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Clinical Information:
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| Depression | Coping with Grief and Loss |
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Understanding Depression
Depression occurs when feelings of extreme sadness, despair, agitation, hopelessness or helplessness last for at least two weeks or longer and when these uncomfortable feelings interfere with our daily activities like working, eating or sleeping. In some cases psychological traumas (like being diagnosed with cancer or HIV/AIDS, going through a major operation, rape or death of a loved one) may drive a person into a depression, but usually the onset of depression is gradual, occurring over a period of several weeks or months. |
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Characteristic features of major depressive episode
• Depressed mood: feeling sad, tearful.
NB: Often irritable mood in children.
• Loss of pleasure or interest in usual activities: almost everything no longer feels good.
Disturbance of appetite: increase or decrease in appetite with significant weight loss or gain.
NB: Failure to make expected weight gains in children.
• Sleep disturbance: difficulty falling or staying asleep through the night. Awakening too early and struggle to get back to sleep. Oversleeping at times.
• Psychomotor retardation or agitation: extreme tiredness and physical inactivity, or restlessness and overly active.
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Loss of energy: feeling exhausted/tired
• Feelings of worthlessness and guilt: feeling useless, stupid, less intelligent, etc.
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Difficulty in thinking or concentrating: difficulty making decisions, remembering.
• Recurrent thoughts of death: suicidal thoughts or attempt, with or without a plan.
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Other risk factors
• Loneliness
• Lack of social support
• Recent stressful life experience
• Family history of depression
• Marital/relationship problems
• Financial strain/ problems
• Early childhood trauma/abuse
• Alcohol/drug abuse
• Unemployment/underemployment
• Health problems/chronic pain |
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Causes of depression
There is no single cause of depression. Contributing factors may include:
• Early life experience, genetic predisposition, lifestyle factors, certain personality traits.
• Changes in the body’s chemistry influence mood and thought processes, and biological factors contribute to some cases of depression.
• In addition, chronic and serious illnesses such as heart disease or cancer may be accompanied by depression.
• With many individuals, however, depression signals first and foremost that certain mental and emotional aspects of a person’s life are out of balance.
• Significant transitions and major life stressors such as death of a loved one, marital conflict (or divorce), or loss of a job can help bring about depression.
• Other less common factors that may lead to depression could include loss of identity and/or self-esteem. |
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Managing Depression
Depression is a highly treatable condition when an individual receives competent care that usually involves medication and psychotherapy.
Clinical psychologists help people through psychotherapy and counselling to identify factors that contribute to their depression and to deal effectively with the causes thereof. The main goals of psychotherapy and counselling in treating depression are as follows:
• To pinpoint the life problems that contribute to depression, and to help patients understand which aspects of those problems they may be able to solve or improve;
• To identify negative or distorted thinking patterns that contribute to feelings of hopelessness and helplessness that accompany depression;
• To explore other learned thoughts and behaviours that create problems and contribute to depression. For example psychotherapy and counselling can help depressed individuals to understand and to improve patterns of interacting with situations or persons that contribute to their depression;
• To help people to regain a sense of control and pleasure in life. Psychotherapy and counselling help people to see choices and to gradually incorporate enjoyable, fulfilling activities back into their lives.
Do-it-yourself home programme
• Eat well balanced and regular meals
• Remain active – maintain regular schedule/activities
• Exercise
• Get more rest
• If sleepless, do not toss and turn in bed – read or watch TV etc |
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