Depression

What is depression?

Depression is a common but serious mood disorder that causes severe symptoms that affect how you feel, think, and perform daily activities, such as completing tasks, sleeping, or eating. It is important to note that there is a difference between feeling normal sadness (which is often temporary and situational) versus having a clinical level of depression (also called major depressive disorder, or colloquially “major depression”).

Signs and symptoms

To meet a clinical level of depression, the following symptoms must be present for most of the day, nearly every day, for at least two weeks:

  • Persistent sadness

  • Feelings of hopelessness, or pessimism

  • Feelings of irritability, frustration, or restlessness

  • Feelings of guilt, worthlessness, or helplessness

  • Loss of interest or pleasure in hobbies and activities

  • Decreased energy, fatigue, or feeling "slowed down"

  • Difficulty concentrating, remembering, or making decisions

  • Difficulty sleeping, early morning awakening, or oversleeping

  • Changes in appetite or unplanned weight changes

  • Thoughts of death or suicide, or suicide attempts

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment

Note: There are additional factors that account for a proper diagnosis, so please keep in mind that having a few or all of these symptoms do not indicate that you have major depression. A proper diagnosis can only be made by a licensed clinician.

There are also different types of depression:

  • Major depression: which includes symptoms of depression most of the time for at least 2 weeks that typically interfere with one’s ability to work, sleep, study, and eat.

  • Persistent depressive disorder (previously called dysthymia): which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.

  • Perinatal depression: which occurs when a woman experiences major depression during pregnancy or after delivery (postpartum depression).

  • Seasonal affective disorder: which comes and goes with the seasons, typically starting in late fall and early winter and going away during spring and summer.

  • Depression with symptoms of psychosis: which is a severe form of depression where a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things that others do not see or hear).

What causes depression?

Research suggests that genetic, biological, environmental, and psychological factors play a role.

Depression can develop at any age, even in children and adolescents (although in these age groups, depression sometimes presents with more prominent irritability than low mood). Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions often exacerbate when depression is present, and research shows that people who have depression and another medical illness tend to have more severe symptoms of both illnesses.

Some risk factors include:

  • Personal or family history of depression

  • Major life events, trauma, or stressors

  • Certain physical illnesses and medications

How can CogniThrive help?

There are different modalities and evidence-based approaches specific to the treatment of depression, which include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). At CogniThrive, we will discuss which one may be most appropriate. Moreover, in individual psychotherapy, we can help by:

  • Teaching new ways of thinking

  • Identifying unhealthy behavioral patterns

  • Addressing environmental or situational factors that contribute to the depression

  • Helping clients develop effective problem-solving skills to address some of the major life stressors

  • Discovering inner strength, hope, and healing, as these factors may be difficult to find alone when times are challenging

  • Increasing protective factors (e.g., social support) and decreasing risk factors (e.g., unhealthy coping skills)

Other treatment options

Sometimes, psychotherapy alone may not be sufficient to treat depression. If this turns out to be the case, we will refer you to your primary care physician to have a medication consultation.

Medications

Antidepressants are commonly used to treat depression. You may need to try several different kinds before finding the one that improves your symptoms and has manageable side effects. Antidepressants usually take 4-8 weeks to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before deciding whether it works.

If you begin taking antidepressants, do not discontinue them without speaking to your health care provider first. People sometimes decide to discontinue on their own when they start to feel better, only to have the depression return later. Your primary care physician will help you slowly and safely decrease your dose. Abrupt cessation can cause withdrawal symptoms.

Brain Stimulation Therapies

If medications do not reduce the symptoms of depression, the following brain stimulation therapies may be options to explore: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and vagus nerve stimulation (VNS). You can read more about them on the National Alliance on Mental Illness website here.