Depression is a common condition with a number of different symptoms, such as loss of energy, loss of interest in activities and in life, sadness, loss of appetite and weight, difficulty concentrating, self criticism, feelings of hopelessness, physical complaints, withdrawal from other people, irritability and indecisiveness, and suicidal thinking. Many people who are depressed feel anxious as well - worried, nauseated or dizzy, sometimes with hot or cold flushes, blurred vision, racing heart beat and sweating.
Clinical depression can vary from mild to severe. This implies that not all individuals experience all the symptoms of depression and at the same intensity.
Clinical depression is different from ordinary sadness. Mood fluctuations are normal. We all feel sad at times.
Depression does not happen to people who are unusual in any way or "crazy". Along with anxiety, which is more common than depression, it is the "common cold" of emotional problems. Of women, 25% will suffer a major depressive episode during their lifetime, and of men, 12%. Less serious depressive episodes (mild or moderate depression) are even more common.
Depression is multiply determined. A number of different factors can cause it. These factors can be biochemical, interpersonal, behavioural or cognitive (thinking). Depression therefore may be in a person's family, it may result from conflict or losses, an increase in stress levels and negative thinking.
Behaviour: There is considerable evidence
that people who suffer significant life stresses are more
likely to become depressed (loss of work, friendships, a
loved one). Depressed people tend to engage in fewer activities
and often become inactive. Thus they miss out on rewarding
behaviour, i.e. participating in activities that give them
pleasure. Sometimes people get depressed because they have
difficulty asserting themselves, solving problems or dealing
with new demands. Feeling out of control is another trigger
for depression.
Thinking in certain ways tends to cause depression. For instance labelling oneself a failure, predicting negative outcomes for the future and thinking in extremes are all examples of thinking styles that not only lead to depression but perpetuate it.
How does Cognitive Behaviour Therapy (CBT) work for Depression ?
CBT treats depression by identifying and changing the behaviours and thinking patterns that cause and maintain depression. This therapy focuses on present, "here and now" thoughts and behaviours. In CBT, you and your therapist will identify your symptoms and their severity, select goals you wish to attain in treatment (such as increasing self esteem or improving communication). You will also look at how your actions or lack of actions contribute to you feelings and identify negative or unrealistic ways of thinking that may make you feel depressed.
How effective is Cognitive Behaviour Therapy for Depression ?
Numerous research studies across the world and major universities have consistently demonstrated that CBT is as effective as anti-depressant medication. With twenty or less sessions of individual therapy, approximately 75% of patients experience a significant decrease in their symptoms. A combination of CBT and anti-depressant medication increases the efficacy of CBT to 85% in some studies. CBT also teaches people to prevent depressive symptoms from coming back.
Various medications have been found to be effective in the treatment of depression. It usually takes two to four weeks before you will feel the benefit of the medication in your system. Some medications may have negative effects - these are usually temporary and decrease over time. Unlike tranquillisers, anti-depressants are not addictive.
What is expected of you as a patient ?
CBT treatment for depression requires your active participation. You will help in the planning of your treatment and your therapist may also give you homework exercises to assist you in changing your behaviour, thoughts and relationships as necessary. Although many patients suffering from depression feel hopeless about improvement, there is a very good chance that your depression may be substantially reduced with this treatment.