What is depression

Depression is a low mood that lasts for weeks or months and can affect day to day functioning.  It can affect any one of us at any time in our lives. Symptoms include sadness, hopelessness, frustration, loss of interest and an overall dismal outlook on each day ahead. Feelings that come with it can be anything from guilt, shame, anger, anxiety, tiredness, irritability, tearfulness, emptiness, deep sadness etc and most importantly you can’t just decide to stop feeling depressed.

There are different levels of depression. For example, the mild to moderate depression can be described as feeling low for most of the day but managing some form of enjoyment / lift in mood. But after the event, the mood will fall. More severe levels of depression will involve a constant outlook of doom and gloom. The low mood persists even throughout experiences that used to be enjoyable.

Types of depression

These are very specific to each individual. Some people may be able to function in public, some may not. Some may have sleeping issues, some may not. It is different for everyone so try not to assume you know what it’s like for others.  There may be similarities but it is different for everyone.  Some of the most common types of depression are listed below:

· Major Depressive Disorder (MDD) - is a persistently low mood that interferes with daily life

· Persistent Depressive Disorder (PDD) - MDD is a severe form of depression while PDD is a lower-grade, chronic depression. PDD may get triggered by a traumatic event in life. Examples include losing a job, having a loved one pass away, experiencing a crime or going through a breakup

· Postpartum Depression (PPD) - is a complex mix of physical, emotional, and behavioral changes that happen to some women after giving birth

· Premenstrual Dysphoric Disorder (PMDD) - a very severe form of premenstrual syndrome causing a range of emotional and physical symptoms every month during the week or two before your period

· Seasonal Affective Disorder (SAD) - related to changes in seasons — SAD begins and ends at about the same times every year. If you're like most people with SAD, your symptoms start in Autumn and continue throughout the winter months, stealing your energy and bringing in a constant low mood

· Atypical Depression (AD) - Atypical depression is a type of depression where it is still possible to experience a temporary boost in mood in response to positive experiences

Impacts of depression

Depression can be like a black cloud which slowly moves over and around your life and places a low mood over you continuously. It makes any life outwith the black cloud unimaginable, and even the smallest of day to day actions seem like mission impossible. For example, getting out of bed, brushing your teeth, eating, even the basics can seem like an insurmountable task. This black cloud follows you everywhere – to work, to meet friends and especially when you are at home alone.

Depression can affect your way of thinking, your physical being and your behaviours. Thoughts are negative and everything has a negative filter. Things may feel and look hopeless, the future may seem bleak, you may think you are worthless or useless, experience shame for having depression, or experience a lot of self-blame. Often self-esteem and self-confidence can become incredibly low.

Some people may also experience physical changes due to their depression. Sleep for example may become a challenge and insomnia may set in, or the other extreme – you may sleep longer, and want to sleep all the time. Appetite may also change again, ranging from loss of appetite to over-eating or comfort eating.  Sexual interest may decline and impact on relationships. Energy levels and motivation to do tasks, to exercise, to complete work may fall dramatically and if severe enough, impact your career. You may also experience lethargy and find concentration and memory are slowly fading further and further away from your grasp.

Lastly, all of this will impact your behaviours. Naturally because of the lack of sleep, unhealthy eating and other life changes you may feel less able to go out, see friends or family, and begin to isolate yourself. You do less of the things you enjoy, exercise less and therefore even going to work can feel like a challenge. This is known at the vicious cycle of depression.

Vicious cycle of depression

So how do we reverse the cycle of depression?

Treatment for depression usually can involve a combination of lifestyle changes, talking therapies and medicines. Now anti-depressants could probably be a whole other blog, so we are going to leave that one for today and focus on lifestyle changes and therapy!

What happens in a session with myself?

The initial session is all about getting to know you, about your childhood (if you are open to that), and looking at how your life experiences have shaped you as well as the coping mechanisms you have developed as a person. We then explore what has brought you to counselling and that may involve an explanation of when depression first came into your life, what that was like, what form your depression takes and the impact it has had on your life.

We might then explore if there are particular situations / events causing the depression, and if so look at these issues with a fresh pair of eyes. Problem solving and looking at things with a different perspective can also be useful. Sometimes there aren’t obvious reasons for the depression. That’s ok - we can figure that out together. Sometimes there doesn’t seem to be any reasons at all and that’s also ok.

We can explore too how your thoughts can influence your feelings. You might be surprised at how much they do.  We could devise goals (baby steps to get your life back on track). I wouldn’t expect you to do a marathon without training, and so I wouldn’t be setting massive unrealistic goals at a time when you are feeling depressed, lacking energy and motivation. I will however be there with you every step of the way to support you emotionally, practically and be there to cheer you on. Most importantly I will be taking guidance from you, on what changes you want to make and those you feel able to make.

We will explore your world, your typical day and what your biggest struggles are. We then together make a plan in how to approach and overcome these.

We will also possibly explore confidence and self-esteem which can often take quite a dent when you are depressed. We will explore how confident you feel, how you see yourself (your core beliefs - the story you tell yourself about yourself!), and then we start to re-build your self-worth.

Lifestyle is also something we might explore. We all know how much food and exercise can impact mood and sleep! We also will review what levels of self-care you currently have and together explore which ones you would like to have!

Towards the end we reach the ‘light at the end of the tunnel’ phase. This is where activities, people, experiences that make you happy, are introduced back into your life (hopefully some old and some new)! Finally, we can start to look into the door to the future, which is often completely closed and locked to those who experience depression. We can start to look forward to and plan for the future.

I am very flexible in the way that I work and therefore can pull in other CBT tools, self-help books/resources/podcasts and much more. I will always encourage you to continue working inbetween sessions too. The more you put into therapy the more you get out of it, I often say to clients. If you are open to making use of journalling, gratitude diaries, mindfulness – these can also aid the recovery process of depression.

That is a very rough outline of what might take place in the therapy room. However, there is no one rule for clients as everyone is a unique individual and experiences depression in their own way.

Summary

Depression is one of the most common mental health problems, with one in ten people in Scotland diagnosed with the illness at some point in their lives. I believe this is increasing all the time and it’s probably even higher than the research shows, as so many can suffer in silence. The most important thing if you experience depression is that you reach out to those around you, speak to your GP if you feel you can, or reach out to a professional Counsellor or Psychotherapist. You don’t have to suffer alone. What would you do if someone you loved told you they were depressed and shared this with you? I’m guessing you would be open with them, invite them to share how they are feeling and encourage them to get the support they need, right? Why would it be any different if you reached out? Whether its family, friends, GP, professional Counsellor – just reach out because you deserve to feel better.

For more information:

• Depression: www.actionondepression.org

•  Samaritans: www.samaritans.org/scotland/samaritans-in-scotland

•  Breathing Space: www.breathingspace.scot

•  Public Health Information Scotland: www.scotpho.org.uk/health-wellbeing-and-disease/mental-health/data/depression-and-anxietynondepression.org

•  Samaritans: www.samaritans.org/scotland/samaritans-in-scotland

•  Breathing Space: www.breathingspace.scot

•  www.scotpho.org.uk/health-wellbeing-and-disease/mental-health/data/depression-and-anxiety

Reference:

https://www.seemescotland.org/stigma-discrimination/stigma-relating-to-individual-mental-health-conditions/depression/#:~:text=Depression%20is%20one%20of%20the,some%20point%20in%20their%20lives. [Accessed 21.2.2023]