What is Depression?
Depression is essentially a human experience. If you think you may be battling depression, you are not alone. People from all walks of life can relate to the common experiences of sadness, grief, and sorrow that is part of life. People with depression suffer emotionally, cognitively, and physically. Scientists believe that depression is related to many neurobiological responses. Depression affects many parts of the brain, including the amygdala (which plays a pivotal role with emotions –especially sadness, fear, and anger), the hippocampus, slowed blood flow within the brain, and other neurobiological functions.
The World Health Organization estimates that in First World countries, about 15% of men and 25% of women experience depression in any given year, and that 25% of all health care visits are related to depression. Other researchers believe that men express depressive symptoms differently than women, and that men’s socialization patterns and behaviors, would indicate a greater prevalence of depression among men. Most people would identify depression as the following:
- Feeling sad, lethargy, blue, listless, and down
- Feeling gloomy or having the inability to have fun
- Behaviors such as crying, moving in a sluggish manner, or not moving at all.
- Thought patterns that are slow, or thoughts of death and suicide.
- Low self-esteem
However, it is important to understand that depression includes other symptoms that the public might not know or recognize:
- Feelings of irritability, anger, frustration (this is especially common for men)
- Inability to sleep
- Feelings of worthlessness and inadequacy
- Thoughts of worthlessness (I’m not good enough, I’ve made too many mistakes, I’m weak and defective)
- Significant weight loss or weight gain, when not dieting (Usually considered a change of 5% of a person’s body weight, loss or gain, within thirty days)
- Difficulty to concentrating
- Anxiety that exacerbates depression
Sigmund Freud believed that depression and melancholia are linked to a person’s inability to be angry with significant person in their life. Thus, a person, unconsciously and irrationally attacks themselves. Often people are put into a double-bind, in which she or he is required to become submissive to another. Caught in the complex emotional web of the double-bind also precludes the person to express the indignation, rage, and the fury of being trapped. The bereavement of relationships is also related to depression, since depression is an emotional response to loss. Loss, that includes death, or having experienced neglect, trauma, emotional, spiritual, physical, or sexual abuse are all related to depressive symptoms. These soul wounds are linked to depression.
Another perspective of depression is that of Aaron Beck, a cognitive and behavioral researcher who believed that an individual’s idiosyncratic perceptions affect their behaviors and emotions. Beck believed that people with depression have:
- Negative thoughts about themselves
- Negative thoughts about the environment or the world
- Negative thoughts about the future
This cognitive triad is linked to skewed and negatively biased thinking patterns. Negative thinking about the self would include thoughts such as “I’m a loser” or “I’m a failure.” Negative thoughts about the world and environment might include thought such as “Others would respond badly to me if I expressed my thoughts or feelings” or “He or she would reject me.” Negative thoughts about the future might include thoughts of “Life will never get better.”
Thoughts or cognitions, as viewed by Aaron Beck are not objective and therefore subjective, rigid, and habitually irrational. These thoughts seem to be true, because they are congruent with depressive emotions. The trap is that because the thoughts are mood congruent, they seem convincing. Because the thoughts are easily believable, individuals do not see the lack of logic of these thought patterns. Unsound and subjective thoughts such as these are problematic:
- Why bother?
- I’m fat and a failure
- I’m old, unattractive and disgusting
- Life is pointless
- He or she doesn’t like me
- I’m a terrible parent/spouse/coworker
These thoughts create a trap and the more a person believes the thoughts, the more the thoughts strengthen and reinforce the beliefs and the thoughts become more and more credible and pervasive. The cycle of negative emotional processing is linked to the negative bias in attention, perceptions, and memory. Those with depression translate these negative biases into their conscious memories, thoughts, and actions.
What is the role of stress on depression?
Stress, trauma, and adverse experiences are related to myriad depressive symptoms. Stress and depression lead to a series of molecular and cellular events that cause changes in the brain and the body. These complex neural and cellular changes are not only linked with depression, but with other health problems such as high blood pressure, diabetes, heart disease. Stressful life events that are considered adverse experiences include:
- Spiritual abuse
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Intimate partner violence
- Observing violence within a household
- Living with someone who abuses alcohol, medications, and drugs
- Living with someone who has mental illness
- Parental separation or divorce
- Incarcerated household member
Is there hope if I struggle with depression?
Yes. Many people have struggled with the complexity of depression, and many of those who have sought help have experienced a reduction in symptoms. Scientists have identified the concept of neuroplasticity; the ability of the brain to alter its structure and ability to function in response to memory, learning, brain injury, and disease. Because the brain is adaptable and malleable change is always possible. Counseling and therapy is essentially a re-learning and re-structuring process of the brain.
One of the most important aspects of working through depression is to engage with people that are trustworthy, dependable, and reliable. It can help to find a candid and sincere therapist. Studies show that having a consistent healthy therapeutic relationship can reduce symptoms of depression. A skilled therapist can help you address your thoughts, feelings, and behaviors and suggest ways to improve your life. I believe it is important to examine a person’s thoughts, feelings, and behaviors in order to relieve depressive symptoms. Some of the ways that I work with clients is to:
- Examine long-held beliefs and ascertain if they are logical and helpful or if they are dogmatic and impede living life to the fullest.
- Find realistic expectations for dealing with depression.
- Address grief symptoms linked to death, and from failed and hurtful relationships.
- Ascertain if antidepressant medications can be useful, and make referrals to competent psychiatrists and psychiatric nurse practitioners. In fact some studies show that individuals who work with a therapist and address cognitive thought issues, and take antidepressants, make more progress than people that only do therapy, or only take medications.
- Examine behaviors such as physical exercise, drug and alcohol use, sleep regimen, and eating patterns that affect depressive moods.
- Find ways of connection. Isolation is one of the most debilitating effects of depression. It is crucial that people with depression, connect with healthy and reliable friends, family, and co-workers. It is also sometimes advisable to avoid toxic people.
- Examine boundaries and how to assertively set boundaries.
- Examine and incorporate your religious and spiritual beliefs. Many people throw-the-baby-out-with-the-bathwater, because of religious and spiritual trauma. It is a healthy response to step away from a toxic religious environment and still maintain one’s personal faith. Acknowledging one’s personal spirituality (be that through nature, energy, waves, light, God, G-d, Allah, gods, goddesses, goodness, Buddha, Jesus, Mother Earth, etc.), is helpful to diminish the effects of depression.
- Incorporate practices such as gratitude, meditation, journaling, thought records, mood records, and other emotional regulation techniques.
- Integrate self-compassion and non-judgmental self-talk.
- Create self-confidence so that you can find working solutions to address the inevitable difficulties of life.
R. David Johns has a PhD in Counseling Education and Supervision, and a Master’s Degree in Mental Health Counseling. He is a Licensed Professional Counselor (LPC) and Licensed Addiction Counselor (LAC) in the state of Colorado. As a counselor and therapist he works with people to better deal with the effects of depression. For an appointment call 303-642-6636 or email at [email protected]t