Everyone feels blue on occasions but if you’re feeling down most of the time and your daily life is being affected, you may be suffering from depression.
Depression is a serious illness characterised by overwhelming feelings of long-lasting sadness. Symptoms can include feelings of guilt, anxiety, irritability/agitation, low self-esteem, diminished motivation, tearfulness, hopelessness and helplessness.
Physical symptoms can include disturbed sleep patterns, reduced energy levels and sex drive, and weight and appetite changes, amongst others.
Someone with depression may lose interest in hobbies and social activities, avoid contact with friends, and experience increased difficulties in home and family life.
The experience of depression can be very distressing. However, it's important to remember that feelings of helplessness and hopelessness are symptoms of your depression – they do not define the reality of your situation. Things can and do get better.
There are many different types of depression, with the severity of symptoms varying from person to person. The most common diagnosis is major depressive disorder, often referred to as unipolar depression or clinical depression.
Other people suffer from bipolar disorder (often referred to as manic depression). This is characterised by periods of depression as well as by periods of mania or extremely elevated mood.
Around 1 in 7 women will experience postnatal depression (PND) within a year of having a baby. PND should not be confused with the all-too-common baby blues. It can be long-lasting and is as serious as other types of depression.
Seasonal affective disorder (SAD) is another common form of depression, affecting an estimated 7 percent of people. Often known as winter depression, the symptoms of SAD tend to be most marked between December and February.
Depression is very common, affecting more than 450,000 people in Ireland (1 in 10) at any one time, according to depression support charity, Aware.
Women are roughly twice as likely as men to be diagnosed with depression. An estimated 1 in 4 women will require treatment at some stage in their lives.
However, men are much more likely to attempt suicide or to die by suicide. This may reflect the fact that men are less likely to seek treatment or to discuss their emotional difficulties.
Cognitive behavioural therapy (CBT) is commonly regarded as the most effective psychological treatment for depression. Many studies show CBT to be at least as effective as antidepressants in the treatment of mild to moderate depression. Research also shows CBT substantially reduces the risk of a depressive relapse. For major depression, research indicates a combination of medication and CBT is more effective than medication alone. The rich literature supporting cognitive behavioural therapy is the reason the UK’s National Institute for Health and Care Excellence (NICE), which issues guidelines for the treatment of medical and psychological conditions, recommends CBT as the psychological treatment of choice for depression.
CBT researchers have found that depressed thinking tends to be characterised by negative automatic thoughts (NATs) and views about yourself, your world and your future.
Often, very stressful life events can trigger depressed thinking. However, research also shows a negative thinking style is a risk factor for depression – not simply a result of depression. Feelings of worthlessness and powerlessness (“there’s no point”) affect your mood and behaviour. This can potentially drive a vicious cycle of avoidance and isolation that worsens initial symptoms. Unchallenged, it becomes increasingly difficult to escape a downward spiral.
CBT helps you break this cycle through cognitive restructuring (encouraging you to identify and challenge critical, unhelpful thinking patterns) and behavioural activation (engaging in activities that boost mood and self-esteem). Often, these will be everyday activities that you previously enjoyed prior to becoming depressed.
When we change our thinking and behaviour, we change our mood. The techniques and skills learned in CBT help you to ultimately become your own therapist, reducing the risk of future relapse.