Online Therapy

What Depression is and what it isn't

 

The word depression is used to describe various and sometimes overlapping experiences. To many people being depressed means feeling sad,’ blue’, down, disappointed, or upset. However, one can feel all these emotions without being ‘clinically’ depressed. Feelings of sadness or the ‘blues’ are generally brief and have slight effects on normal functioning.

 

Clinical depression is an emotional, physical and cognitive (thinking) state that is intense and long-lasting and has more negative effects on an individual’s day-to-day life.

 

It is also important to distinguish depression from the sadness we naturally

experience after loss, such as during bereavement. Although the grief

associated with loss is often intense and long lasting, such emotions are

healthy and functional, allowing people to adjust to their new life after the loss. 

Depression on the other hand is not functional or healthy.

Instead of providing people with new avenues for development and growth,

depression often robs us of finding meaning in our lives and inhibits our

personal growth.

 

Finally, it is helpful for depressed people to understand what depression is and isn’t. It is not something to be ashamed of or guilty about. It is not a character flaw or the sign of a weak personality lacking in discipline or personal strength.

It is not just a “mood” that someone can “snap out of”. Most importantly, depression is not permanent – that is, the chances for complete recovery are excellent. A number of psychological and pharmacological treatments (antidepressant medication) are effective, affordable and readily available.

 

Treatments for Depression

There are two major forms of treatment for depression that may be used individually or in combination, depending on the type of depression.

 

                                                               

 

 

 

 

 

Psychological treatments

Psychological treatments for depression provide a supportive environment to share and work through difficulties. Psychologists help by providing skills and strategies to change thinking patterns and behaviours that contribute to depression. Studies on the effectiveness of psychological treatments for depression have shown that cognitive-                       behavioural therapy and interpersonal therapy are particularly successful.

 

These approaches are structured, specialised therapies and have been found to be much more effective than general counselling. They provide techniques and skills that can help reduce and control depression and lessen underlying sensitivity to future episodes of depression.

 

 

 

Antidepressant medications

One defining aspect of depression is a change in the balance of chemicals in the brain that impact on our mood. Lacking some specific chemicals in our brain can contribute to feeling low, sad and fatigued. Antidepressant medications are drugs that help restore the brain’s chemical balance to alleviate biological symptoms of depression.

 

 

 

Combination treatments

For some types of depression, particularly more severe depression, a combination of both anti-depressant medication and psychological treatment may be most helpful. Antidepressant medication helps change an individual’s mood state, and increases responsiveness to psychological treatment. This treatment provides support and strategies to change depressed thinking and behaviour and improves long-term coping skills to minimise future relapse.

 

Things you can do to manage depression

Problem areas and solutions:

Loss of interest in pleasurable activities and daily routine

People who experience depression are often unable to complete daily tasks and do not enjoy activities they previously enjoyed. They miss out on positive experiences associated with a sense of achievement and on the pleasure derived from completing daily tasks. The people around them may also suffer as a result.

 

                                                          There is evidence to show that increasing activity levels and participating in pleasurable                                                                   experiences can help reduce depressive symptoms. The following points provide guidelines                                                             for increasing pleasurable activities and the sense of accomplishment you experience.

 

                                                          Make a list of activities you need to complete as well as some that you find (or used to find)                                                             enjoyable. Make sure you write down as many activities as you can. Remember to also list                                                                 activities that are only marginally enjoyable.

                                                          Plan activity schedules each day to gain a sense of achievement when these are completed.                                                             Include enjoyable activities and try to increase the amount of time each day available for                                                                   these.

                                                          Think about what you have accomplished once you have completed a daily task. When                                                                       participating in pleasurable activities think about their enjoyable aspects. Talk to others                                                                   about activities they enjoy and reflect on positive experiences.

 

Remember that during a depressive episode you often lack motivation to work through daily routines and things you enjoyed previously may not seem as enjoyable. Focus on the positive, no matter how small, and remember that as you recover the enjoyment you experience will increase.

 

Changes in sleeping patterns

Changes in sleeping patterns (over sleeping and/or insomnia) are common in individuals experiencing a depressive episode. Disruptive sleeping patterns can make you feel worse and make routine communication and activities seem overly difficult and frustrating. Regular healthy sleeping patterns are critical to recovering from depression. Listed below are a few key points to assist you in establishing healthy sleeping patterns.

 

• Make sure you get up around the same time every morning regardless of how tired you feel.

• Avoid sleeping during the day or taking naps in the early evening.

• Reduce tea and coffee intake to a maximum of 2 cups per day and do not have any tea or coffee after 4pm.

• When you are awake at night do not lie in bed trying to sleep for more than 30 minutes at a time. Get up, go to another room and engage in a relaxing activity, such as reading, listening to music or a relaxation exercise. When you feel sleepy, return to bed and sleep.

 

Worrying and negative thinking

People with depression often worry about the future and have negative thoughts about themselves and their circumstances. These thinking patterns are unhealthy in that they reduce a person’s ability to focus on recovery and tend to increase their vulnerability to other unhealthy emotions and behaviours.

 

Changing negative thinking patterns and reducing worry is not as easy as it may seem. This is an area where people often require the assistance of a psychologist or other mental health professional. Below are some helpful suggestions for learning to control worry and reduce negative thinking.

 

• When worrying about a problem, write down exactly what the problem is. If there is more than one problem, write each one individually. Once you have written each problem down, systematically complete a problem solving exercise. Address each one by examining all the possible outcomes (positive and negative) and their likelihood of occurring.

• Take time to think about how realistic your negative thoughts are.

• Explore different thoughts and explanations for circumstances.

       Keep a record of these more helpful ways of thinking.

• Avoid excessively discussing negative thoughts and feelings with

       colleagues, family or friends. Instead, try to focus on positive aspects

       of situations. Negative thinking and dwelling on negative topics will

       not help you feel better.

• Keep yourself busy and your mind focused on tasks. Avoid

       unstructured time where your mind may wander and dwell on

       negative themes.

• Try to think positively. There are many things you can do to address the cognitive (thinking) component of depression. These include: making a list of your skills, talents, and achievements; identifying the three most beautiful things in your environment; reminiscing about a time when you were really happy, successful or content.

• Set aside a daily “worry time” of 15 minutes when you do nothing but ruminate about your problems. Once this time is finished leave all your concerns behind and begin working on thinking more positive thoughts. If during the day you begin to focus on your worries, remind yourself that there is a designated time for this and move your thoughts away from your problems. After some time people often complain that they have difficulty filling 15 minutes with their worries.

• Keep a journal of your thoughts, identify negative and unhelpful thoughts and try to correct them.

• Do not make any major life decisions, such as quitting your job or getting married, while depressed. Remember, you may not be seeing yourself, the world, or the future in a clear way when you are depressed.

 

Irritability, agitation and fatigue

 

People with depression often experience irritability, agitation and fatigue. Sometimes they feel frustrated with their rate of recovery or the level of support available and annoyed that they don’t have the energy to do anything. They may become more easily upset with those around them.

Irritability, agitation and fatigue are often compounded by changes in sleeping patterns and other symptoms associated with depression, such as negative thinking.

Being irritable or agitated is a normal part of depression. It is important that others around you who provide support are aware of this. This is so they can be more patient and understanding, rather than annoyed and unsupportive.

 

Below are some tips to help you deal with irritability and agitation.

 

• Make sure you take the time to educate and advise key support people, such as close friends, family and colleagues, of what you are going through. Help them to understand that if you appear irritable or agitated it is not because you are unhappy with them, but rather because you are recovering from depression. Thank them for their support and provide feedback on how they can best continue to support you.

• When you are feeling irritable or agitated, stop and settle yourself down. Ask yourself what is driving your emotions. If it is negative thinking, then use strategies outlined previously to tackle negative thoughts. If you are tired, pace out your workload to allow for this. If you feel unmotivated, try and incorporate some enjoyable activities into your schedule.

• Practice regular relaxation activities and organise regular times to talk with a support person, like a psychologist or counsellor, about how you are coping and implementing new coping skills. By taking time out to relax regularly and to communicate with supportive people, you greatly reduce the impact of potentially irritating and frustrating experiences.

• Be as active as possible despite fatigue. Try to schedule activities to fill up the spare hours of the day. Activities may include exercise, social interaction or even routine household chores. If activity seems impossible, try to force yourself to do three things each day, such as getting out of bed, getting changed out of your pyjamas and brushing your hair. Even the smallest amount of activity is better than no activity at all.