Depression: down in the dumps

Depression can be a debilitating condition and very frightening to experience. Strong moods and extreme thinking can make it hard to recognise yourself.  Physical symptoms such as gaining or losing large amounts of weight or drastic changes to one’s sleeping patterns eventually compel people to seek medical or psychological support. Even when people have a family history of depression, they feel surprised to find that they have these symptoms and feel confused about what has caused them to feel this way.

When the symptoms of depression (see below) are suspected or recognized it is always advisable to seek medical opinion. Once reviewed by a trained physician, then seeking supportive and professional counselling is recommended to manage any emotional or psychological aspects of the condition. My practice is to always insist that people with depression are seeking regular medical support in addition to psychotherapy or counselling. Research conclusively indicates that combination treatment with medical, psychological and alternative therapies provides better outcomes.

A Process-Oriented approach to depression basically believes that symptoms are attempting to draw attention to a meaningful underlying process. In other words, your depression is not simply a biochemical experience, but also a psycho-socio-emotional one (see next paragraph). Getting to the core of the symptom in order to uncover this meaningful aspect is at the heart of a process oriented approach. You will see from the list below that a one-size fits all approach to depression would miss the many potentially meaningfully processes which are lurking behind similar superficial symptoms.

For simplicity’s sake, here is a list of common underlying processes that tend to appear as depression on the surface:

Psychological – a lifetime of suffering with negative, highly critical or perfectionist thinking patterns, an abuse history which has yet to be fully resolved; poor self esteem or loss of confidence; dealing with chronic psychological or physical illness or addictions; chronic sense of abandonment or rejection in life.

Social – loss of life direction or meaning; spiritual confusion or disconnection; financial difficulties, loss of job, spouse or significant other (including animals); chronic disempowerment or social isolation (due to gender, race, religion, skin colour, gender identity, sexuality or other); social anxiety or agoraphobia; poor social skills or extreme introversion or sensitivity; boredom or feeling stuck in a routine with life, unable to create desired change. 

Emotional – a pattern of unexpressed sadness, anger or frustration; acute or chronic suppression of grief response or trauma response after death, injury or other trauma.

Symptoms of Depression

A person with depression would experience five or more of these symptoms for most or all of the day, nearly every day for 2 weeks or longer:

1.Depressed mood

2.Markedly diminished interest or pleasure in all, or almost all, activities   

3.Significant weight loss/weight gain or decrease/increase in appetite

4.Insomnia or hyper-somnia (sleep a lot/not at all)

5.Physical agitation or sluggishness

6.Fatigue or loss of energy

7.Feelings or worthlessness/excessive or inappropriate guilt

8.Diminished ability to think or concentrate or indecisiveness

9.Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

If you recognise yourself or a loved one in these pages, please seek help immediately. Depression is a highly treatable condition and Medicare Rebates are now available allowing ongoing treatment for this diagnosis.

Go gently,

Michelle

© Please request permission from the author to reproduce any part of this article. I must acknowledge Silvia Camastral, whose article on depression inspired and informed this article.