Depression

By: Meir Stolear, BA (Hons.), MSc (London)

What is depression?

Throughout the world, depression is the most common mental health problem.

Many studies on depression are predicting that most of us will, at some time, experience symptoms of depression severe enough to affect our lives. The World Health Organization (WHO) is predicting that depression will become a worldwide epidemic.

Depressive disorders have been with human kind since the beginning of recorded history. For example, King David, as well as Job, suffered from depression. The Greek philosopher Hippocrates referred to depression as melancholia. In the nineteenth century medical doctors saw depression as an inherited weakness of temperament. Freud linked the development of depression in humans to emotional guilt and psychological conflicts. In the 1950’s and 60’s depression was divided into two types, endogenous and neurotic. Endogenous means that the depression is caused by biological factors such as genetic defects, whereas neurotic (or reactive depression) is caused by environmental factors, such as loss of loved ones or other significant losses. In the 1970’s’ and the 80’s much attention was given to the effect that depression has on the sufferers and less on the causes.

Since the 1990’s not all experts agree on the causes of depression, however, most agree on the following:

  • Depression is very different from healthy grief or sadness.
  • Symptoms of depression are: negative thoughts and beliefs, constant negative moods followed by negative behaviour, which leads to ill-effects on the body functions, such as sleeping disorders, eating disorders, poor sexual libido and more.
  • It is agreed that certain people, especially those with bi-polar depression (manic depression) disorder have a genetic tendency towards such conditions.
  • Depression can increase vulnerability to other illnesses, such as coronary diseases, HIV, asthma, stress disorders and more. It is assumed that depression can increase illnesses and bring about premature death.
  • Most of the diagnosis for depression is done by GPs in a primary care setting and not by mental health specialists, which may mean that the disorder is under-diagnosed.
  • Despite clear research evidence and clinical guidelines for treatment of depression, the disorder is often poorly treated.
  • Most experts agree that for full recovery from depression (biological or psychological) the sufferer needs medical interventions combined with psychological treatments.

What are the symptoms of depression?

  • Mood changes: feeling low, sad or numb much of the time, increase in other unhealthy negative emotions such as guilt, anxiety, hurt, anger, etc.
  • Psychological changes: poor concentration and focus, poor decision-making, poor short-term memory, pessimistic outlook, excessive self-downing and self-criticism, loss of life-meaning and personal goals.
  • Physical symptoms: impaired sleep, eating problems, loss or gain of weight, poor sex drive, excessive tiredness, low energy, aches and pains.
  • Behaviour changes: avoiding work and/or any social activities, self-imposed isolation and very poor self-care.

Treatments for depression Most treatments for depression involve either medical or psychological interventions. However, evidence has shown that a combination of the two had achieved superior results.

There are many types of medications and psychological treatments for depression. However, so far most of the scientific evidence has shown that a course of anti-depressants combined with Cognitive Behaviour Therapies (CBT) is the most effective and efficient form of treatment one can have. Whereas anti-depressants can start lifting a depressed mood within three to six weeks, CBT, on the other hand, teaches rational thinking, motivates the client to adopt a healthy behaviour, to attend to and achieve personal goals, to create new meanings to life, teaches unconditional self-acceptance and unconditional emotional responsibility. Moreover, CBT helps to develop new life strategies so as to prevent lapses and relapses. It’s helping to develop healthy self-reliance and discourage dependency on medications, doctors, therapists and other people.

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