Out of the Blue
A Rough Guide to the Psychology of Depression
In the UK, up to half of women and a quarter of men are likely to have a depressive episode at some point in their lives. So, what is depression? How can we recognise it? And what might we do about it?
How do you know someone’s depressed?
The first sign that someone you know is depressed will probably be a dip in mood that lasts longer than you would normally expect. They stop finding pleasure in the things they used to enjoy. Other signs to look out for could be:
• Eating more (or less) and putting on weight (or losing it)
• Sleeping too much or too little
• Problems concentrating, thinking and making decisions
• Loss of energy, constant tiredness, or alternatively, an inability to sit still
• Feeling worthless, guilty, or self-blaming
• Thinking about death and suicide attempts
Where does depression come from?
There is no single cause of depression, but rather a series of possible factors that bring it about.
Currently the most talked-about psychological understanding of depression is derived from an approach called Cognitive Behavioural Therapy (CBT). In short, CBT suggests that depression is not just caused by chemical changes in the brain, but is the result of relatively engrained styles of thinking and acting.
From an early age we develop rules and strategies for surviving in the world, particularly around what we need to do or be, in order to be loved or successful. We may not even know we’ve made these assumptions about life until they start to cause us problems. If, for example, our early experience taught us that we must always be top of the class, we may not know how much is riding on it until we find ourselves no longer in prime position. Similarly, if we believe that we need to be the most popular person around in order to be okay with ourselves, our mood will fluctuate with our social standing.
Depression begins when the rules we have lived by (perhaps unknowingly) are broken. This is why depression can be triggered by seemingly insignificant events. Scoring an average pass in an exam or falling out with a group of friends may look trivial at face value. But if they violate rules on which we’ve based our self-esteem, they can be disastrous and can lead to full-blown depression. The depression itself then acts as a trap. We look at how sad and incompetent we feel, and this makes us feel worse. It’s a vicious cycle – we get depressed about being depressed.
What could we do about it?
Depression was once called ‘the common cold of psychiatry’. It’s not always easy to shift, but it’s very common. So there’s no need to feel ashamed if you’re depressed and need help. You’re not the only one.
The first treatment offered by a GP is usually anti-depressant medication. For some people that will be enough to get them out of their depressive slump, but others will need more than that to get back on their feet.
Most psychological interventions for depression available on the NHS are based on CBT to some extent. CBT teaches a series of psychological skills designed to combat low mood, such as: organising an enjoyable and productive day, challenging negative thought patterns, getting a good night’s sleep, or learning to be assertive.
These are all vital skills in shaking off depression and re-connecting with the world. There are a variety of self-help books available for people who feel able to work at it under their own steam, but extreme cases of depression will require professional help and guidance. When we’re depressed the world can look pretty bleak. But there is hope and help available. There is a way out of the prison of depression.
To know more, you may like to check out the NHS website dedicated to CBT:
To read about a personal struggle with depression, click here
Written by Roger Bretherton.
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