Understanding depression

Depression is a condition characterized by low mood. It affects a significant number of people at some time during their lives (somewhere between 5% and 25% of people are at risk), and three times as many women as men are likely to be sufferers.

A number of resources are available here for those affected by depression. One or more of them may work for you. I Had a Black Dog, by Matthew Johnstone draws on the writer's own experience to help people fight and master their depression. Overcoming Depression, by Professor Paul Gilbert, is the title of both a self-help book and a series of talks on Audio CD. Manage Your Mood, by David Veale and Rob Willson, uses Behavioural Activation techniques to help readers manage and overcome the debilitating effects of depression.

What do we mean by depression?

Depression manifests itself in a number of different ways, affecting not only how we feel, but how we think about things, our energy levels, memory, concentration and ability to sleep, and even our appetite for sex.

Some of the ways we are affected by depression can be classified under the following headings:

  • motivation: depression can lead to apathy, loss of energy, a feeling that everything we do is pointless;
  • emotion: as well as the characteristic low mood (anhedonia – the loss of capacity to experience pleasure), depression can also result in an increase in negative emotions, such as anger, resentment, irritability, anxiety and fear;
  • thinking: depression can affect concentration and the ability to remember; it can also adversely affect the way that sufferers think about themselves, the future and the world in general;
  • behaviour: people with depression often withdraw themselves from their social world, preferring instead to hide themselves away; they may also experience strong feelings of being trapped, of wanting to do something but not knowing what;
  • physiology: the anxieties that are part of depression can bring about direct physiological changes, as a result of the production of the hormone cortisol; at the same time, the physical symptoms of depression such as lack of sleep can have secondary effects on both mind and body.

What causes depression?

As with many conditions, there is no single cause for depression. However, it generally arises because, for some reason, we no longer feel that we are loved, cared about or respected. Depression may be inherited (or, at least, it is possible for someone to be genetically predisposed to suffer from anxiety and depression); or it may be the result of life events such as bereavement, the loss of a significant relationship, or redundancy. One factor that is likely to be important is the way we deal with stress. If we are able to recognise stressful situations in advance and back away from them, we can often avoid their consequences; if, on the other hand, stress is unavoidable, or our stress threshold is low, then our mood is likely to be affected. An important factor here is our ability to cope: if we perceive ourselves to be unable to cope with a difficult situation, levels of certain chemicals in the brain that control our mood are likely to be reduced, resulting in anxiety and depression.

Are all depressions the same?

No. Some depressions are transient, and may pass without intervention. Others may be resolved in a few weeks or a couple of months by some form of therapy, and never occur again. However, many people’s depression is likely to reappear, and in some cases to be chronic (lasting longer than two years).

Some forms of depression are combined with hypomania, contrasting the low mood with spells of extremely high mood. This condition, called bipolar disorder, can often be treated very successfully (for more information on bipolar disorder, see Overcoming Mood Swings, also at this website). Others, often involving delusions, are described as psychoses, and although these are serious, distressing and sometimes very difficult to treat, they are fortunately comparatively rare.

How can we beat depression?

People with the more severe forms of depression, the psychoses and bipolar disorder for example, need urgent professional help. If you suspect that this could be you, see your GP as soon as possible. However, most forms of depression respond very well to simple forms of treatment, often on a self-help basis.

The traditional way to treat mild and moderate depression has been to prescribe drugs of one sort or another. These often work, at least in the short term. However, drugs do nothing to address the underlying causes of depression, so once the course of treatment is over the depression all too often comes back. In the last twenty years or so doctors have discovered that one of the most successful ways to treat depression is to help the sufferer to change the way they feel about things – in effect, to see their situation in a more favourable light; in a way that is kinder and less self-critical. Depression, after all, is often a reaction to feeling uncared for in one way or another, and this feeling often is transferred to the way sufferers feel about themselves. Helping people to make this change is known as cognitive therapy, and it goes hand in hand with behavioural therapy – changing our reaction to situations; together, the two are know as Cognitive Behavioural Therapy (CBT).

There are several ways to apply CBT to depression. Some of them involve counselling, in which the patient is helped by a therapist to try to identify the causes of their depression, see them in a different light, and thus dispose of them. (To find a therapist in your area who specialises in the treatment of depression, see Find a Therapist at this website.)

Sometimes just listening to someone who understands what you feel is all it takes. Professor Paul Gilbert has recorded Overcoming Depression: Talks with Your Therapist, published on audio CD by Robinson (and available from Amazon.co.uk, RRP £10.99), in which he explores the effects of depression and offers insights into ways to help cope with and lift depression.

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Listen to Professor Paul Gilbert on Overcoming Depression (2 mins).

Buy now from Amazon (RRP £10.99)

For more on our self-help resources click here >

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