Depression is a serious mental illness that impacts one’s self-image, perspective, hope, purpose, sense of capability and general outlook on life. While sadness is a natural emotion flowing from loss or disappointment, depression has no adaptive purpose. Sadness can signal to us the meaning of a rejection letter or lost friendship and activate personal growth. Depression prompts immobilization and offers stagnation. Sadness lacks the distorted thinking that prolongs the suffering that is so debilitating in depression.
Depression is often accompanied by low energy and poor motivation. It really is a life sucking disorder. In a way, it is anti-life. The distortion can be so serious, that we forget our successes. We negate our accomplishments. We might even forget them entirely. It’s rare to experience depression and not also have low self-worth. Such negation of Self leaves many vulnerable to suicidal ideation or death by suicide.
There are Different Types of Depression
While depression is often thought of in terms of its impact on our mood, its impact on our thinking and behavior makes it particularly debilitating. The most common types of depression include:
- Clinical depression which is reflected in significant impairment of one’s daily life functions and loss of interest in activities;
- Bipolar disorder characterized by mood swings that range from depressive lows to rapid manic elevations in mood;
- Postpartum depression that emerges after childbirth; and
- Persistent depressive disorder (dysthymia) which is a milder form of depression that has persisted for a long time. While the symptoms may not present as severe as clinical depression, some people report low moods that might include poor appetite, low productivity, always feeling kinda “blah,” having poor concentration or low self-esteem for a period of at least two years. It can be lifelong.
What Causes Depression?
Genetics, substance abuse, early adverse childhood experiences and trauma can all play into why some people experience depression and others don’t.
Key to understanding the treatment for depression is to recognize that depression is always accompanied by distorted and illogical thinking. In fact, you can’t really experience a particular feeling about something unless you have reasoned with that experience in your mind.
If your mind is skewered negatively by your perception, then the meaning and interpretation of what you experience will be negative and your mood will match what it believes exists.
How You Think Affects How You Feel
In other words, your thoughts will always be “off,” that is, illogical, unrealistic or outright wrong if you are feeling depressed or anxious. We call these illogical and unrealistic thoughts, thinking errors. The body creates a feedback loop in which your thoughts impact your mood which then plays into your behavioral choices. For example, if you think you are “useless” or a “loser,” then you feel bad about yourself, have lowered motivation and might be inclined to stay in bed and not actually do anything because your thinking might be “what’s the point?” You don’t get things done, fall behind, disconnect from interests, people, anything meaningful which then reinforces that you are “useless” and “a loser” and the cycle repeats all over again.
What Works to Treat Depression
Cognitive therapy and cognitive behavioral therapy (CBT) are the most common and researched modalities for treating depression. With these treatments, we learn to identify certain patterns of thought and then replace them with healthier thinking that is more reflective of reality. Cognitive therapy tends to focus on the here and now while CBT will include analysis of one’s past and also behavioral techniques to shift behaviors. Some common techniques used in CBT are:
- Developing Self-Awareness: Identifying thought patterns to determine how they shape outlook.
- Setting Goals: To help facilitate purposefulness and increase motivation.
- Self-Monitoring. Using a journal, log or daily planner to track strategies and symptoms over time to determine triggers, progress and increase awareness of what works well.
- Problem-solving. Learning how to prevent relapse into negative feedback loops with specific solutions.
- It’s a dreaded work that we often reframe as “practice,” but the cornerstone of CBT is homework. It’s important to implement new strategies and ways of being outside the session. The better you are able to do this, the more likely you will get what you need out of therapy.
Not One-Size-Fits-All Approach
A blended approach is probably the best for treating depression and treatment might depend on the severity. If severe, medication is a good option. Seeing a psychiatrist and a psychotherapist for talk or behavioral therapy may help tremendously.
Eye Movement Desensitization and Reprocessing (EMDR) is another modality that has proven effective if some of the root cause of negative thinking or mood results from trauma. We know that trauma can distort thinking and make us more hypervigilant regarding negative cues in our attempt to feel safe. EMDR, Accelerated Resolution Therapy and Brainspotting can help remove the visceral effect and deep hurt that emerges with certain kinds of thinking or reexperiencing of traumatic memories so that they don’t intrude so extensively on life in the present.
Below are some links to information to help you get a deeper understanding of the way in which depression can impact your functioning:
Bookmark our online mental health journal for weekly updates on matters relating to well-being and good mental health. Miss your last group session? You’ll find summaries of coping skills practiced in the UR Journal.