Depression afflicts about ten percent of the population in the United States — almost 20 million adults. A medical condition often linked to brain functioning and chemical imbalance, depression interferes with a person’s ability to function. Like any medical condition, when a severe case goes untreated, it creates disruption and suffering. Depressive episodes may occur only once, but more often they take place several times in a lifetime. However, in many instances, these episodes are unnecessary, treatable, and preventable with appropriate care.
Depression affects many aspects of a person — his/her mood, body, thoughts and overall functioning. One’s sleeping, eating, self-esteem, and hope for the future fall under its cloud. Depression influences the ways that people think and perceive just about everything.
Having depression does not mean that a person is weak or is deficient in some way. It is not a condition that can be wished or willed away. People with depression are unable to simply “pull themselves together” and get on with things. Without treatment, depression can last for months or years, regardless of what else is happening in a person’s life. Yet experience shows that depression is treatable when a person follows a carefully designed treatment plan.
Symptoms of Depression
- Being sad much of the time; feeling persistently anxious or “empty”
- Ongoing feelings of hopelessness and pessimism
- Feeling guilty, worthless and helpless
- Loss of interest in previously enjoyable activities, including diminished sex drive
- Having less energy, feeling tired often
- Problems concentrating, memory loss, difficulty making decisions
- Difficulty sleeping, early-morning awakening, or sleeping too much
- Weight loss or weight gain, loss or increased appetite
- Restlessness and irritability
- Physical symptoms with no apparent cause, including stomach problems, headaches, and chronic pain
Causes of Depression
Studies do show that depression may be genetic and a person may be biologically susceptible to the condition. While it is possible that depression may be inherited, this does not mean that one will definitely have depression if his/her parents or parent has it. Most often, depression is caused by a combination of genetic, psychological and environmental factors that interact in complex ways.
Women tend to suffer from depression twice as much as men, as hormonal issues (such as menopause) are more likely to contribute to the condition. Women are often vulnerable to depression immediately after giving birth; this is sometimes referred to as the “baby blues.” Men are less likely to admit to being depressed, and physicians are less likely to diagnose it in males. However, the rate of suicide in men is four times higher than that in women, even though more women attempt suicide. Cultural issues and norms seem to play a role in how depressive symptoms are manifested and dealt with between the genders. With men, depression is often masked by alcohol or drug use, or by socially acceptable behaviors such as excessive working. Men often experience depression not by feeling hopeless or helpless but by being irritable, angry, discouraged and bitter. Not surprisingly, men are also less likely than women to seek help even when their depression is recognized.
Treatment of Depression
Most often, a combination of medication and psychotherapy yields the best results in the treatment of a major depressive episode. If the depression is rooted in an environmental event or situation, such as a divorce or failure in school, and no positive history of depression exists, then psychotherapy alone may well be sufficient. Short-term, or “episodic” psychotherapy that focuses on the negative thought and behavior patterns associated with the depression has been demonstrated to be quite effective in treating depression. Therapy often includes completing “homework” assignments that address the symptoms and behaviors actively, as opposed to only talking about the condition in a more passive way.
A client realizes best results when she is actively involved on a day-to-day basis in her recovery, making an effort which inspires and empowers her. By practicing new behaviors and responses to challenging situations as they arise and by striving to change negative styles of thinking and behaving, the client can significantly reduce acute and persistent symptoms. Effective therapy also focuses on changing a person’s disrupted and “dysfunctional” personal relationships, which may be contributing to the depressive symptoms.
In my work with clients, I conduct a thorough assessment and establish a working contract. I then collaborate with the client to develop a treatment plan and chart a course for recovery. This process may include a psychiatric consultation and/or other medical evaluations. Frequently, spouses, significant others, or family members are invited to participate in the client’s treatment. I may also ask the client to read books and articles pertaining to their particular symptoms and situations. Using this combination of interventions, most people experience significant symptom relief within the shortest possible timeframe.
