How does depression differ from occasional
sadness?
Everyone feels sad or 'blue' on occasion. Most people grieve over upsetting life
experiences such as a major illness, loss of job, a death in the family or
divorce. These feelings of grief tend to become less intense on their own as
time goes on.
Depression occurs when feelings of extreme sadness or despair last for at least
two weeks or longer and when they interfere with activities of daily living --
such as working, or even eating and sleeping. Depressed individuals tend to feel
helpless and hopeless and to blame themselves for having these feelings. Some
may have thoughts of death or suicide.
People who are depressed may become overwhelmed and exhausted and stop
participating in certain everyday activities altogether. They may withdraw from
family and friends.
What causes depression?
Changes in the body's chemistry influence mood and thought processes, and
biological factors contribute to some cases of depression. In addition, chronic
and serious illness such as heart disease or cancer may be accompanied by
depression. With many individuals, however, depression signals first and
foremost that certain mental and emotional aspects of a person's life are out of
balance.
Significant transitions and major life stressors such as the death of a loved
one or the loss of a job can help bring about depression. Other more subtle
factors that lead to a loss of identity or self-esteem may also contribute. The
causes of depression are not always immediately apparent, so the disorder
requires careful evaluation and diagnosis by a trained mental health care
professional.
Sometimes the circumstances involved in depression are ones over which an
individual has little or no control. At other times, however, depression occurs
when people are unable to see that they actually have choices and can bring
about change in their lives.
Can depression be treated successfully?
Absolutely. Depression is highly treatable when an individual receives competent
care. Psychologists are among the licensed and highly trained mental health
providers with years of experience studying depression and helping patients
recover from it.
There is still some stigma, or reluctance, associated with seeking help for
emotional and mental problems, including depression. Unfortunately, feelings of
depression often are viewed as a sign of weakness rather than as a signal that
something is out of balance. The fact is that people with depression can not
simply 'snap out of it' and feel better spontaneously.
Persons with depression who do not seek help suffer needlessly. Unexpressed
feelings and concerns accompanied by a sense of isolation can worsen a
depression. The importance of obtaining quality professional health care can not
be overemphasized.
How does psychotherapy help people recover from depression?
There are several approaches to psychotherapy -- including cognitive-behavioral,
interpersonal, psychodynamic and other kinds of 'talk therapy' -- that help
depressed individuals recover. Psychotherapy offers people the opportunity to
identify the factors that contribute to their depression and to deal effectively
with the psychological, behavioral, interpersonal and situational causes.
Skilled therapists such as licensed psychologists can work with depressed
individuals to:
Pinpoint the life problems that contribute to
their depression, and help them understand which aspects of those problems they
may be able to solve or improve. A trained therapist can help depressed patients
identify options for the future and set realistic goals that enable these
individuals to enhance their mental and emotional well-being. Therapists also
help individuals identify how they have successfully dealt with similar
feelings, if they have been depressed in the past.
Identify negative or distorted thinking patterns
that contribute to feelings of hopelessness and helplessness that accompany
depression. For example, depressed individuals may tend to overgeneralize, that
is, to think of circumstances in terms of 'always' or 'never.' They may also
take events personally. A trained and competent therapist can help nurture a
more positive outlook on life.
Explore other learned thoughts and behaviors
that create problems and contribute to depression. For example, therapists can
help depressed individuals understand and improve patterns of interacting with
other people that contribute to their depression.
Help people regain a sense of control and
pleasure in life. Psychotherapy helps people see choices as well as gradually
incorporate enjoyable, fulfilling activities back into their lives.
Having one episode of depression greatly
increases the risk of having another episode. There is some evidence that
ongoing psychotherapy may lessen the chance of future episodes or reduce their
intensity. Through therapy, people can learn skills to avoid unnecessary
suffering from later bouts of depression.
In what other ways do therapists help patients and their loved ones?
The support and involvement of family and friends can play a crucial role in
helping someone who is depressed. Individuals in the 'support system' can help
by encouraging a depressed loved one to stick with treatment and to practice the
coping techniques and problem-solving skills he or she is learning through
psychotherapy.
Living with a depressed person can be very difficult and stressful on family
members and friends. The pain of watching a loved one suffer from depression can
bring about feelings of helplessness and loss. Family or marital therapy may be
beneficial in bringing together all the individuals affected by depression and
helping them learn effective ways to cope together. This type of psychotherapy
can also provide a good opportunity for individuals who have never experienced
depression themselves to learn more about it and to identify constructive ways
of supporting a loved one who is suffering from depression.
Are medications useful for treating depression?
Medications can be very helpful for reducing the symptoms of depression in some
people, particularly for cases of moderate to severe depression. Some health
care providers treating depression may favor using a combination of
psychotherapy and medications. Given the side effects, any use of medication
requires close monitoring by the physician who prescribes the drugs.
Some depressed individuals may prefer psychotherapy to the use of medications,
especially if their depression is not severe. By conducting a thorough
assessment, a licensed and trained mental health professional can help make
recommendations about an effective course of treatment for an individual's
depression.
Depression can seriously impair a person's ability to function in everyday
situations. But the prospects for recovery for depressed individuals who seek
appropriate professional care are very good. By working with a qualified and
experienced therapist, those suffering from depression can help regain control
of their lives.
The American Psychological Association Practice Directorate gratefully
acknowledges the assistance of Daniel J. Abrahamson, Ph.D., Lynne M. Hornyak,
Ph.D., and Lynn P. Rehm, Ph.D., in developing this fact sheet on depression.
Copyright, APA October 1998