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Depression: more than just sadness

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Sadness and low mood are an everyday part of life. However, on occasions, these feelings can be more pervasive, impairing, and enduring suggesting that a diagnosis of Major Depressive Disorder is relevant.

A major depressive episode can include feelings of sadness, loss of interest or pleasure in activities, changes in appetite or weight, disturbances in sleep, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and in some cases, suicidal ideation. And these symptoms are likely to impact on a person’s ability to carry out their main roles, such as work/school and social functioning.

What causes depression?

The causes of depression can often be complex and multifaceted. The bio-psycho-social model of depression suggests that depression can be influenced by genetic vulnerabilities, brain chemistry, life experiences, and social environment. Understanding depression through this lens emphasizes the need for comprehensive and individualized approaches to prevention and treatment.

  • Biological Factors: Biological factors play a significant role in the development of depression. Imbalances in neurotransmitters, such as serotonin and dopamine, have been implicated in the regulation of mood. Genetic predisposition also contributes, as individuals with a family history of depression may be more susceptible. Additionally, structural and functional changes in the brain, particularly in areas associated with mood regulation and emotion processing, are observed in individuals with depression.
  • Environmental Stressors and Trauma: Environmental factors, such as stressful life events and trauma, can trigger or exacerbate depressive episodes. Loss of a loved one, financial difficulties, relationship problems, or chronic stress at work are examples of stressors that may contribute to the onset of depression. Traumatic experiences, particularly during childhood, can have lasting effects on mental health and increase the risk of developing depression later in life.
  • Psychological Factors: Unhelpful thought patterns and maladaptive coping mechanisms are common psychological factors associated with the onset and maintenance of depression. People with depression might find they engage less in meaningful and enjoyable activities which can also maintain their feelings of depression.

Evidence-Based Treatment options

While the causes of depression are diverse, evidence-based psychological interventions offer promising avenues for managing and depression, including the following:

Cognitive Behavioral Therapy (CBT):

Cognitive Behavioural Therapy (CBT) is one of the most widely researched and utilised psychological interventions for depression. This therapeutic approach is grounded the premises that our feelings are influenced by our thoughts or interpretations of a situation. CBT aims to help clients identify and modify negative or unhelpful thought patterns that contribute to depression, and to increase positive coping behaviours. Numerous studies have demonstrated the efficacy of CBT in treating depression.

Behavioural Activation:

The behavioural component of CBT is known as Behaviour Activation (BA). BA is a therapeutic approach that targets the behavioural aspects of depression. This intervention recognises the interplay between mood and activity levels, aiming to break the cycle of withdrawal and inactivity often associated with depression. Behavioural Activation encourages individuals to engage in meaningful and rewarding activities, fostering a sense of accomplishment and positive reinforcement.

Research supports the effectiveness of Behavioural Activation, particularly in treating individuals with mild to moderate depression. By systematically increasing pleasurable and goal-oriented activities, individuals can experience a shift in mood and motivation.

Acceptance and Commitment Therapy (ACT):

Acceptance and Commitment Therapy (ACT) is a mindfulness-based cognitive therapy that emphasises acceptance of difficult thoughts and feelings while encouraging individuals to commit to values-driven actions. ACT aims to help individuals create a rich, meaningful life while accepting the inevitable challenges and discomfort that may arise.

Studies have shown that ACT can be effective in reducing depressive symptoms and enhancing overall psychological flexibility. By fostering acceptance and encouraging individuals to align their actions with their values, ACT empowers individuals to navigate through the complexities of depression. This approach is particularly valuable for individuals struggling with the impact of depressive thoughts on their daily functioning.

Other therapies to manage chronic depression

Other therapies which are aimed at dealing with adverse childhood experiences and trauma can also assist individuals who experience more chronic or complex forms of depression. Schema therapy, EMDR and DBT can also be used to help those with more chronic depression understand the root causes of their depression and learn ways to manage and cope with the symptoms.