People experience depression for many reasons and can be helped with a variety of treatments. Depression is a common condition, and according to NAMI, 25-30 million Americans suffer from depression. Generally, people who experience depression report feelings of worthlessness, hopelessness, body aches and pains, low energy, and a lack of pleasure in daily activities and life. Everything may feel very difficult for the sufferer. According to the National Institute of Mental Health (NIMH), symptoms of depression may include the following:
- Difficulty concentrating, remembering details, and making decisions
- Fatigue and decreased energy
- Feelings of guilt, worthlessness, and/or helplessness
- Feelings of hopelessness and/or pessimism
- Insomnia, early-morning wakefulness, or excessive sleeping
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Overeating or appetite loss
- Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
- Persistent sad, anxious, or "empty" feelings
- Thoughts of suicide, suicide attempts
According to the Mayo Clinic, depression symptoms in children and teens can be different than they are in adults...
- In younger children, symptoms of depression may include sadness, irritability, hopelessness and worry
- Symptoms in adolescents and teens may include anxiety, anger and avoidance of social interaction
- Changes in thinking and sleep are common signs of depression in adolescents and adults but are not as common in younger children
- In children and teens, depression often occurs along with behavior problems and other mental health conditions, such as anxiety or attention-deficit/hyperactivity disorder (ADHD)
- Schoolwork may suffer in children who are depressed
There are many different types of depression including:
- Major depression or clinical depression can prevent individuals from functioning normally. An episode of clinical depression may occur only once in a person's lifetime. More often though, it recurs throughout a person's life. One of the symptoms must be either depressed mood or loss of interest in the usual activities. Also, the depressive symptoms must cause clinically significant distress or impairment in functioning.
- Dysthymia (chronic low-grade depression) is characterized by a long-term (two years or more) depressed mood. The symptoms present are similar, but not enough for a diagnosis of major depression and is less disabling for the sufferer.
- Seasonal affective disorder, seasonal depression or SAD, is a depression that occurs each year at the same time. It usually begins in the fall or winter and ends in spring or early summer. Less frequently, SAD occurs as "summer depression," which begins in the late spring or early summer and ends in fall.
- Bipolar is a complex mood disorder that alternates between periods of clinical depression and episodes of elation or mania. There are two subtypes of bipolar disorder. Bipolar I is characterized by patients having a history of at least one manic episode with or without major depressive episodes. Bipolar II disorder is characterized by patients having a history of at least one episode of major depression and at least one hypomanic (less severe, only mildly elated) episode.
- Postpartum depression is diagnosed when a new mother develops a major depressive episode within one month after delivery and is more severe than the "baby blues" which affects nearly 75% of new moms. Hormonal factors and the abrupt drop in hormones unique to women post-delivery are likely to contribute to depression following childbirth. Hormones directly affect the brain chemistry that controls emotions and mood, and women are at greater risk of depression at certain times in their lives such as before their period, throughout puberty, during and after pregnancy, during perimenopause and after menopause.
- Atypical depression differs from other types of depression. Symptoms include increased hunger, weight gain, over sleeping, a sensation of heavy arms and legs and mood that fluctuates in response to situations and interpersonal experiences.
- Psychotic depression involves symptoms of psychosis such as delusional thoughts or hallucinations that accompany the symptoms of depression.
- Adjustment disorder is a type of stress-related mental illness. Symptoms include feeling anxious or depressed and possibly suicidal, and develop within 3 months of an event and are more severe than expected. In addition to somatic complaints and feelings of sadness and hopelessness, suffers may withdraw from people and experience impulsive and self-destructive behaviors.
Depression may develop in response to significant life events, such as a change in marital status, death of a family member or friend, or career and financial difficulties. People who are trying to manage chronic illnesses such as cancer, heart disease, pain, kidney disease, arthritis, lupus, multiple sclerosis, HIV/AIDS or Parkinson's disease may also experience depression.
Some common mental health conditions may co-occur with depression and include: anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder and alcohol and substance abuse. No two people experience depression in exactly the same way. Depression for the sufferer often feels overwhelming and can be a challenge to live with, but there are excellent treatment options available. You don’t have to be alone with your depression, and there is no shame in asking for help.
What are some effective treatment options for depression?
In my private practice, I use a form of treatment called interpersonal psychotherapy. Interpersonal therapy for depression puts emphasis on the way symptoms are related to a person's relationships, including family and friends. This type of therapy focuses on the relationships in your life and how they can contribute to your symptoms of depression. This relatively short-term therapy helps patients improve the relationships in their lives in order to relieve the potential causes of depression. If social problems are occurring they are explored in depth.
Cognitive Behavioral Therapy
Research is clear that Cognitive Behavioral Therapy (CBT) is extremely effective in helping with depression. CBT is a technique that targets thoughts and actions. During sessions, you and your therapist work to develop and understand unhelpful thought patterns and behavioral habits that contribute to depression. CBT then focuses on helping you practice the desired changes in both your thoughts and behavior in order to form a new and healthier habits. If social problems are occurring they are addressed as well. CBT is evidence-based, and known to be a fast and effective treatment to help people manage life in more effective ways.
Many are open to using mindfulness meditation to facilitate the healing process. Mindfulness provides a way of working with emotions at a very deep level. Mindfulness helps people pay attention to the "here and now" and helps individuals become aware of their negative, distorted thoughts such as "I can't do anything right" and learn to acknowledge them, without judgment, with the realization that these thoughts are not accurate reflections of reality. This helps individuals begin to view their thoughts as less powerful. The experience of "learning to observe thoughts" ultimately leads to distorted thoughts having less weight as people master the practice of mindfulness. I work with other forms of meditation in addition to mindfulness meditation, and have found meditation to be a very helpful adjunct to traditional psychotherapy.
Sometimes, deeply-held beliefs may interfere or block successful depression treatment. The experience of trauma can leave us with dysfunctional beliefs about ourselves. Some examples include: “I’m worthless,” “It’s all my fault,” "the world is cruel" and “I don’t deserve to be happy.” Such beliefs can easily lead to depression as well as anger, shame, grief, guilt, anxiety, compulsive overeating, self-sabotage, hopelessness and helplessness, fear of success and/or failure, patterns of victimization and fear of closeness or abandonment. EMDR can successfully remove these blocking beliefs about the self and the world. EMDR is then used to "install" positive, helpful and accurate beliefs about the self and world. Often, removing the "interference" of blocking beliefs allows individuals suffering from depression to begin to allow other forms of treatment to work.
Whether you are interested in CBT, DBT skills, EMDR therapy, meditation, interpersonal or expressive talk therapy for depression, I have successfully treated a wide range of clients with depression, from moderate to severe, and collaborate with other mental health professionals such as psychiatrists if medication is needed. Many of my patients are successful executives and creative individuals who struggle with depressive symptoms. If depression is interfering with your life, it is important to work with a mental health provider.