Suffering with depression
What is depression?
We all feel sad or under the weather at times, but we only talk about depression when these feelings are prolonged, or when they are so strong that they impair our normal way of living. Feelings of depression are more severe and persist much longer than the brief moments of despondency that we all experience from time to time.
Many people with symptoms of depression often ask themselves: “Am I really losing my mind?”, or “What's wrong with me?”. These questions tend to become even more nagging when we hear our loved ones say “Stop being so dramatic, pull yourself together”. While most of us feel like we are alone in trying to overcome the depressed mood, depression is in fact a disease that one in four people will experience at some point of their life.
What causes depression?
The causes of depression are many, and they may vary considerably. In most cases these can include:
- biological causes related to the level of hormones or neurotransmitters (serotonin and norepinephrine) in the brain
- psychological causes: relationship breakdown, job loss, death of a loved one, unemployment , financial problems or physical ailments.
The causes often seem obvious: disappointment, frustration, loss of someone or something important. However, not in all cases are the causes of depression so self-evident. It is not always clear why we are feeling blue, down in the dumps, or out of sorts. Regardless of the underlying reasons, in most cases the feelings of depression are so strong that a specialist’s help is required to deal with them.
Usually, a few of the following symptoms occur:
- feelings of despondency, sadness, guilt
- loss of self-confidence and low self-esteem
- lack of interest in everyday issues and inability to derive pleasure from doing things that we used to enjoy
- feeling of loneliness, even when among other people
- difficulty making decisions
- not being able to cope with issues that used to give us no trouble
- feelings of exhaustion
- irritability, continuous anxiety, or a state of slowdown noticeable in the way we move and communicate
- loss of appetite and weight, or overeating and weight gain
- sleep disturbances, difficulty falling asleep, or waking up frequently
- worse concentration, poor memory
- fatigue, usually in the morning
- avoiding contact with people
- self-harm, or even suicidal thoughts.
Where to seek help?
Depression can be treated with psychotherapy or antidepressant medications.
When is psychotherapy needed?
In most cases cognitive-behavioural therapy is very effective on its own, and combining it with drug therapy significantly improves the results and prevents recurrence of depression in the future. This is especially true when the underlying causes are our deep-rooted beliefs about ourselves, others, and the world. It is precisely these beliefs that hinder our day-to-day lives, and often cause severe emotional disorders that can last for years.
What is cognitive behavioural therapy?
It is one of the approaches in psychotherapy, particularly useful in working with anxiety, depression and low self-esteem. It works by showing the relationship between thoughts and emotions, changing the negative thoughts, and developing better ways/techniques that will help us deal with difficult situations better.
This therapy is very effective in the treatment of many emotional disorders, especially in the treatment of neuroses and depression, because it helps us realise that depressing thoughts play a significant role in our disease. The way we think affects how we feel, and this determines how we behave and how our body reacts.
People who suffer from depression have a lot of negative thoughts most of the time. Each negative thought makes us more depressed and prevents us from performing our daily activities. As a result, we begin to blame ourselves for being lazy and irresponsible, which produces a sense of guilt that makes us feel worse and our depression gets worse. In other words, we get into a vicious circle.
Cognitive behavioural therapy allows us to change our mood by changing our way of thinking, which in itself is the most common cause of depression. This type of psychotherapy also gives us a chance to deal with problems that could cause a recurrence of depression.
Dynamic and interpersonal psychotherapies can help overcome difficulties in establishing interpersonal contacts. If depression is caused by family problems or by problems in a relationship with a partner, a therapist specialising in the treatment of family and partner relationships can help.
Verbal therapies are very safe and effective, but having a therapist with adequate professional qualifications, as well as having confidence in the therapist, are extremely important.
What kind of pharmacological agents may have a positive effect?
In addition to traditional antidepressants, which can only be prescribed by a physician, research has shown that St. John's wort also brings positive results in the treatment of mild depression. It is similar in action to antidepressants, and some argue that it has fewer side effects.
If depression is chronic, stronger anti-depressants are helpful. However, it must be noted that antidepressants do not work right away, and it may be three to four weeks before their positive effects are felt.
What to choose - therapy or pills?
The decision depends on the severity of depression. Cognitive behavioural therapy is very effective and in most cases it is used as the only treatment. Sometimes, however, in very severe depression the treatment is supported by medication.
Usually, three out of four people suffering from depression start feeling better two to six weeks after beginning the therapy.
If depression is left untreated, we can suffer its symptoms for up to two years, and a small number of people with depression die by suicide.
How can you help yourself?
What can help is, for example, a conversation with someone close to whom you can confide a painful experience to, as retelling the experience can improve your mood. People suffering from depression feel unmotivated and lethargic; they often avoid leaving home and seeing other people.
It helps to be active, go for a walk, do some exercise. Physical exercise keeps us fit, helps us sleep better and increases the level of hormones responsible for our good mood. It is also recommended that we do something at home - focusing on different activities will enable us to break the depressing thoughts, and this will improve our well-being.
Eating well is also important, even if we do not always feel like eating. Alcohol is not recommended as it actually worsens depression, even if its effects seem to be positive at first.
If you can’t fall asleep, do not keep thinking about it. Instead, do something relaxing, such as reading, watching TV, or listening to your favourite music.
If you know what causes your depression, you can try to think about possible solutions to the underlying problems. It is good to try out the best ideas.
If you want to help a person suffering from depression, the most effective thing will be to listen to that person without giving your own opinions, judgements, or advice. If the depressed person feels worse and starts talking about life being meaningless, or about their intention to hurt themselves, treat this seriously and try to convince the person to see a doctor or psychotherapist as soon as possible. The risk of suicide is three times higher among men than among women. This may be because men are more likely than women to seek help in alcohol or drugs, and less likely to seek professional treatment.
Regardless of the severity of depression - do not lose hope. Depression is very common and the available therapy will help you to deal with it. Often, after the depression is over, people become stronger, more resistant to stress and can cope with other problems in life more easily.
Helpline numbers for people living in England:
- Samaritans UK: 08457 90 90 90 is a phone line open all day, every day. Use it if you need to talk to someone, when you’re struggling with suicidal thoughts, or if you're in a desperate situation. Email: email@example.com
- NHS Direct: For health advice and information 24 hours a day, 365 days a year, just dial. 111 from any landline or mobile phone free of charge.
This article was prepared by Barbara Paczkowska, MSc, CBT Psychologist and Therapist - January 2014
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