What is depression?

Depressive symptoms can include feeling very chronically sad and hopeless, having low energy, repressed or flattened emotions, a poor attitude and a bleak outlook on life. Some ripple effects of depression can include feelings of indifference, low self-esteem, underachievement and poor motivation.

The National Institute of Mental Health (NIMH) defines depression as:

"An illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and just get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression."

Depression is now technically called "Mood Disorder." There are various forms of Mood Disorders:

"Major Depression" is the term used to describe a serious heavy debilitating depression that may include thoughts of suicide (see below for symptoms ).

"Dysthymic Disorder" is a chronic lower level depression with less pronounced, less severe than major depression. This is a more commonly diagnosed form of depression that is fairly constant for at least two years for adults and one year for children.

"Bi-Polar Disorder" is characterized by mood swings between severe depression and (usually brief) periods of mania/elated mood. Treatment for bi-polar disorder includes psychotherapy, which may be combined with mood regulating medication.

"Cyclothymic Disorder" is a lower level, chronic version of bi-polar disorder that includes less severe mood fluctuations. As in dysthymic disorder, Cyclothymic symptoms are fairly consistent for at least two years for adults, and one year for children.

Symptoms of depression:

These feelings commonly last for 2 weeks or longer:

• Persistent sad, anxious, or 'empty' mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being slowed down
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening or oversleeping
• Appetite and/or weight loss, overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain

What causes depression?

Clinical research has shown that there is a strong biological component in the cause of depression. It is common for individuals diagnosed with depression to have a family history of this condition or other mental illnesses. Stresses in the environment can exacerbate symptoms. These can include but are not limited to; death, divorce, relationship dissolution, illness, financial difficulties, employment or business complications, current political climate/terrorism threats, and major life changes/losses.

Treating Depression with Cognitive Behavioral Therapy

One of the more popular forms of psychotherapy used today is Cognitive-Behavioral Therapy (CBT). The premise of CBT suggests that by changing the way you think and behave you will change the way you feel. Cognitive-Behavioral Therapy combines two different kinds of psychotherapy; cognitive therapy and behavior therapy.

Cognitive therapy teaches you how certain thinking patterns are causing your symptoms. These inaccurate thought processes give you a distorted picture of what's going on in your life, making you feel anxious, depressed or angry for no truly valid reason. These thoughts may also provoke you into ill-chosen actions such as unhealthy relationships, substance abuse and other compulsive behaviors.

Behavior therapy helps weaken the connections between thoughts (or cognitions) about troublesome situations and habitual reactions (or behaviors). This may include feelings of fear, anxiety, depression, rage, or self-destruction. Behavior therapy can teach mind and body calming techniques, so it is possible to feel better, think more clearly, and make better decisions.

Cognitive Behavioral Therapy provides a sense of empowerment and a set of tools. Through use of these tools, the unpleasant, unhealthy symptoms can subside and life can be more manageable and fulfilling. The cognitive aspect of CBT includes the conscious alteration of thoughts, beliefs, ideas, attitudes and assumptions. The behavioral aspect of CBT consists of applying life management and coping skills thereby enacting changes and improvements in the problem areas. As a result of this two part equation, depression, stress, compulsions and other disruptive feelings can begin to be minimized.

Anti-depressant Medication

Medication is not for everyone although it can be very useful for some people. I do not prescribe medications, but will gladly refer specific individuals to a Psychiatrist if necessary.

If you are already taking medication or decide to begin taking medication, it is generally advised that you participate in regular psychotherapy. The combination of medication with the psychotherapy can be very effective at managing and treating a variety of psychological disorders. There is a wide range of anti-depressant medications that a psychiatrist can prescribe.

Some people with mild depression may do well with psychotherapy alone. People with moderate to severe depression often times benefit from the addition of anti-depressants.