Depression

The word depression is used to cover a wide range of issues, form short periods of low mood to a life time inability to carry out your every day functioning. It is the most common problem that brings people to counsellors and it can afflict any one. For example, someone may have a wonderful partner, loving family, lots of friends and a good job and yet they experience feelings of emptiness or numbness that seems totally out of proportion to the external cause. Equally important to know is that depression has nothing to do with being weak and feeble minded, or having a lack of insight and understanding. In fact depression can affect us all whatever our circumstances, situation and position in life. The exact cause of depression is not known. Some people tend to be more prone to it, and it can develop for no apparent reason. Some people may have no particular problem or worry, but symptoms can develop quite suddenly. Depression may also be triggered by a life event such as relationship problems, bereavement, redundancy, illness, etc. Or it can be mixture of the two. For example, the combination of a mild low mood with some life problems, such as work stress, may lead to a spiral down into depression. Other research suggests that a chemical imbalance in the brain might be a factor. This is not fully understood. However, an alteration in some chemicals in the brain is thought to be the reason why antidepressants work in treating depression. Women tend to develop depression more often than men. Particularly common times for women to become depressed are after childbirth (postnatal depression) and the menopause.

Symptoms of depression

  • Low mood for most of the day, nearly every day. Loss of enjoyment and interest in life, even for activities that you normally enjoy.
  • Abnormal sadness, often with weepiness.
  • Feelings of guilt, worthlessness, or uselessness.
  • Poor motivation. Even simple tasks seem difficult.
  • Poor concentration. It may be difficult to read, work, etc.
  • Sleeping problems:
  • Difficulty in getting off to sleep.
  • Waking early and unable to get back to sleep.
  • Sleeping too much.
  • Lacking in energy
  • Difficulty with affection, low libido
  • Poor appetite and weight loss. Sometimes the reverse happens with comfort eating and weight gain.
  • Irritability, agitation, or restlessness.
  • Symptoms often seem worse first thing each day.
  • Physical symptoms such as headaches, palpitations, chest pains, and general aches.
  • Recurrent thoughts of death. Some people get suicidal ideas such as ..."life's not worth living".

In general, mild depression means that you have some of the symptoms listed above, but are still able to cope reasonably well with normal activities. For example, you may still be able to do your normal job, and get by with household chores, but perhaps with difficulty. Your doctor may suggest one or more of the following.

The treatment
Talking through feelings may be all that you need for mild depression. Your doctor may also 'talk things through' with you or refer you to a counsellor. In some cases there is a particular problem that triggered the depression, or is making it worse. For example, marital problems, sexual problems, bereavement, previous childhood abuse, etc. Integrative counselling directed at a specific area may then be helpful. Other types of therapy sometimes used include: existential therapy, person centred and psychodynamic techniques..

Cognitive Behavioural Therapy.
Cognitive therapy is based on the idea that negative thinking can trigger, or 'fuel', certain mental health problems such as depression. Cognitive behavioural therapy helps you to understand your thought patterns. In particular, to identify any negative, unhelpful ideas or thoughts which you have that can make you depressed. The aim is then to modify your ways of thinking to avoid or prevent these ideas from occurring. Therapy is usually done in weekly sessions over several months. You are likely to be given 'homework' between sessions. With severe depression your doctor may suggest one or more of the following.

Antidepressants are usually the first-line treatment for moderate or severe depression. This may then allow you to function normally, and increase your ability to deal with any problems or difficult circumstances.