FEELING DOWN

I have been coming across quite a few people who are feeling down at the moment, and thought I would add this article about depression. Around 60-70% of adults will at some time experience symptoms of depression of enough intensity to affect their life. GP’s report that up to 50% of attendees may have some depressive symptoms, and about 5% have major depression. So what is depression?

Depression may present itself in various forms. The following symptoms can occur in varying proportions from one individual to another:

MOOD CHANGES are primary, shown as feelings of persistent sadness, of being down in the dumps, of hopelessness and helplessness. Anxiety and increased irritability are often present.

COGNITIVE CHANGES of various degrees of intensity are experienced, such as lack of concentration, confused thinking, indecision and difficulties with remembering. Typically the content of thought is very negative and pessimistic, people seeing themselves as inadequate or even as bad, finding their environment unfulfilling and their future bleak.

BIOLOGICAL CHANGES affect sleep, appetite, weight, sex-drive and the ability to enjoy usual activities. People often complain of aches and pains, or excessive fatigue and slowness of thinking and movement.

BEHAVIOURAL AND MOTIVATIONAL symptoms are characterised by inactivity, unwillingness to initiate activities, avoidance of work and social activities, crying and sighing.

CAUSES:
No single cause of depression has been identified and the consensus of opinion is that several factors can act together, for example, genetic vulnerability, family history, social vulnerability (loss of social support, isolation, socio-economic disadvantages) and psychological vulnerability involving a history of loss and disruptive childhood experiences. Often episodes of depression appear to be precipitated by major life events, such as the death of a loved one, divorce, financial difficulties or loss of job.

The common pathway of these several interacting factors can be both biochemical and psychological. In some depressions there is an imbalance in several brain chemicals. Psychological changes are more universal, the main features being a striking negative bias in the interpretation of events and in memory, and a predominance of dysfunctional or unhelpful attitudes regarding oneself and the world.

TREATMENTS:
During the past few years very effective treatments have been developed for depression. These include anti-depressant medication and short-term psychological treatments. Both theses approaches can provide relief from depression within 3-4 weeks and long lasting relief within 3-6 months.

PSYCHOLOGICAL THERAPIES:
Cognitive or cognitive-behavioural therapy has been the most extensively evaluated. It has been shown to be as effective as anti-depressant medication, but to be superior to medication in the prevention of relapse and recurence of illness.

Cognitive Therapy is structured and collaborative; patient and therapist work togehter on explicitly agreed goals. Different components of the therapy focus on thoughts as a means of alleviating low moods. Time may be spent on re-establishing previous activity levels. The sufferer learns to combat the negative style of thinking which maintains depression and to develop coping skills which help not only in acute episodes of depression, but also to face future difficulties and major events. Goals for change may involve:

A way of acting e.g. Being more outgoing

A way of feeling e.g. Being less scared and less depressed

A way of thinking e.g. Learning to problem solve or get rid of self defeating thoughts

A way of dealing with physical or medical problems e.g. Lessening back pain

A way of coping e.g. Training developmentally disabled poeple to care for themselves.

For more information, please visit www.babcp.com