Depression

Depression is a complex disorder that is multi-faceted that has no specific cause nor is there a single, off-the-rack cure. Although there are many common features and symptoms, it is experienced differently in each individual.

Its cause can be biological, social and psychological however it is not caused by just one event or factor. And often the risk-factors that lead to depression can be seen many years prior to actually experiencing depression.

This is how the National Institute of Mental health in the U.S. puts it:

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

There are many good websites that can give a clinical definition and any search will bring up volumes on how depression is defined:

www.blackdoginstitute.org.au
www.moodgym.anu.edu.au

Differing Opinions - What We Experts Have to Say

Ideas about treating depression vary greatly depending on who you talk to. Here are some of the things you might hear or have heard:

• A psychiatrist might recommend and prescribe anti-depressants: "Take a pill; call me in the morning."
  
  Comment: Medications can help but find a psychiatrist who can work psychologically too (not all are trained for this) or who will work alongside
  your therapist.



• Neuroscience might say: "You are just hard-wired that way."
  
  Comment: Maybe so but its going to be pretty hard to buy a new hard drive. In fact, research is now showing that making changes can lead to changes in brain function. So don't despair - 'hard-wiring' is not absolute!



• Geneticists might say: "You have a depression gene; bad luck."
  
  Comment: Whilst some people are predisposed to depression, there is no such thing as a 'depression gene'.



• Drug companies might say: "It's a chemical imbalance; we can rearrange your brain chemistry."
  
  Comment: The likelihood of brain chemistry alone causing depression is
  extremely low.



• Coaches might say: "Get up off your arse and get moving soldier!"
  
  Comment: Whilst this might be technically correct, as an intervention it is
  almost useless.



• The deeply depressed person says: "Suicide is the cure."
  
  Comment: Depression shifts. Suicide doesn't. Don't fall for this one.



• Psychotherapy/counselling says: "Let's work together and understand what is going on in your life and how you deal with some of those things. Let's see in what way that contributes to your depression, see what you can control, deal with what you can't and get your life back on track."
  
  Comment: You are a unique human being, dealing with a very complex and painful disorder. Make sure you get treated as such. No one 'wants' to be depressed. Work with someone who is skilled, understanding and willing to work with you.

Anti-depressants

Pharmaceutical companies have been very effective at selling the idea that depression is 'just' a chemical issue that needs rectifying through taking a prescribed drug.

Certainly pharmacotherapy (prescribed medications) can be helpful, even very helpful, to many depression sufferers. Often symptoms are felt as being reduced when using anti-depressant medications. They take a while to work and you may need to be patient and try more than one. Also, be prepared to be on them for at least several months but always consult your doctor.

However this is not the magic bullet we are lead to believe. If it were, depression rates would fall simply by prescribing medication but we know depression rates are rising despite new and more widely available medications.

For the majority, brain chemistry is far from the sole or even main reason they are depressed. The other issues still need to be addressed with psychological interventions.

Counselling and Psychotherapy Treatment

Even in the counselling and psychotherapy field there is much said about what types of therapy are best.

Cognitive Behavioural Therapy (CBT)

CBT is most frequently cited as being the effective psychological treatment for depression. This tends to be because it is the most easily measured form of counselling and is practiced most by general practitioners and psychologists, making research data more available. This enables people (particularly governments) to see treatment as a predictable science that can be standardised. Unfortunately, this 'one size fits all' approach doesn't suit everyone and those who have the subjective experience of depression may have a different view and will require more individualized treatment.

Interpersonal Therapy

Interpersonal therapy is also seen as resulting in good outcomes for depression sufferers. This is because depression is often significantly influenced by the interactions a person has and the type of relationships he or she has.

In both cases, CBT and Interpersonal Therapy, depressive symptoms need to be addressed; (see Depression Symptoms) i.e. thinking or cognitive function or increasing social connections etc. It's important to bear in mind that it's impossible for anti-depressant medications to deal with these areas.

For more information on depression see:

• Depression
• Depression Treatment
• Depression Symptoms

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