Am I Depressed?

Depression is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression. 

The symptoms of depression may vary from person to person, and also depend on the severity of the depression. Depression causes changes in thinking, feeling, behavior, and physical well-being.

• Changes in Thinking - You may experience problems with concentration and decision making. Some people report difficulty with short term memory, forgetting things all the time. Negative thoughts and thinking are characteristic of depression. Pessimism, poor self-esteem, excessive guilt, and self-criticism are all common. Some people have self-destructive thoughts during a more serious depression.
• Changes in Feelings - You may feel sad for no reason at all. Some people report that they no longer enjoy activities that they once found pleasurable. You might lack motivation, and become more apathetic. You might feel "slowed down" and tired all the time. Sometimes irritability is a problem, and you may have more difficulty controlling your temper. In the extreme, depression is characterized by feelings of helplessness and hopelessness.
• Changes in Behavior - Changes in behavior during depression are reflective of the negative emotions being experienced. You might act more apathetic, because that's how you feel. Some people do not feel comfortable with other people, so social withdrawal is common. You may experience a dramatic change in appetite, either eating more or less. Because of the chronic sadness, excessive crying is common. Some people complain about everything, and act out their anger with temper outbursts. Sexual desire may disappear, resulting in lack of sexual activity. In the extreme, people may neglect their personal appearance, even neglecting basic hygiene. Needless to say, someone who is this depressed does not do very much, so work productivity and household responsibilities suffer. Some people even have trouble getting out of bed.
• Changes in Physical Well-being – I’ve already talked about the negative emotional feelings experienced during depression, but these are coupled with negative physical emotions as well. Chronic fatigue, despite spending more time sleeping, is common. Some people can't sleep, or don't sleep soundly. These individuals lay awake for hours, or awaken many times during the night, and stare at the ceiling. Others sleep many hours, even most of the day, although they still feel tired. Many people lose their appetite, feel slowed down by depression, and complain of many aches and pains. Others are restless, and can't sit still.

Now imagine these symptoms lasting for weeks or even months. Imagine feeling this way almost all of the time. Depression is present if you experience many of these symptoms for at least several weeks. Remember, depression is treatable.

What Causes Depression?

You may have heard people talk about chemical imbalances in the brain that occur in depression, suggesting that depression is a medical illness, without psychological causes. However, all psychological problems have some physical manifestations, and all physical illnesses have psychological components as well. In fact, the chemical imbalances that occur during depression usually disappear when you complete psychotherapy for depression, without taking any medications to correct the imbalance. This suggests that the imbalance is the body's physical response to psychological depression, rather than the other way around.

Some types of depression do seem to run in families, suggesting a biological vulnerability. This seems to be the case with bipolar depression and severe major depression. Major depression seems to occur, generation after generation, in some families, but not with a frequency that suggests clear biological causes. Additionally, it also occurs in people who have no family history of depression. So, while there may be some biological factors that contribute to depression, it is clearly a psychological disorder.

People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are more prone to depression. Psychologists often describe social learning factors as being significant in the development of depression, as well as other psychological problems.  People learn both adaptive and maladaptive ways of managing stress and responding to life problems within their family, educational, social and work environments. These environmental factors influence psychological development, and the way people try to resolve problems when they occur. Social learning factors also explain why psychological problems appear to occur more often in family members, from generation to generation.  If a child grows up in a pessimistic environment, in which discouragement is common and encouragement is rare, that child will develop a vulnerability to depression as well.

A serious loss, chronic illness, relationship problems, work stress, family crisis, financial setback, or any unwelcome life change can trigger a depressive episode. Very often, a combination of biological, psychological, and environmental factors are involved in the development of depressive disorders, as well as other psychological problems. When you feel depressed, and don't know where to turn, talk to someone who can help.

How does psychotherapy help decrease depression?

Psychological treatment of depression (psychotherapy) assists the depressed individual in several ways. First, supportive counseling helps ease the pain of depression, and addresses the feelings of hopelessness that accompany depression.  Second, cognitive therapy changes the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create depression and sustain it. Cognitive therapy helps the depressed person recognize which life problems are critical, and which are minor. It also helps him/her to develop positive life goals, and a more positive self-assessment. Third, problem solving therapy changes the areas of the person's life that are creating significant stress, and contributing to the depression. This may require behavioral therapy to develop better coping skills, or Interpersonal therapy, to assist in solving relationship problems.

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