What is Depression?

We all feel low, sad or miserable at times. Usually we can see what makes you sad or miserable. Perhaps we talk to a friend or family about it.  The low mood does not interfere our lives too much if the depressive feeling goes away in a couple of days or a short span of time.  We can cope with it.

Depression is more than simply feeling sad or unhappy for a few days. Depression is neither something you can “snap out of” by “pulling yourself together” nor a sign of weakness.  It is an illness with acute feelings of sadness and despair accompanied with symptoms.

• feel unhappy most of the time (but may feel a little better in the evenings)
• lose interest in life and can’t enjoy anything
• find it harder to make decisions
• can’t cope with things that you used to
• feel utterly tired
• feel restless and agitated
• lose appetite and weight (some people find they do the reverse and put on weight)
• take 1-2 hours to get off to sleep, and then wake up earlier than usual
• lose interest in sex
• lose your self-confidence
• feel useless, inadequate and hopeless
• avoid other people
• feel irritable
• feel worse at a particular time each day, usually in the morning
• think of suicide.

According to The Royal College of Psychiatrists, most of people with depression present at least 5 or 6 of the above symptoms. The symptoms of depression are similar to the symptoms of anxiety. Hence, it often becomes a “chicken and egg” situation and can easily fall into a vicious circle of depression and anxiety.

Depression: Key facts

• Depression is a common mental disorder. Globally, an estimated 350 million people of all ages suffer from depression.
• Depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease.
• More women are affected by depression than men.
• At its worst, depression can lead to suicide.
• There are effective treatments for depression.

(published by World Health Organization in April 2016)

The Royal Colleague of Psychiatrists recommend to seek professional help if you find yourself in one of the following situations;

• When your feelings of depression are worse than usual and don’t seem to get any better.
• When your feelings of depression affect your work, interests and feelings towards your family and friends.
• If you find yourself feeling that life is not worth living, or that other people would be better off without you.

Medication

If your depression is moderate to severe, it is important that you inform your medical practitioner. Medication can be very useful. Most people with moderate or severe depression benefit from antidepressants, but not everyone does. There are about 30 different kinds of antidepressants available. You can discuss with you doctor if you want/need to seek a medical intervention. Once you start taking antidepressants, you should have a consultation with your GP regularly to review that the prescription and dosage are appropriate to your condition.

Why does depression happen?

Depression can happen with or without an obvious reason. It usually results from a combination of recent events and other longer-term or personal factors, rather than one immediate issue or event.

*A life-changing event, such as, losing a job, a breakdown of relationship/marriage, bereavement. Giving a birth, can trigger depression.

*Long-term social isolation

*Prolonged work stress

*Physical illness

*Substance abuse (narcotic or/and alcohol)

*Family history/Genes – Depression can run in families and some people will be at an increased genetic risk. Some people are genetically dispositioned to depression. However, having a parent or close relative with depression doesn’t mean you’ll automatically have the same experience. Life circumstances and other personal factors are still likely to have an important influence.

*Personality – Some people may be more at risk of depression because of their personality, particularly if they have a tendency to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.

*Gender – women seem to get depressed more often than men. It may be that men are more reluctant to talk about their feelings, and more likely to turn to excessive drinking or becoming aggressive to mask depressive feelings. Women are more likely to experience stress of having to work and look after children.

Psychodynamic Psychotherapy can help

The first step in working on depression is to understand what it is and how it affects you. The second step is to look at what may be causing it.

Psychodynamic psychotherapy can have a significant benefit on how you are feeling and how you are coping with difficulties. Putting troubled emotions and thoughts into works can relieve emotional distress. It is cathartic. Also, it helps you clarify complex feelings and ideas and focus on those problematic feeling ideas more objectively. The role of psychodynamic psychotherapists is to provide a safe space and time to explore underlying issues which may be difficult to confront on your own and support the process by various means.

“The conclusion reached in this review is that there is strong support for the use of psychodynamic psychotherapy in the treatment of a broad range of psychological conditions. Moreover, the improvements gained through psychodynamic psychotherapy are typically maintained beyond the termination of treatment. Psychodynamic psychotherapy appears to be as effective as other psychotherapies, but more comparative trials are needed before firmer conclusions can be drawn.” (The effectiveness of psychodynamic psychotherapy ; a systematic review of recent international and Australian research, Dr Cadeyrn J. Gaskin, Gaskin Research, December 2012)

“With the caveats noted above, the available evidence indicates that effect sizes for psychodynamic psychotherapies are as large as those reported for other treatments that have been actively promoted as “empirically supported” and “evidence based.” It indicates that the (often unacknowledged) “active ingredients” of other therapies include techniques and processes that have long been core, centrally defining features of psychodynamic treatment. Finally, the evidence indicates that the benefits of psychodynamic treatment are lasting and not just transitory, and appear to extend well beyond symptom remission. For many people, psychodynamic psychotherapy may foster inner resources and capacities that allow richer, freer, and more fulfilling lives” American Psychologist, in press Copyright 2009, American Psychological Association www.apa.org/journals This article may not exactly replicate the final version published in the APA journal. It is not the copy of record. Revised: 10-9-2009 The Efficacy of Psychodynamic Psychotherapy Jonathan Shedler, PhD University of Colorado Denver