We all have times when we feel sad, but depression is something that affects your daily life, making it hard to find enjoyment in day-to-day activities. We take a look at what depression is, its causes, and how counselling/therapy can help.
What is depression?
Depression is a mood disorder that can take many forms: some days you may find it impossible to get out of bed, while other days you may feel more able to go about your normal daily tasks. Living with depression can be incredibly difficult, both for those suffering and those around them. Due to the nature of the condition, however, seeking help can often be delayed.
Psychotherapist Laura Duester explores depression and how counselling can help.
Do I have depression?
For some, an obstacle to them seeking help is understanding whether or not they actually have depression. Before we go into the symptoms of depression, it's important to point out that if you are struggling with your emotions and feel unable to cope, it could be worth seeking support. You are worthy of help, no matter how trivial you may perceive your problems to be.
What does depression feel like?
If you have depression, you are likely to have at least five of the following symptoms.
You may feel:
- like life isn’t worth living
- constantly anxious, tearful and worried
- like you can’t concentrate
- irritable and intolerant of others
- you are not getting enough enjoyment out of life
- you have a lack of self-esteem
- you have excessive and inappropriate guilt
- you have no motivation or interest in things you used to enjoy
You may experience:
- changes in sleeping patterns - broken nights or oversleeping
- changes in eating patterns - loss of appetite or overeating
- tiredness and a loss of energy
- persistent headaches and/or stomach upsets
- chronic pain
- a slower speaking pattern than usual
- loss of libido
- changes to the menstrual cycle
You may also:
- neglect hobbies and interests
- isolate yourself from friends and family
- take part in fewer social activities
- notice your productivity falling at work
In some circumstances, you might not even notice that you have developed depression, especially if it has been a gradual process over several weeks or months. Sometimes it takes a friend, a family member or a partner to point out that you may have a problem.
Why do we become depressed?
Sometimes it’s instantly apparent what the cause is, but other times there isn’t an obvious reason why you feel so down. It could be that you’ve lost something or someone, or it could stem from disappointment or frustration. Usually, there will be more than one reason why you suffer from depression, and these reasons differ from person to person.
Common reasons behind the development of depression include:
Distressing life events
Distressing life events can take their toll on us. Divorce, family problems or losing a job are all momentous in our lives that can alter our mood.
Losing someone close to you can increase the risk. It’s not always just the loss that causes depression, it’s the way we deal with it. If you don’t grieve or express your feelings properly, they can build up and contribute to depression.
Your childhood experiences can affect you in adult life. If you were physically or emotionally abused, or not taught to cope with troubles that enter your life, it could lead you to have problems as you grow up.
‘Frozen anger’ is a term that’s closely related to depression. You may have gone through something that caused you to become angry, but at the time you couldn’t express your feelings properly. This type of anger becomes suppressed; it can then build up and become a cause of depression.
Feeling like you’re alone, stressed, physically exhausted and/or have no one to talk to can all contribute to the condition.
Regular heavy drinking can make you more susceptible to developing depression.
Some types of physical illness can make people more prone to depression:
- hormonal problems, e.g. an underactive thyroid
- viral infections, e.g. glandular fever or flu (prevalent in younger people)
- painful or lasting illnesses, e.g. arthritis
- life-threatening conditions, e.g. heart disease and cancer
- chronic conditions, e.g. diabetes and epilepsy
Types of depression
There are several different forms of depression, including:
Mild depression - When depression symptoms have a limited impact on daily life. Generally, sufferers of mild depression will experience a persistent low mood and spirit. They may find it difficult to motivate themselves to do things they normally enjoy.
Major (clinical) depression - A more severe form that can lead to hospital admission. Symptoms will be more prominent and interfere with daily life. They can affect eating habits, sleeping, and other day-to-day activities. Some sufferers may feel suicidal and that life is no longer worth living.
Bipolar disorder - A form of manic depression characterised by extreme highs and lows. For example, a period of hyperactivity where sufferers are excited and planning overambitious tasks is followed by a period of severe depression.
Seasonal affective disorder (SAD) - A form that’s closely related to the length of days. It typically occurs in the autumn and winter months when the days are shorter. Symptoms tend to alleviate when the days get brighter and longer.
Martin has helped me see things in a different perspective and has helped me to realise that I have a different alternative to darkness.
When to get help for depression
If you experience depression symptoms for most of the day, every day, for more than two weeks, you should seek help from your GP. If your feelings start affecting many parts of your life, this is a sign you may need professional support. The parts of your life that depression can have a negative impact on include, but are not limited to:
- an overall sense of happiness and enjoyment
Thoughts of suicide and self-harm are also warning signs that your condition is getting worse. If you experience these, you should look to seek professional support.
For many, being treated for depression can seem an impossible task, but the sooner help is sought the better. In some cases, the illness can disappear without treatment. This is not always the case however and there is a danger that living with the condition will put significant emotional and physical strain on your health and well-being. Therefore, many people with depression opt for treatment.
In the initial stages, your GP will look to diagnose the condition by conducting tests to rule out other health problems such as an underactive thyroid. They will then ask various questions about your general health and how your feelings are affecting your mental and physical well-being. From here, the appropriate treatment options will be pursued. These will depend on the nature of depression and your personal circumstances.
Depression treatment and support
Speaking to a professional, whether that's your GP or a counsellor, can help you understand what you need. This can range from self-help tips and breathing exercises, to psychotherapy and/or medication. Everyone is different and will need differing levels of support.
Depression is a treatable condition, even in its most severe form. A range of treatment options should be provided. The two most common forms offered are counselling and medication. These are often used in combination - particularly in more severe cases.
Depression counselling is often recommended as a combination treatment plan. Talking therapy can help you identify, address and manage negative, self-defeating thoughts that may affect the way you behave with depression. The following types of counselling and psychotherapy have been proven effective in treating depression:
Cognitive behavioural therapy (CBT)
According to guidelines issued by the National Institute for Health and Care Excellence (NICE), cognitive behavioural therapy is among the recommended therapies for treating depression. This therapy is based on the premise that the way we behave and think affects the way we feel. People with depression tend to have self-defeating thoughts that can lead to negative behaviour. CBT aims to help sufferers identify and address their negative thoughts and their unhelpful behaviour patterns.
Counselling for Depression (CfD)
CfD is a model of psychological therapy recommended by NICE for the treatment of depression and approved for delivery within the Improving Access to Psychological Therapies Programme (IAPT). Counselling for Depression is one of the therapies recommended in addition to CBT.
The counselling was really great, and I was even put in contact with a person who would support me with my inquiry at work, and represent me if needed. Having professional support in this matter took such a load off my mind.
Mindfulness-based cognitive therapy (MBCT)
This type of talking therapy is specifically designed to help those who suffer from recurring depression. Mindfulness-based cognitive therapy combines elements of cognitive therapy and mindfulness techniques (breathing exercises and meditation) to help break or change your relationship with negative thought patterns.
Interpersonal therapy (IPT)
Interpersonal therapy focuses on how our mental health affects our relationships and how our relationships affect us. The thinking behind it is that psychological symptoms, such as depression, are typically a response to the difficulty in our communication with others. The symptoms gained from this can also cause communication to deteriorate, thus causing a cycle. IPT works best with those who have identifiable problems.
Psychodynamic therapy aims to find out how a person’s unconscious thoughts affect their behaviour. This type of therapy can help individuals understand and unravel their deep-rooted feelings and experiences.
Although the term ‘group therapy’ can be applied to many talking therapies, it’s mainly used with those that work best within a group dynamic. One of the main benefits of this type of therapy is the support network of peers going through the same sort of issues. It aims to encourage you to share your experiences and work on understanding yourself better.
Art therapy uses artistic mediums to help individuals explore their emotions in a new way. It uses art as a form of communication - this is especially good for those who find it difficult to verbalise their feelings.
Alongside counselling, medication may be prescribed by GPs to help sufferers who are experiencing moderate to severe depression. Antidepressants can help to ease common depression symptoms such as poor sleep, low mood, and poor concentration. They can help sufferers function better and even increase their ability to deal with difficult situations if they arise.
Such medication, however, is not effective for everybody and does not tackle the root cause alone. This is why counselling for depression is recommended in combination with medical intervention.
The important thing to remember is that you have options. Support is available and it won't always be this way. You are not alone in this.
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