Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is costly, widespread, and can be very debilitating. As an illness, depression can be defined as MOOD disorder that affects the way we think, feel, and behave. Depression as a diagnosis is a label intended to facilitate communication about a group of symptoms (experiences) often reported by people as occurring together.
What are the most common symptoms of depression?
These are the most common symptoms people report when they seek treatment for symptoms of depression:
- Persistent sad, anxious, or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or 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, or making decisions
- Insomnia, early morning awakening or oversleeping
- Appetite and/or weight loss, or 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.
A diagnosis of depression does not tell us anything about the underlying causes of the symptoms, which need to be clearly identified and addressed in order to achieve long-term relief.
What are the psychological factors contributing to Depression?
Although there can be many factors causing symptoms of Depression, research points to life events involving loss, as highly associated with the onset of depression. Psychodynamic theories also understand depression as a symptom related to largely conscious and unconscious experiences of loss. Beginning with Freud, psychoanalysts have referred to the losses as the “catastrophes of childhood,” and have identified three themes around which the experience of depressive affect tends to develop: loss of the attachment figure, loss of the love of that parental figure, and loss of the parental approval. There is a fourth “calamity” that also plays a role in the development of depressive affect, related to feelings of guilt and the need to punish ourselves.
Naturally we want to do everything we can to avoid re-experiencing the pain of these childhood catastrophes. For this reason, we are equipped to develop coping strategies (in psychodynamic therapy these coping strategies are called defenses, while in Cognitive-Behavioral Therapy this is often referred to as automatic thoughts) that allow us to take reality in bite size by intervening between outside events and our emotional reactions. These defenses, coping strategies, or automatic thoughts, often go unnoticed, and they are so familiar, and believable that we take them as “truths.” Although they operate out of our field of awareness, the parts of our brain in charge of survival strategies is picking up on the messages impacting us at every level.
Take for instance the case of an adult that experienced early childhood abandonment, who has life-long struggles to develop emotionally intimate relationships so that he or she can successfully avoid feeling the pain of another abandonment. The tools used to create emotional distance can be anything that a person can feel, think or do to keep the other person at a safe distance. Although the person achieves certain level of safety or control in the moment, the long-term effect is one of isolation, which can lead to an episode of depression, and ultimately reinforces their self-concept, often unconscious, of being unworthy of love.
We learn to cope with difficult emotions in ways that were effective in the past, and that are effective in the short-term. In the past, they provided very an important protection of our attachments to our parents upon whom our survival depended in childhood. However, the protective mechanisms in childhood, are often root cause of the problems of the adult.
“Defensive processes, organized coping responses aimed at minimizing the experience of distress, function protectively, but not without untoward consequences. The degree of defense in relationships and functioning in the world become the main distinction between resilience and increased vulnerability for developing psychopathology,” Diana Fosha (2000). CBT therapy also recognizes that the maladaptive schemas developed in childhood can make the patient vulnerable to developing or relapsing into depression (Young, Weinberger, Beck, 2001).
When we become adults, defensive/coping strategies that are rotted in childhood wounds are often ineffective. Mainly because we tend to respond to present situations AS IF they are replicas of the past. When our defenses don’t work properly, we experience anxiety or depressive affect, which are usually the reasons why people finally seek therapy.
What should you do if you are experiencing symptoms of Depression?
Emotional pain and sadness are part of life. When people first experience symptoms of depression it can be difficult to know if there is something that needs to be done. Usually, people make adjustments to their life style, such as increased exercise, change in diet, take time off, reach out to friends, or use self-help books/resources. All of these supportive measures can be of help. However, if symptoms don’t go away or if they return, it is best to seek professional help.
Depression is a treatable condition. The sooner you seek a consultation with a mental health professional, the more likely it is that you can experience prompt relief of symptoms. Delaying in seeking help can result in longer and more expensive treatment, not to mention, unnecessary suffering.