"I'm miserable, I'm depressed" - these are expressions we often use in our daily lives when we are not feeling well, feeling either sad, dissatisfied, or upset.
Naturally, such negative feelings can be quite natural and normal to experience under certain circumstances, as in cases of a broken relationship, mourning over a deceased relative, or losing a valued job. But what happens when these feelings persist? When is depression more than a passing gloom? This guide will try to answer some common questions.
*Please note the concepts of CBT treatment for Depression will not be detailed here but reviewed in a separate article.
What does depression feel like?
Depression is a condition that affects us on several levels, both physically and emotionally, and as an extension, it often impacts our social lives, work, interpersonal relationships with loved ones, and our overall sense of motivation.
Depression is a common phenomenon manifested by one or more of the following symptoms: consistent low mood for two weeks or more, loss of pleasure and interest, feelings of guilt regardless of objective reality, low self-esteem, sleep and appetite disturbances, a feeling of general low energy and decreased concentration.
It is crucial to remember anyone may struggle with Depression, as it is an illness and not a flaw in character. Some of the most famous, powerful, and successful people in the world had openly shared their struggle with Depression, from Winston Churchill to Robin Williams, Ernest Hemingway to J.K. Rowling, as well as Jon Hamm, Lady Gaga, Dwayne Johnson, Bruce Springsteen, and Abraham Lincoln, who wrote in 1841: “If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth".
You can suffer from depression in a mild and short form, or, alternatively, in a prolonged and severe form, which can even be life-threatening. The problem can be chronic or a one-time event or an experience that comes and goes. Be that as it may, the illness of depression causes significant damage to the function in daily life and the quality of life.
What are the different types of Depression?
Clinical depression (Major Depressive Disorder):
Refers to a significant feeling of despondency and despair both in intensity and scope, which leads to a notable impairment in functioning and causes great suffering, beyond what is perceived as appropriate for the situation. This is a slightly different feeling than the usual "down" feeling that we all know, in that Depression feels all-encompassing, and is often associated with a general sense of hopelessness.
Dysthymia (silent depression, latent depression):
Prolonged depression is present but at a lower intensity than in the case of major (clinical) depression. Low mood, lack of pleasure, lack of desire, and a feeling of gra
yness - all these persist and cause great suffering. The suffering is less obvious often to the environment, and many people report “wearing a happy face” while struggling with an ongoing depressive mood. Eventually, it may often lead to a rise in frustration and an increased sense of detachment and being unsupported or understood due to the gap between the external impression and the difficulties experienced within.
Postnatal Depression (during pregnancy and postpartum depression) – Not to be confused with Baby Blues:
Postnatal depression is a very significant phenomenon - if not recognized and treated in time, it may manifest and lead to years of suffering. Postnatal depression often includes a strong alienation from the baby, difficulty connecting with and taking care of them, thoughts of death, decreased appetite, and sleep disorders. This condition can be dangerous and requires treatment as soon as possible, as it may impact the person (mother), the baby, and their development as the child’s care and the relationship between the mother and the baby may be severely impacted.
*It is sometimes (mistakenly) confused with Baby blues - which are often felt during the postpartum period – in which mothers may struggle with increased fatigue and low mood, mostly due to hormonal reasons; however, Baby blues are often recognized by the person as a temporary, manageable change in mood and thinking.
Very severe and extreme depression may develop to a point where the person’s reality check is distorted, developing various thoughts and beliefs that are irrational and non-sensible (for example, that their body is rotting or that they are actually already dead). In such situations, depression may be in such extremity that low mood is no longer experienced, but rather there is an emotional detachment. Psychotic depression is a very dangerous condition that requires urgent psychiatric help and medication.
Depression and Anxiety:
Depression and anxiety are often closely related and feed into each other - Anxiety disorders (e.g. OCD, Social Anxiety, or PTSD) often cause depression, and depression is often accompanied by anxiety. Seeing a professional is needed to identify the root of the problem, recognize whether it is Depression or Anxiety disorder that is the primary condition, and recommend an appropriate treatment plan. The treatment for both is quite similar, and apparently, there is some similarity in the biological mechanisms that lead to both.
How common is depression?
According to the data in the western world, about 15% of the population suffers from depression at some point in their lives.
Is CBT effective for Depression?
Research suggests that using the Cognitive Behavioural Treatment model is as effective as drug treatment in patients suffering from depression. Out of all psychotherapeutic approaches, CBT is the most commonly recommended by bodies such as NICE Guidelines and NHS England.
Of course, treatment with antidepressants can also be very effective, and a combination of CBT and medication is sometimes advised to produce the best results.