PSYCHOTHERAPY FOR DEPRESSION

Depression is a serious illness, not a harmless part of life. It is a complex disorder with a variety of causes. It is never caused by just one thing. It may be the result of a mix of factors, including genetic, chemical, physical, and sociological causes. It is also influenced by behaviour patterns learned in the family and by the way we interpret the world around us.  Depression affects thousands of people in the UK.

It is always troubling, and for some people it can be disabling. Depression is more than just sadness or “the blues.” It can have an impact on nearly every aspect of a person’s life. People who suffer from depression may experience feelings of despair and worthlessness, and these can have an enormous impact on both personal and professional relationships.

DEPRESSION IS PERVASIVE

When a person suffers from depression, it can affect every part of his or her life, including one’s physical body and one’s behaviour, thought processes, mood, ability to relate to others, and general lifestyle.

Depression does not seem to be related to ethnicity, education, income, or marital status. It strikes slightly more women than men. Some researchers believe that depression tends to strike more often in women who have a history of emotional and sexual abuse, economic deprivation or a dependency on others. There also appears to be a genetic link. This is evidenced by the fact that depression is more common among parents, children, and siblings of people who are diagnosed with depression.  The average age at the onset of a depressive episode is the mid-twenties. However, people born more recently are being diagnosed at a younger age.

It is unknown whether life experiences cause mood changes, which create changes in brain chemistry; or whether it works in reverse!

Many physicians believe that depression results from a chemical imbalance in the brain.  They often prescribe antidepressant medication, and many people find relief as a result.  However, there is no reliable test to identify such a chemical imbalance. It is unknown whether life experiences cause mood changes, which create changes in brain chemistry; or whether the process works in reverse.  Depression may be associated with physical events such as other diseases, physical trauma, and hormonal changes. A person who is depressed should always have a physical examination as part of the assessment process to determine the role of physical causes.

People who are diagnosed with clinical depression have a combination of symptoms from the following list:

• Feelings of hopelessness, even when there is reason to be hopeful
• Fatigue or low energy
• Greatly reduced interest or pleasure in most regular activities
• Low self-esteem
• Feelings of worthlessness
• Excessive or inappropriate guilt
• Reduced ability to think or concentrate
• Indecisiveness
• Thinking distorted thoughts; having an unrealistic view of life
• Gain or loss of weight without dieting
• Change in appetite
• Change in sleeping patterns
• Recurrent thoughts of death
• Suicidal thoughts
• A specific plan for committing suicide
• A suicide attempt
• Feelings of restlessness or being slowed down

When a person is suffering from depression, these symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. This means that
the person’s family, social relationships and work life are impaired.  When a person is suffering from depression, symptoms such as these are not the result of a chronic psychotic disorder, substance abuse, a general medical condition, or bereavement.  Depression may include feelings of sadness, but it is not the same as sadness. Depression lasts much longer than sadness and while depression involves a loss of self-esteem, grief and disappointment sadness does not. In general, people who are depressed function less productively whilst people who are sad or disappointed continue to function.

Depression can often be prevented. It is especially important to take preventive action if you are aware that you have predisposing factors such as those mentioned above.  Once you have worked through your depression it will be important to engage in behaviours that will help you to prevent another cycle of depression such as:

Identify your risk factors and be aware of where you are vulnerable.

Each of us has unique risk factors, such as things we were taught in our families of origin, values we have learned, and the presence or absence of a family history of depression. Anything that has been learned can be unlearned and replaced with something healthier.

Learn to manage stress.

You can learn proven techniques for calming and relaxing yourself. Consider taking a stress management class or buying a set of relaxation tapes.

Learn problem-solving skills.

Many people who develop depression never learned problem solving skills. They need to develop the ability to view problems from many viewpoints and look for a variety of solutions

Build your life around things you can control. 

Learn to recognize what you can control and what you can’t. Avoid spending much effort on situations that won’t pay off for you.

Learn self-acceptance.

Instead of rejecting  the parts of yourself you don’t like, learn to manage them more productively.

Become aware of selective perception. 

Observe how you generate ideas and opinions about people and events. Remember that these are just your views, not necessarily objective facts.

Focus on the future, not the past.

Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.

Develop a sense of purpose.

Many depressed people lack a sense of purpose or meaning. This means they have no goals and nothing in the future drawing them forward. To prevent depression, develop your sense of purpose and meaning.

Strengthen your emotional boundaries and set limits.

Boundaries define your role in a social situation. They determine how you will and will not behave in a given situation. Having clear, strong boundaries is empowering, while boundary violations make you feel victimized and helpless. Setting limits means having and enforcing rules for what behavior you expect in a relationship.

Build positive and healthy relationships. 

Think about what you need from others in relationships.  Learn to read people and trust your instincts about whether they are good for you.

Avoid isolation.

Talk to people about what’s going on with you. If you keep your thoughts to yourself, you may be unaware that they are distorted.  If you share them with another person, you can become more objective.