The word depression clearly has different understandings for different people, individuals may often refer to "feeling depressed" when feeling sad or low in their everyday lives. These moods are usually transitory and pass, however for some these feelings do not pass and have a severe impact interfering with their ever day lives, lasting weeks or months and even if they do go away, the feelings regularly return. Depression also comes in many different forms including
Although differing in symptoms and severity, all of these types of depression could be described as exhibiting an enduring and pervasive sense of negative well-being, that effects individuals across a wide range of circumstances.
It has been estimated that worldwide some 300 million people some form of depression at least for some part of their lives.
(Source: P Gilbert, Overcoming Depression, 1997).
Depression is also not as some might suggest a modern condition, being observed my Hypocrites as melancholia some 2,400 years ago. Furthermore, there is evidence, although we can’t ask them that most if not all mammals, particularly those experiencing prolonged stress, can suffer depression suggesting that depression is a natural response to external stressors.
In the recent past depression has become associated with chemical imbalances in the brain and indeed there is much evidence to support the link between depression and imbalances in the neurotransmitters, the chemicals involved in transmitting signals between neurons, in the brain. The result of this link is that depression has been commonly treated with synthetic chemicals, such as serotonin, that mimic the actions of these neurotransmitters. However as with all causal relationships, other than saying that there is a link, the direction of the link is unclear. It is just as probable that these chemical imbalances are caused by the negative patterns of thought as the imbalances causing the negative moods. In any event it is recognised that genetic or biological causes of these imbalances are probably rare and that in most cases the depression was originally triggered by an external event or situation.
Depression is usually diagnosed through the use of depression tests that rate a patients ‘feelings’ with clinical depression being diagnosed if a certain number of feelings, that are signs of depression, are present over a certain period of time. According to the medical model a person can be only diagnosed as suffering from clinical depression if five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning and that at least one of the symptoms is either a depressed mood or loss of interest or pleasure.
These symptoms are:
The above symptoms will also have to:
For clinical diagnosis to be made the symptoms need to persist for longer than 2 months or be characterised by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
Diagnosing clinical depression (or any other medical condition) is outside the ethical remit of any counsellor or psychologist, being the work of Doctors and Psychiatrists.
However, the medical model of depression does pose some interesting dilemmas. It states that depression can be diagnosed only if the symptoms cannot be better attributed to bereavement. So, since grieving is a natural response, we can see that depression could also simply be an out-of-place natural response, furthermore, if bereavement can cause depression like symptoms , why not other kinds of loss such as loss of employment, loss of financial security, loss of independence, etc, etc. It would seem highly probable then, that at least for many people, depression may well be related to real life issues, that are beyond the control or coping strategies of the individual and that depression may well be a natural psychic defence, shutting down and protecting the individual from the stressor, rather than facing the situation. Treating a chemical imbalance that has been caused by environmental situations with drugs, without treating the emotional feelings towards whatever environmental conditions that underlie the depression would seem illogical.
Although a counsellor should NEVER suggest that a client should come off their medications, counselling would seem to have an important role alongside the medical treatment of depression, with of course the consent of the client’s doctor. Indeed it is becoming increasingly common for counselling to be offered to patients with depression within doctor’s surgeries, or for doctors to advise their patients with depression to seek counselling, so that the underlying traumas can be addressed.
The following steps will help someone overcome depression and aid recovery;
The above steps would help depression suffers, overcome their depression, perhaps where drug therapy alone has failed. Learning to recognise their negative thought patterns and giving them understanding as to how these arose, will in a good many cases give them an insight into their depression, enabling them to utilise their conscious rational minds in spotting negative thinking as it arises and giving them strategies for both coping with the stressors that caused the negative thoughts and the negative thoughts themselves. For most people, given the right opportunity, will overcome their depression and move forwards to a more positive future and for those whose depression returns, early self-recognition of their symptoms will limit the impact of their depression and aid a speedier recovery.
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