A Guide to Understanding and Beating Depression

A guide to understanding and beating depression by Counselling in Melbourne

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Given that there are nearly 322 million depression sufferers worldwide, it’s obvious that now, more than ever, we need to be mindful of our mental health. [1]

But how can we prevent or beat depression when we’re constantly under pressure to achieve more and we never know what life might throw down our path?

How can we not feel depressed when we’re so invested in other people’s dreams, that we completely forget about ours?

However, not every episode of sadness or grief is a clear sign of depression. Not every unpleasant event that we go through generates a depressive episode.

So, let’s take some time to understand depression, how it differs from a fleeting moment of sadness, and what we can do to keep this emotional problem under control.

What is Depression?

Ask anybody about this condition and the first word that might come out of their mouth is ‘sadness.’ In other words, we often tend to confuse depression with sadness. But while sadness is an emotion, depression is a mental disorder that affects our emotions, decisions, and actions.

In broad lines, depression is a psychological and emotional disorder that can influence our mood, thinking, and behaviour in a profoundly negative manner. This condition is characterised by a persistent feeling of sadness, lack of motivation, pessimism, and a significant loss of interest in activities that used to bring us joy and satisfaction.

Depression is a relatively common problem with approximately one out of ten adults being diagnosed each year. Furthermore, experts say women are twice more likely to struggle with a depressive episode than men.

According to the National Institute of Mental Health, in 2017, approximately 17 million adults in the United States were diagnosed with major depression. And the most vulnerable group seems to be young adults, aged 18 to 25. But the worst part is that nearly 60% of all U.S. adults diagnosed with depression don’t receive proper depression treatment [2].

In the absence of quality mental health services (counselling, psychotherapy, medication) this condition can lead to suicidal ideation or worse.

What Are the Symptoms of Depression?

We all get ‘depressed’ at times. We all have moments of sadness when life seems less ‘colourful,’ and we feel like nothing’s working out the way it’s supposed to be. For example, it’s normal to feel ‘down in the dumps’ after a breakup or divorce.

But there’s a huge difference between a fleeting moment of sadness or disappointment and a depressive episode. One of the main criteria based on which mental health professionals separate a temporary state of grief and sorrow from a severe episode of depression is the duration. In other words, if it lasts longer than a couple of weeks, then you’re probably dealing with a form of depression.

The symptoms of this condition can affect more than just your emotional and psychological health. This condition can have a significant impact on your physical health as well, not to mention your social life. The point is, when depression ‘strikes,’ it affects all aspects of your well-being.

Some of the main symptoms of depression are:

  • Pessimism
  • Lack of motivation
  • Persistent sadness
  • Irritability
  • Feelings of guilt and helplessness
  • Loss of interest in pleasurable activities
  • Lack of focus
  • Low self-esteem
  • Physical and mental exhaustion
  • Changes in appetite
  • Low libido
  • Suicidal ideation
  • Poor-quality sleep
  • Headaches and migraines
  • Digestive problems

What Causes Depression?

1. Biological factors

If you ask a psychiatrist, he or she will tell you that depression – like any other form of mental illness – has a biological component. In other words, this condition could be the result of a chemical imbalance in the brain.

For example, abnormal levels of serotonin and norepinephrine, two neurochemicals that regulate mood, can contribute to the onset of depression, causing symptoms such as anxiety, fatigue, and irritability.

According to a 2017 study published in the Asian Journal of Psychiatry depression affects neuroplasticity which, in turn, disrupts affect regulation. [3]

In case you didn’t know, neuroplasticity is the brain’s ability to form new neural connections. From a psychological perspective, neuroplasticity translates to adaptability and mental flexibility. As for affect regulation, this mechanism allows us to exercise control over our emotional responses and not let one ‘bad’ emotion ruin our mood.

In the context of depression, losing your mental flexibility, and consequently, your ability to get a handle on your emotions is a recipe for disaster. That’s why people living with depression can easily get caught up in negative emotions and let this overpower their objectivity and control over their feelings.

2. Psychological factors

When it comes to psychological factors that contribute to depression, experts usually gravitate towards loss, failure, and stress.

For example, the death of a loved one or a marriage going down the drain can cause a major depressive episode. Furthermore, a failed business or a lost opportunity can also generate feelings of disappointment and depression, depending on how we interpret failure.

But one of the major psychological factors that contribute to this condition is stress. And there are plenty of reasons to feel stressed nowadays. From lack of job opportunities and financial problems to couple and family issues, life can sometimes seem like an endless chain of burdensome events.

Lastly, since the way we handle life’s ‘ups’ and ‘downs’ depends mainly on how we interpret them, perhaps we should take a closer look at our thinking. In other words, rigid beliefs about how life should unfold or the tendency to focus exclusively on the negative aspects of life can seriously affect your mood and cause depression.

3. Social factors

Most experts agree that human beings are the product of both biological and environmental factors. In other words, our environment can play a crucial role in the onset of depressive episodes.

Exposure to abuse, violence, neglect, poverty, financial instability, and other related factors can make people who are already prone to depression even more vulnerable to this condition.

What’s interesting is that depending on treatment preferences – psychotherapy or medication – people with depression tend to attribute different causes to their condition. [4] In other words, those who are in therapy tend to believe their depression is the result of childhood causes, whereas those under medication don’t necessarily look for a cause to explain their condition.

Understand and beat depression

How is Depression Diagnosed?

When it comes to treating depression, healthcare professionals use psychotherapeutic and psychiatric interventions, but most often, a combination of the two leads to the best possible results.

However, it’s impossible to treat this condition without diagnosing it. That’s why clinical psychologists and psychiatrist start by thoroughly assessing the person’s overall condition, using clinical interviews or psychological tests.

The purpose of a psychological and psychiatric assessment is to reveal the most prevalent symptoms, along with medical and personal history, and the possible environmental factors that could have contributed to the onset of depression.

The reason why mental health professionals place a strong emphasis on in-depth clinical evaluations is to ensure a correct diagnosis which will later help them come up with the appropriate intervention plan.

Therapies for Depression

1. Psychotherapy

Most clinicians use psychotherapy to treat mild-to-moderate forms of depression. For severe types of depression, clinical practice guidelines recommend a combination of psychotherapy and antidepressants.

Although many counsellors and therapists focus on individual sessions where the client discusses issues that are causing his/her depression, there are times when family or couples’ therapy could help clarify problems that arise within his/her close social circles.

At the same time, group therapy is an excellent approach for depression sufferers as it brings together people who are dealing with the same problems. In a way, it’s comforting and encouraging to know that you’re not the only one dealing with this problem. Furthermore, group therapy also gives you the opportunity to discover strategies and techniques that have worked well for others and might work just as well for you.

Depending on the severity of your depression, treatment may take anywhere between several weeks to several months. However, many patients report substantial improvements after about 10-15 sessions.

2. Medication

Since mood disorders are, in part, the result of neurochemical imbalances in the brain and other biological factors, clinicians can sometimes prescribe medication, especially for severe forms of depression.

One recent study published in The American Journal of Psychiatry concluded that a mix of cognitive-behavioural therapy and medication might be the ideal approach to treating depression. [5]

Antidepressants are specifically designed to correct the chemical imbalances that are partially responsible for your depressive episodes. Although you might experience a significant improvement right from the first two or three weeks, the full benefits of medication will only occur after two-to-three months of treatment. In other words, you need to be patient and disciplined enough to continue treatment despite the potentially unpleasant side effects that you might experience.

If you feel like your medication isn’t working out the way it’s supposed to, you can always talk to your psychiatrist who will most likely change the dose or replace it with another antidepressant. Keep in mind that finding the ideal treatment – in terms of dose and type of antidepressant – is a matter of trial and error.

3. Digital resources

We live in a world where knowledge and information are one click away. The Internet has opened the door to numerous exciting opportunities and solutions to our everyday problems.

Even mental health services have undergone some significant changes as a result of digitalisation. In other words, nowadays, there are numerous online programs and platforms dedicated to helping us improve our mental health and well-being.

For example, a 2017 study published in World Psychiatry revealed that smartphone-based mental health interventions represent a promising approach for managing depression. [6]

But aside from smartphone apps and web-based platforms dedicated to providing mental health services, you can also find plenty of online support groups where people share valuable knowledge and resources that could help you manage depression and other related disorders.

How to beat depression - Counselling in Melbourne

5 Expert Tips to Help You Manage Depression:

1. Get a handle on rumination

When life throws us a curveball, we sometimes feel overwhelmed by all sorts of thoughts and interpretations that we attribute to that event. Unfortunately, our tendency to over-analyse a situation or event can quickly turn into an obsession. And when that happens, our mind begins to ‘drown’ in intrusive thoughts, regrets, fears, and all sorts of negative scenarios.

We go to bed thinking about all the unpleasant aspects of our life, and we wake up worrying about what the future might have in store for us. That’s how rumination usually manifests.

But why are we doing this?

Because we think we’re getting rid of something. We overanalyze hoping that we will somehow understand the logic behind a situation or event that’s hard to accept for us. We ruminate because we think it will help us prepare for problems that may arise.

But while reflecting on past events can lead to a better understanding of the present, ruminative thoughts keep us in a circle of self-doubt, confusion, and disappointment.

To combat rumination, you must start by ‘choosing your battles.’ In other words, if you feel like you’re just going around in circles, overanalyzing the same scenario, simply say “STOP” and try focusing on something else.

2. Keep a busy schedule

One of the reasons why people with depression tend to spend a lot of time ruminating about the past or worrying about the future is that their level of engagement in rewarding activities is close to zero.

And it’s not because they’re lazy or irresponsible, but because they lack the energy and motivation to be productive and keep a busy schedule.

As you probably know, people who are dealing with depression have low self-esteem and an overall ‘grim’ perspective on life. They tend to doubt their abilities, and they find it extremely difficult to muster the energy and internal resources necessary for the completion of a task. In short, they often give up before trying.

And the worst part of not having a busy schedule is that you lose the chance to prove yourself that you are in fact capable of achieving something. In other words, zero activities equal zero rewards, and that will only reaffirm the beliefs you already hold about yourself (“I’m useless” “I’m not good enough” “I’m a disappointment to everybody” and so on).

The only way to get past these limiting beliefs is by slowly engaging in pleasant and rewarding activities. Think about what used to bring you joy before depression took over your life and robbed you of motivation. Or, start looking for new activities that might be motivating enough to lift you off the couch.

Start small and avoid pushing yourself too hard. For example, if you want to clean your house, there’s no point in doing it all in one day if you don’t have the energy and determination to reach this goal. Start with one room then work your way up from there.

Remember, the goal is not to achieve maximum performance, but to keep yourself busy throughout the day.

3. Exercise regularly

When was the last time you went out for a jog or maybe a relaxing walk through the park?

Whether you’re dealing with depression, anxiety, stress, or any other mood disorder, most experts believe physical activity is one of the cheapest and most effective strategies for dealing with your emotional problems.

And the reason why exercising is so beneficial for your mental health is that when you engage in low-to-moderate physical activity, your brain releases endorphins which put you in a good mood.

According to a recent article published in The Journal of Psychiatric Research, physical activity is an excellent antidepressant for people who struggle with this condition. [7]

But what happens when you barely have the energy to get out of bed and go about your daily business? What happens when the mere thought of going to the gym is enough to drain your motivation and energy?

As one recent study published in Disability and Rehabilitation points out, people with major depression struggle with a loss of interest, low self-confidence, generalized fatigue, and psychosomatic complaints. [8] And that’s why, for them, exercising might seem way more difficult and exhausting than it really is.

Remember the advice I gave you when we talked about keeping a busy schedule? If you wish to start exercising, do it gradually. There’s no point in forcing yourself to be at the gym for one hour each day if you don’t have the motivation and energy to do it. Start small, maybe ten push-ups a day or a twenty-minute walk around the neighbourhood, then work your way up from there.

Once again, it’s not about performance; it’s about investing in the small everyday actions that keep depression at bay.

4. It’s OK to ask for help

When it comes to physical and mental health, social support has always been a significant predictor for recovery. In fact, family and community support can often act as a buffer against problems like depression.

Unfortunately, not everyone is eager to open up about their problems and share the everyday struggles that are making life difficult and unbearable. Since depression can push us towards isolation, we rarely get the chance to talk to someone who can understand and help us.

But there are plenty of other reasons why we avoid asking for help. For example, some of us might think that asking for help means bothering other people with our problems. And we don’t want to do that.

Or, if we’re living in denial, we might think that talking about depression somehow makes it seem ‘real’ and we don’t want to confront ourselves with that.

There are also those who avoid being open about their emotional issues because they’re afraid others might not understand what they’re going through.

But regardless of the reasons that hold you back from asking for help, keep in mind that this is a battle you cannot win alone. If depression were just a phase or an easily-manageable problem, we wouldn’t have millions of people struggling with this condition.

Finding someone who can lend an empathetic ear or a shoulder to cry on can make a huge difference in your life. It doesn’t matter if it’s a family member, friend, peer, or even a stranger from an online support group. Asking for help is not a sign of weakness, but a step towards recovery.

Lastly, if you feel like the situation has gotten out of hand and depression is causing severe damage to your personal and professional life, perhaps it’s time to consult a professional.

5. Practice gratitude

In broad lines, gratitude is an attitude that we manifest whenever something good happens in our lives. Whether it’s through words or deeds, gratitude generates a pleasant and rewarding emotional state, for both the giver and the receiver.

A 2008 study published in The Journal of Research in Personality revealed that gratitude might have significant clinical implications, as it protects us from depression and stress. [9]

But how can one be grateful when life feels hopeless? How can we exercise gratitude when we feel completely worthless and unable to go about our day-to-day life?

For people who struggle with depression finding reasons to feel grateful can be quite challenging. But you need to remember that practising gratitude is not about grand gestures of recognition or praise but finding joy in the small things.

Be grateful for the roof over your head; be grateful for the people who are there for you; be grateful knowing that no matter how ugly and sad life might seem at the moment, you can always find the strength and courage to reinvent your life.

Final thoughts

Overall, depression represents one of the biggest challenges of our century. Without proper care, this condition can have a serious impact on our overall health and well-being.

If there’s one thing that should bring comfort to those of us dealing with this problem is that depression is a relatively manageable and preventable condition. Over the last decades, researchers and mental health experts have developed numerous strategies, techniques, and treatments to help depression sufferers manage their condition and regain a sense of control and autonomy over their lives.

If you wish to keep depression under control and prevent it from wreaking havoc in your life, remember to:

  • Get a handle on rumination
  • Keep yourself busy and productive throughout the day
  • Exercise as often as possible
  • Turn gratitude into a daily habit

Last but not least, never be afraid or ashamed to talk about your emotional struggles and seek help from people who can understand what you’re going through and provide support.

References

[1] n.a., ” Depression and Other Common Mental Disorders: Global Health Estimates,” World Health Organization, Geneva, 2017.
[2] n.a., “Major Depression,” National Institute of Mental Health, February 2019. [Online]. Available: https://www.nimh.nih.gov/health/statistics/major-depression.shtml.
[3] J. Dean and M. Keshavan, “The neurobiology of depression: An integrated view,” Asian Journal of Psychiatry, vol. 27, pp. 101-111, 2017.
[4] S.-R. Khalsa, K. S. McCarthy, B. A. Sharpless, M. S. Barrett and J. P. Barber, “Beliefs about the causes of depression and treatment preferences,” Journal of Clinical Psychology, vol. 67, no. 6, pp. 539-549, 2011.
[5] B. W. Dunlop, D. LoParo, B. Kinkead, T. Mletzko-Crowe, S. Cole, C. B. Nemeroff, H. S. Mayberg and E. W. Craighead, “Benefits of Sequentially Adding Cognitive-Behavioral Therapy or Antidepressant Medication for Adults With Nonremitting Depression,” The American Journal of Psychiatry, 2019.
[6] J. Firth, J. Torous, J. Nicholas, R. Carney, A. Pratap, S. Rosenbaum and S. Jerome, “The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials,” World Psychiatry, vol. 16, no. 3, pp. 287-298, 2017.
[7] F. B. Schuch, D. Vancampfort, J. Richards, S. Rosenbaum, P. B. Ward and B. Stubbs, “Exercise as a treatment for depression: A meta-analysis adjusting for publication bias,” Journal of Psychiatric Research, vol. 77, pp. 42-51, 2016.
[8] J. Knapen, D. Vancampfort, Y. Moriën and Y. Marchal, “Exercise therapy improves both mental and physical health in patients with major depression,” Disability and Rehabilitation, vol. 37, no. 16, pp. 1490-1495, 2015.
[9] A. M. Wood, J. Maltby, R. Gillett, A. Linley and S. Joseph, “The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies,” Journal of Research in Personality, vol. 42, no. 4, pp. 854-871, 2008.

 

About the editor, Amelia Cambrell

About the editor, Amelia Cambrell

Amelia Cambrell, Psychologist & Counsellor, BA; BSc (Hons); M Psych (Counselling); Dip Clin Hypnotherapy, is a senior psychologist at Counselling in Melbourne and with 15-years of experience in the mental health space is driven to seek client outcomes.

Find out more about Amelia Cambrell

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