energy.
- Feeling worthlessness or experiencing excessive guilt.
- An inability to think, concentrate clearly or difficulty making decisions.
- Feeling irritable.
- A decrease in libido and interest in sexual activity.
- Recurrent thoughts of death and suicide.
If you are experiencing at least five depressive symptoms nearly all day for at least two-weeks straight, you should consult a mental healthcare specialist, like a Clinical Psychologist, for their opinion.
Do I Need Depression Treatment?
If you are feeling depressed or have lost interest and pleasure in your life for nearly the whole day for two weeks straight, you could be experiencing major depression. Some other signs of depression include:
- Isolating yourself from friends and family and preferring to be alone.
- Having difficulty at work and completing tasks.
- Difficulty concentrating and making big or small decision in different areas of your life.
- You just feel like sleeping all the time to avoid the day as it feels better to do so.
- There has been a significant weight gain or loss within a short span of time because you suddenly have no appetite or are overeating.
- You find yourself asking existential questions about the meaning of life which is causing you a great deal of anxiety.
- You are frequently worrying about how you are feeling.
- You are walking sluggishly and slowly because you have no energy or you feel agitated and restless inside.
- You no longer enjoy activities that you used to with the same degree of pleasure. You may even have stopped doing things you enjoyed because they are no longer fun.
- Your loved ones are expressing concern about you.
- You have a lot of negative self-talk like feeling like a failure, a ‘loser’ or hopeless. You are experiencing recurrent thoughts of death and suicide.
What Causes Depression?
Depression is a complex biological and psychological health problem. Although biology may play a role and some believe that depression is caused by a chemical imbalance, Harvard Medical School states that depression can be caused by a number of factors and is not explained by just genetics or a chemical imbalance2.
Although biology may contribute to major depression, psychological stressors can play a significant role as well. Psychological causes of depression can include:
- A significant stressor such as a job loss or divorce.
- Marital problems. Relationships problems with children, friends or colleagues at work.
- Drugs and alcohol abuse.
- Having a history of being raised an abusive or neglectful environment.
- Being isolated and having no social support network or feeling lonely even with a support network.
- Recent life changes like moving to a new country or starting a new job.
- Being a victim of or witnessing a traumatic event (e.g. car accident, an assault, abuse, a natural disaster, being exposed to extreme poverty, spending time in a war zone).
- The death of a loved one.
- Feeling frustrated like you are not achieving your potential.
- Having constant negative thoughts of being a failure or a ‘loser’, feeling worthless or unlovable, or believing you are defective or not normal.
Treating Depression With Therapy
The two most common ways to treat depression involve taking antidepressant medication, such as a selective serotonin reuptake inhibitor (SSRI), and/or consulting a specialist like a psychologist for some form of psychotherapy that has been shown to be effective in treating the symptoms of depression. If you are looking for the most effective psychological treatment for depression, Task Forces from both the American and Canadian Psychological Associations have established that cognitive behaviour therapy for depression has received the most scientific support. Thus, this type of depression therapy can have a significant impact in the treatment for depression.
Here are a few research studies showing how effective this therapy is in treating depression:
- In reviewing over 300 studies, it has been shown that 52-79% of adults and 67-87% of teens receiving cognitive behaviour therapy for depression do better than people not receiving therapy (Butler et al., 2006).
- 90% of the symptoms of major depression can decrease in the first six weeks of treatment (Hollon et al., 1992).
- The treatment of depression with therapy can decrease relapse rates from 76% when only medication is used to just 30% with therapy (DeRubeis et al., 2005).
How Will Therapy Help Me Treat Depression?
When treating major depression, therapy will focus on the following strategies:
Psychoeducation: You will learn basic knowledge about depression, such as symptoms and how therapy for depression works.
Behavioural Activation: When people feel depressed they are typically inactive, so it is important to reverse this cycle and become more active. You will begin to establish a gradual increase in activities that bring you pleasure and a sense of accomplishment in order to improve your mood and increase your energy levels. Just starting to engage in such activities has been shown to be effective in depression treatment.
Changing Negative Thinking: Therapy will also help you to change the ‘cognitive traps’ or ways of seeing things that affect your mood negatively. Examples include changing the way you perceive situations that you may see as being catastrophic, never-ending or unbearable.
Changing Maladaptive Assumptions & Core Beliefs: These are deeper beliefs we have about ourselves, the world and other people. These beliefs tend to develop early in life and colour the way we see the world, which can lead to recurrent episodes of depression that some people experience. Some common examples that are targeted in therapy for depression include, “I am worthless or unlovable”, “The world is not fair” and “Other people always abandon me”.
Relapse Prevention: At the end of therapy, we focus on identifying your triggers for depression and establishing an ‘action plan’ to treat depression before it worsens.
Is Therapy For Depression Effective
Reviews of depression therapy studies have shown that 52-79% of adults and 67-87% of adolescents respond to CBT therapy for depression3.
Many people have consulted me to help them treat their depression. I am proud to share their success with you. Based on their own self-ratings, these are the changes that my clients have made in alleviating their symptoms of depression:
- Decreased depressive symptoms by up to 75% and;
- Increased their quality of life by up to 89%
Feel free to Contact Me for a free 15-minute phone consultation if you think you may be depressed and would like to talk more about the symptoms and treatment for depression.
1) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
3) Butler, AC, Chapman, JE, Forman, EM & Beck, AT. 2006. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review. 26 (1), p. 17-31.