What is Depression?

What is depression?

 A Client is talking to a psychologist. 

A quote from Stephen Fry:

“If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.”

“Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.”

― Stephen Fry.    

Stephen Fry is an actor who has struggled with Bipolar Disorder.

I’m an experienced psychotherapist with 40 years of experience and a lifelong sufferer of depression. After all the facts are read below, depression is a miserable experience. It has been miserable not only for me but also for my family. I can report that medication and group and individual therapy were of enormous help. Suffering depression has made me fully understand my clients and be able to help them recover. My late wife, daughters, and friends gave me warmth, love, and support, which helped me through my dark times.

Bipolar Disorder

Bipolar disorder is a mental health condition affecting mood, energy, and activity levels. It is a mood disorder characterized by periods of depression and periods of mania or hypomania. 

The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include:

  • Overwhelming sadness.
  • Low energy and fatigue.
  • Lack of motivation.
  • Feelings of hopelessness or worthlessness.
  • Loss of enjoyment of things that were once pleasurable for you.
  • Difficulty concentrating and making decisions.
  • Uncontrollable crying.
  • Irritability.
  • Increased need for sleep.
  • Insomnia or excessive sleep.
  • A change in appetite causes weight loss or gain.
  • Thoughts of death or suicide (suicidal ideation).

If you’re experiencing suicidal ideation (thoughts of suicide), seeking immediate care is important. Call 911 or the Suicide and Crisis Lifeline at 988. 

Major Depressive Disorder (MDD)

Major depressive disorder (MDD) was ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030.

  • Feelings of sadness, tearfulness, emptiness, or hopelessness
  • Angry outbursts, irritability, or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation, or restlessness
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions, and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
  • Unexplained physical problems, such as back pain or headaches

Symptoms of depression can cause serious issues with day-to-day activities. Some people may feel miserable without really knowing why.

Persistent Depressive Disorder (PDD)

Persistent depressive disorder is often known as dysthymia or chronic major depression. In the past, this condition was considered a personality disorder, which connotes a permanent, pervasive nature. However, it is likely better conceptualized as a temporary state that can change. 

Major depression includes intense sadness, hopelessness, fatigue, suicidal thoughts, and low mood. In dysthymia, one tends to experience fewer and milder symptoms.

Major depression occasionally happens, while dysthymia’s symptoms last longer and cause ongoing life disruption.

Treatment for major depression typically involves medication and therapy. Dysthymia is often treated with psychotherapy long-term. 

In major depression, the symptoms tend to prevent one from carrying out day-to-day functions, including going to work or daily routines. People with dysthymia often manage daily life and social relationships but have difficulty feeling positive emotions.

Despite the differences, both disorders impede one’s mental well-being, impairing social and occupational functioning. Early diagnosis and treatment can help improve the quality of life with major depression and dysthymia. Suppose someone suspects they have either major depression or dysthymia. In that case, it’s always best to consult a physician or mental health professional to assess symptoms.

Major depression has a range of causes, including biological, environmental, genetic, and psychological. Here are some of the primary factors that contribute to causing major depression:

Many studies have found that physical changes in the brain’s structure and function are linked to major depression. Neurotransmitter imbalances are linked to depression.

Family history can considerably affect a person developing major depression. Research shows that depression is more likely in people with relatives with the condition.

Traumatic events can lead to major depression.

How a person thinks and personality can make them more prone to experiencing major depression. For example, someone with low self-esteem or negative thinking patterns is more likely to develop depression. In contrast, someone with a positive self-image and a more optimistic outlook is less likely to experience depression.

Social isolation and lack of support can lead to depression. 

A combination of factors usually causes major depression. It affects different individuals differently, depending on their personal experiences and characteristics. Early recognition of the condition and timely intervention can help ease symptoms and provide a path to relief and recovery. Seek professional help if you or someone you know is experiencing depression.

Major depression is a common mental health issue that can harm work, social, and personal relationships. It is a serious medical illness that can affect a person’s mood, thoughts, behavior, and physical health. People with major depression may struggle with routine tasks because of overwhelming sadness.

Major depression is caused by genetic predisposition, neurotransmitter imbalance, stress, and environment. Some major life events, such as divorce, job loss, disaster, and negative events, might trigger major depression. 

Antidepressant medication such as SSRIs and SSRNIs is often recommended for people who suffer from major depression. Medication helps balance some of the chemical imbalances in the brain and helps ease many symptoms related to depression.

However, antidepressant medications eventually lose their effectiveness. That is why the MD replaces that prescription with another or adds something to the existing medication. The best recommendation is for a combination of medication and psychotherapy.

I urge anyone experiencing depression to get help. 


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