Everyone can feel sad at times, have a down day or feel a little downhearted from now and then; often situations or difficult life events can easily influence our feelings in this way. However at these times feelings of sadness are generally brief and have a slight effect on normal functioning.
A good example of a difficult life event that can sometimes influence longer, more intense feelings is through a loss or during bereavement. When we experience grief it is often very overwhelming, intense and we can have trouble coping with intense and often a range of feelings. However it is important to distinguish this from clinical depression as such emotions are a healthy response to loss and are an important part of adjusting to a new life.
Clinical depression is an emotional, physical and cognitive (thinking) state that is intense and long-lasting and has more negative and significant effects on a person’s day-to-day life. Approximately one in five people will experience an episode of clinical depression in their lifetime.
Being diagnosed with clinical depression is nothing to be ashamed of, it is not a sign of weakness or something to feel guilty about. Nor is it possible to ‘just get over it.’ It is a condition where recover is possible with professional assistance.
It is helpful to consider what is causing and maintaining depression as this can help to inform the most helpful treatment. There are usually a number of factors that play a role in the development of depression.
Common causes of depression include:
- Life stressors such as work demands, changes in relationships
- Medical illness
- Biological vulnerability such as a family history
- Personality such as being prone to anxiety, low self-esteem, perfectionism or sensitivity to criticism
Signs and symptoms of depression include:
A person may be depressed if for more than 2 weeks he or she has felt down, sad or miserable or has lost interest or pleasure in usual activities, and has also experienced several of the following signs or symptoms. It is important to note that symptoms can be mild, moderate or severe and do not need to include suicide ideation.
- Negative thinking eg. ‘I’m a failure’ or ‘I’m worthless’
- Withdrawal eg. not going out anymore
- Inability to concentrate
- Feelings of hopelessness or helplessness, feeling trapped
- Changes in sleeping or eating patterns
- Feeling irritable, agitation or fatigue
- Worrying alot
- Feeling guilt, overwhelmed, and/or indecisive
- Not getting things done at work or home or school
- Feeling desperate and/or suicidal
There are 2 main forms of treatments used individually or in combination, depending on the type of depression:
1. Psychological treatments:
Provide a supportive environment to work through personal difficulties. Psychologists help by providing skills and strategies to help a person address the contributing factors, which have led to depression. This may involve a person changing their thinking patterns, approaching life stresses or relationships differently, making lifestyle changes, regaining self-esteem or reconnecting with his or her values. This then aims to reduce a person’s vulnerability to future episodes of depression and provides long-term coping strategies. There are a number of psychological treatments that have research evidence supporting their effectiveness include Interpersonal Psychotherapy and Cognitive Behavioural Therapy.
1. Anti-depressant medications:
During clinical depression there is a change in the balance of chemicals in the brain that can impact mood. When some specific chemicals in the brain are very low or lacking this can contribute to feelings of low mood and sadness. Anti-depressant medication can then help restore the brain’s chemical balance to improve mood.
Your general practitioner will be able to provide you with more information on these treatment options.