Depression refers to a disorder in the mood state of an individual. As a condition affecting over 300 million worldwide1, depression is considered a major health issue. What is important to highlight here is that depression is more than experiencing “blues” or emotional responses in daily life. It is a persistent and pervasive disturbance in mood and various other emotional and cognitive features.
What are the signs of depression?
As a mood disorder, depression primarily involves two factors2,3; one, depressed mood and second, a decrease in level of interest related to different things in life. A depressed mood is manifested with a person appearing sad, low, or discouraged more often than not even in the absence of upsetting circumstances. In cases where environmental or life events cause distress, the low mood persists for a significantly longer duration. This change is mood is often expressed by the individual themselves. However, it may also be visible to people close to the person in their overall behaviour, facial expressions, etc. Loss of interest is also commonly reported in activities that were previously considered enjoyable. So say a person may stop indulging in going out with friends, spending time in hobbies, prefer to stay indoors, etc. This often leads to social withdrawal or avoidance of pleasant events.
Certain depressive symptoms2,3 often include bodily changes. These are collectively known as somatic symptoms. Changes in body weight (loss or gain) come under scrutiny under this bracket of symptoms. The weight change is more than 5% of the total weight and occurs in the period of one month. Changes in appetite (increase or decrease) are also considered important in the evaluation of depression. Significant changes in sleep patterns and levels of energy are other somatic signs.
Maladaptive thought patterns2,3 are also present in the clinical picture of depression. These include persistent feelings of guilt and worthlessness. For example a person may report unrealistic negative evaluations of one’s worth and maybe preoccupied with past failings. Thoughts related to death, and suicide are also prevalent in certain cases and must be reported to a professional immediately. On a cognitive level, depression often interferes with normal patterns of thinking, concentration and decision making. Therefore, depressive features include significant difficulty in handling cognitively demanding tasks like studying or taking on assignments at work.
Changes in psychomotor activity2,3 are also present in the clinical presentation of depression. So an individual may exhibit signs such as inability to still, relentless pacing. On the other hand low levels of speech and body movements are evident in some cases.
Assessment and Diagnosis
The assessment and diagnosis of depression requires thorough evaluation by trained professionals such as psychiatrists and clinical psychologists. The assessment of depression requires taking detailed history of the patient’s symptoms from the patient and their close ones. Rating scales are also applied to evaluate the distress cause by the symptoms.
Treatment of Depression
Psychotherapy: Various psychotherapies are available for the treatment of depression. One of the most widely used psychotherapy approach is the cognitive behavioural therapy (CBT). CBT involves dealing with maladaptive thought and behavioural patterns that underlie depressive symptoms (HYERLINK TO HopeQure article). CBT has found widespread acceptance as a treatment alternative for treating depression4. Problem solving therapy is also considered for treating symptoms of depression. It focuses on assisting individuals with depressive symptoms in learning adaptive skills to deal with negative events and occurrences in life. Choosing an appropriate psychotherapeutic approach is based on a thorough review of the patient’s symptoms and needs by the therapist.
Pharmacological Treatment: Depression can be treated with prescribed medications given by trained medical professionals only. Prescribed medications aim to restore mood imbalances and other associated symptoms.
1. WHO. http://www.who.int/mediacentre/factsheets/fs369/en/. Fact hseet.February 2017
2. American Psychiatric Association. (2013). Depressive disorders. In Diagnostic and statistical manual of mental disorder (5th ed.). Washington, DC: Author.
3. World Health Organization (1993). Mood (affective) disorders. In International classification of diseases-Classification of mental and behavioural disorders (5th ed.). Geneva: Author.
4. Australian Institute of Professional Counsellors. (2015, February 6). The efficacy of CBT treatment for depression Retrieved from https://www.aipc.net.au/articles/the-efficacy-of-cbt-treatment-for-depression/