What is Depression?
Depression is a common mood disorder that negatively affects how we think, feel and behave.
It is a complex disorder that affects each person differently. It causes a negative shift in mood, which becomes intense and lasts for a prolonged period of time. This mood shift significantly interferes with our ability to function in daily life or to find enjoyment or pleasure in anything.
Depression not only affects our mood but also the way we view ourselves and the way we understand and relate to everything around us.
Also known as ‘clinical depression’ or ‘depressive disorder’, the two most common forms of depression are:
- Major depressive disorder (MDD)
- Persistent depressive disorder (PDD)
This is when the symptoms of depression are present for most of the day, nearly every day, for at least two weeks. These symptoms affect our ability to work, study, eat, sleep and to function normally. This type of depression can occur just once in a lifetime, but it is more likely that we will experience several episodes.
In this case, the symptoms of depression last for at least two years. We have regular episodes of major depression during this time, but they are interrupted with respite periods where we experience mild symptoms or no symptoms at all.
Depression is much more than just a low mood. Everyone experiences stress, anxiety and low mood sometimes, especially during tough times like the death of a loved one, loss of a job or the ending of a relationship. These are natural reactions to loss, disappointment and other challenging life events. While these feelings share some of the same features as depression, they are not the same. Unlike depression, these feelings will eventually pass and don’t affect our ability to function in daily life.
Depression can lead to a number of mental, emotional, physical and behavioural problems if left untreated, including substance abuse – frequently used as a way of ‘escaping’ unpleasant symptoms.
Depression is one of the most treatable mental health disorders, with a very high success rate for a full recovery. It is important to seek professional help to get the treatment needed to recover and get back to enjoying a full life.
What are the Different Types of Depression?
There are many types of depression, which might be triggered by a unique set of circumstances or appear to have no apparent trigger at all. Depression can affect anyone at any time, and different types include:
- Major depressive disorder (MDD)
- Persistent depressive disorder (PDD)
- Seasonal affective disorder (SAD)
- Antenatal and postnatal depression
- Premenstrual dysphoric disorder (PMDD)
- Bipolar disorder
- Psychotic depression
- Situational depression
This is typically characterised by a number of key features, including depressed mood, loss of interest in activities usually enjoyed, changes in appetite and sleep, fatigue, difficulty concentrating, constant worry and anxiety, and thoughts of death or suicide. There may be no obvious reason for this type of depression. MDD is usually diagnosed when the symptoms are experienced most days, and last for longer than two weeks.
Previously known as dysthymia, this type of depression can be mild, moderate or severe. It is a type of chronic depression that lasts for two years or more but includes times when symptoms are less intense (for a month or two at a time). Whilst the symptoms may not be as severe as MDD; they are extensive and long-lasting.
This type of depression has a seasonal pattern. It typically starts when the days become shorter and colder, with symptoms including lack of energy, oversleeping, overeating and food cravings. It is believed to be caused by a disturbance in the normal circadian rhythm of the body, along with a drop in serotonin and melatonin levels (from reduced sunlight). Symptoms subside when the season ends, and there are more hours of daylight and an increase in temperature.
This type of depression is triggered by hormonal changes during a pregnancy. It can begin during pregnancy or following the birth. While mood changes are normal at these times, the symptoms of depression are far more severe and last for a longer period of time. Left untreated, they can significantly affect the mother’s relationship with her newborn and the baby’s development. This type of depression can happen to any pregnant woman, but those who lack support or have had depression before are at increased risk.
This type of depression produces similar symptoms to premenstrual syndrome (PMS), but those related to mood are significantly more pronounced, such as mood swings, feeling sad, hopeless, self-critical, bouts of crying, irritability and severe feelings of anxiety or stress.
The vast majority of those with bipolar disorder (previously known as manic-depression) will have episodes of major depression. They will, however, also experience periods of extreme high mood too – euphoric or irritable – with periods of normal mood in between. In severe cases, episodes may include psychosis.
This typically occurs when a person has major depression in addition to some form of psychosis – such as delusions or hallucinations – where there are periods of losing touch with reality. People with psychotic depression may also be paranoid.
This is a short-term, stress-related type of depression that can develop after a traumatic event or change of events in our life. It is an adjustment disorder, where we are unable to come to terms with what has happened and adjust to the new situation. Events can include the death of a loved one, divorce, retirement, having a baby, life-or-death experiences, medical illness and problems at work. This type of depression can magnify the intensity of stressful life events and cause severe disruption in our daily life. Major depressive disorder can develop if we do not receive treatment.
All types of depression are treatable, and there is no need to suffer in silence or to try to manage the symptoms alone. There are specific treatment programmes available to address every type of depression. Most programmes will include a combination of psychotherapy, medication, and lifestyle changes, designed to meet each individual’s specific needs.
What are the Causes of Depression?
There is ongoing research into the causes of depression, which currently suggests there is no single cause. Depression is not simply the result of a ‘chemical imbalance’. It usually results from a combination of factors and can have many different triggers, including:
- Female sex hormones
- Brain chemistry imbalances
- Medical illness
- Substance use
- Stressful life events
Depression can run in families, and some people will be at an increased genetic risk. It doesn’t mean we will automatically have the same experience as a relative with depression, as no single cause acts in isolation. There are many other factors likely to have an important influence over how our genes are expressed.
Statistically, women have depression more often than men, which could be due to factors that are unique to women, such as hormonal factors. Women are especially likely to be affected by depressive disorders at times when their hormones are fluctuating – during the menstrual period, pregnancy, childbirth and perimenopause.
Having too much or too little of certain neurotransmitters (including dopamine and serotonin) can contribute to depression. Medications to treat depression often focus on balancing these chemicals, which are involved in mood regulation.
Our personality can contribute to depression, particularly if we have a tendency to worry, are perfectionists, have low self-esteem or are self-critical and negative. Having these traits doesn’t mean we will develop depression, but they can be a contributing factor. Recent research has shown that it is possible to change personality traits through some talk therapies and that they are not ‘set in stone’ as previously thought.
Sometimes depression coexists with a longstanding or life-threatening illness, such as cancer, chronic pain, a thyroid condition or heart disease. Medication for many conditions may come with side effects that can also cause – or contribute to – depression. Head injuries are also an under-recognised cause, as they can trigger mood swings and emotional problems.
Many people with depression also have a substance use disorder. Drug and alcohol use can both lead to and result from depression.
A number of lifestyle factors can play a part in contributing to depression, including poor nutrition, stress, substance use, lack of exercise, lack of sunlight, and not getting enough sleep. Research has shown that adopting or maintaining a healthy lifestyle is a good starting point in preventing or managing depressed mood over time.
Continuous exposure to violence, neglect, abuse, bullying or poverty can overwhelm a person’s ability to cope and make some people more susceptible to depression. Researchers have also found that early losses and emotional trauma can make us more vulnerable to depression later in life.
Stress plays an important role in depression. If the stress is short-lived, the body usually returns to normal. However, when genetics, biology and chronic stressful life situations come together, it is possible that depression will result.
Depression is an extremely complex disease, for which there are many possible causes. It is now understood that several of these causes need to interact in order to bring on depression and that no two people will be affected in the same way.
What are the Common Symptoms of Depression?
Depression affects different people in different ways and can cause a wide variety of symptoms. These symptoms can vary from very mild to severe and include:
- decreased energy and / or increased fatigue
- a variety of aches and pains, without obvious cause and / or do not respond to treatment
- upset stomach, digestive problems
- sleep problems – insomnia or oversleeping
- changes in appetite – along with weight changes.
- thinking we are a failure – low self-esteem
- persistent anxious / worried thoughts
- difficulty thinking clearly, concentrating or making decisions
- thinking negatively – pessimism
- loss of perspective – thoughts of death or suicide.
- feeling of worthlessness or guilt
- restlessness and irritability – sometimes anger
- loss of interest in normal activities – feeling that everything is hopeless
- feeling unhappy / sad / tearful frequently
- uncontrollable emotions – mood swings for no obvious reason.
- avoiding social events and activities, we usually enjoy – becoming isolated
- not able to meet responsibilities at work and / or at home
- neglecting hobbies and interests – lacking motivation
- escapist or risky behaviours, such as misuse of alcohol or drugs
- self-harming or suicidal behaviour.
Some medical conditions can mimic the symptoms of depression – such as thyroid problems, brain tumours and vitamin deficiencies – so it is important to rule out such medical causes first.
It is important to remember that we all experience some of these symptoms from time to time. Symptoms must be present persistently, over a prolonged period of time, for a diagnosis of depression to be made.
Can Depression be Treated?
Depression is one of the most treatable mental health disorders, and there is a range of effective treatments that can help us to recover and stay well.
The best treatment programme will be based on the type of depression and whether it is mild, moderate or severe. Programmes will usually be a combination of treatments designed to meet each individual’s needs, including:
A number of ‘talking therapies’ are often used, as they can teach us new ways of thinking and behaving, and change habits that may be contributing to our depression.
There are many therapies that can be used effectively to treat depression, including:
- Cognitive Behaviour Therapy
- Mindfulness-Based Therapy
- Dialectical Behaviour Therapy
- Psychodynamic Therapy
- Interpersonal Therapy.
The main medical treatment for depression is antidepressants. These can work well in the treatment of depression, although they can take 2-4 weeks to begin working. There may be side effects, so it’s important when we first start taking them to be under medical supervision.
For more severe forms of depression, a combination of mood stabilisers, anti-psychotics and antidepressants may be needed.
Through psychotherapy, we can gain a better understanding of ourselves and what causes us to feel depressed. We also learn healthy coping strategies and examine ways in which we can help ourselves after treatment, including lifestyle changes. Regular exercise, a healthy diet, good sleep, avoiding self-medication, relaxation training and attending self-help groups can all be highly beneficial to our long-term recovery and to maintaining our mental and physical wellbeing.
There is no one proven way that people recover from depression – everyone is different. The important thing is to know that all types of depression are treatable – and with professional support, we can find the right treatment plan to meet our individual needs.
Depression Treatment at White River Manor
At White River Manor, we provide a holistic treatment programme for depression disorders, which is shaped around your personal preferences and therapeutic needs and addresses any co-occurring conditions.
Using a combination of traditional methods, ancient philosophy and cutting-edge science, the team at White River Manor treats the whole person and not just the depression, ensuring deep transformational healing and a full recovery.
We understand that recovery is a lifelong pursuit of positive habit building, maintaining mental wellbeing and avoiding triggers, which is why we also include a complete aftercare plan to support you following treatment.
We will be there to guide and support you, and your loved ones, throughout the whole recovery process.
If you, or someone you know, are struggling with depression, please contact us and take the first step to improve your mental wellbeing and quality of life.