What is Depression?

“I have been noticing a change inside me, a gradual shift from an effortless smile to a smile which is now taxing. Getting up in the morning is now a BIG task. I have been regular at work, always. But now reaching late is my new normal. I feel heavy inside and nothing really makes any sense. I have no VALID reason. I used to love sketching, eating and dancing but I seem to have no energy or interest to do any of these things. There seems to be a disconnect between me and people, a sort of invisible boundary. No matter how hard I try to reach out to them, I fail each time. Why am I crying in the middle of the day when no one is watching?. I feel exhausted with life, which I once used to love.”

Depression is a common and a serious mental illness. According to the World Health Organization (WHO), 350 million people worldwide suffer from depression. Depression is a word that is widely used but less understood. It is often confused with sadness, anxiety, phobia or stress.

Signs and Symptoms of Depression

There are various signs and symptoms of depression that can be easily identified. A person with depression may show some of these symptoms at a point.

  • They will feel a certain level of sadness that will persist as a constant mood throughout the day and can last for weeks. This sadness can also be gauged from the person’s demeanor and expressions. Some people may also point out somatic complaints like body aches and pains. There can also be extreme emotional dysregulation in the form of anger outbursts and increased irritability.
  • The person tends to enter a state of mind wherein they may not be able to enjoy activities that they usually found themselves to be interested in. They experience a loss of interest in pleasurable activities. People around a depressed person may start to feel like they are withdrawing socially. Their libido also decreases.
  • A person with depression can experience a significant weight loss or weight gain. This can also be equated with an increase or decrease in the appetite of the person. They may feel like they have to force themselves to eat or find themselves craving certain types of foods.
  • The person starts feeling fatigued and tired easily. They may seem irritable and also experience extreme loss or increase in the amount of sleep that they are getting. Fatigue can be experienced without any physical exertion as well. Smallest of tasks can feel like they require great effort.
  • There are other signs as well like a reduced ability to focus and not being able to make decisions in everyday life. They may harbour feelings of extreme guilt, hopelessness and worthlessness. They enter into a zone of helplessness with their condition.
  • They could also start having a lot of thoughts around suicide or may even have attempted it.

Visibly impact various areas of a person’s life - social, occupational and personal. They are not able to cope up with day to day challenges and their self care takes a hit. The excerpt given in the beginning of the article can now be better understood with the theoretical understanding of the symptoms.


Types of Depression

Some common symptoms of depression are universal such as low mood, irritability, exhaustion, agitation, anhedonia, mood swings, sleep disturbances, changes in appetite, and the triad of hopelessness, helplessness, and worthlessness. Depression can cause physical and chemical changes in your brain. However, there are different types of depression and certain symptoms differentiate one from the rest.

  1. Depression- Also known as major depressive disorder. This occurs when you feel depressed for the majority of the time. Other symptoms of this include- insomnia or sleeping too much, significant weight gain or weight loss, loss of motivation, decreased interest in activities you used to enjoy before, feeling exhausted without doing much, restlessness, feeling worthless and guilty, suicide ideation, difficulty concentrating and making decisions. All this persists for at least two weeks or more.
    • Anxious distress- this involves losing control of yourself, feeling restless and tensed that something terrible could happen and this keeps making you feel anxious and distressed with the inability to focus on anything else.
    • Melancholy- feeling intensely sad and wanting to give up, even good things don’t give you joy anymore and you feel you have nothing positive to look forward to, difficulty waking up in the morning due to lack of motivation, not wanting to face the reality, sleeping poorly, losing weight without trying, having suicidal thoughts.
    • Agitated- this includes feeling uneasy and restless all the time, talking a lot, fidgety, being impulsive, trying to distract yourself but not being able to stay still or focused.x
  2. Persistent Depressive Disorder- When depression lasts for 2 years or longer it is known as persistent depressive disorder. There is also a low-grade persistent depression known as dysthymia. Symptoms of this include- appetite changes (eating too little or too much), fatigue, sleep issues (sleeping too much or not much), and reduced self-esteem and self-worth, difficulty concentrating on tasks, feelings of hopelessness.
  3. Bipolar Disorder- This involves extreme and intense mood swings shifting like a pendulum from high energy and elevated mood to a low or depressive state. A person will experience symptoms of major depression in a low state of mood. This is also known as manic depression.
  4. Seasonal Affective disorder- This sort of depression hits people mostly during the winters when there’s a lack of sunlight and days and nights seem similar and gloomy. Due to lack of sunlight a person’s energy level supposedly goes down. It’s therefore known as seasonal as it goes away during summers and spring.
  5. Psychotic Depression- A person with this disorder experiences symptoms of major depression along with symptoms of psychosis such as hallucinations such as hearing or seeing things that are not there in reality, delusions are false beliefs such as having a belief that someone wants to hurt you (delusion of grandeur), paranoia or being suspicious about people trying to harm them such as their family.
  6. Peripartum (Postpartum) Depression- Sometimes women experience major depression after giving birth to a child. It can last for weeks and even months. It has the same symptoms as major depressive disorder. This can get serious including suicide ideations and therapy should be taken. Few men can also experience symptoms of depression during the peripartum period.
  7. Premenstrual Dysphoric Disorder- Some women experience symptoms of depression during the start of their menstrual cycle. It includes symptoms such as mood swings, irritability, anxiety, difficulty focusing, anxiety, sleep, and appetite disturbances, and feeling overwhelmed.
  8. Situational’ Depression- Sometimes a person can have difficulty managing a major life event of change such as grief or death of a loved one, losing one’s job, divorce, etc. This is also known as ‘stress response syndrome’.
  9. Atypical Depression- This is different from major depression as in other forms of depression especially the persistent ones usually nothing gives joy even things you once liked and you continue feeling sad. However, in this kind, a positive event can uplift your mood and make you feel better. Some symptoms of this include- increased appetite, sleeping a lot more than usual, being oversensitive to criticism and getting triggered easily, feeling heaviness in your arms and legs.
  10. Treatment-Resistant Depression- Some people after being treated for depression using different treatment modalities like medication or depression counselling and therapy don’t show improvement and their symptoms persist. This could be due to some other factors adding to your depression which makes it difficult to treat.

Difference Between Sadness and Depression

Sadness Depression
There are bouts of unhappiness which are temporary. There are bouts of unhappiness which are permanent.
There is a specific cause. There is no specific cause.
A normal routine is maintained. A normal routine is hampered.
There is no permanent feeling of worthlessness. There is a constant feeling of worthlessness.
Suicidal ideology is absent. Suicidal ideology is present.

Myths About Depression

Depression is one of the most common and one of the most misunderstood disorders. There are quite a few myths about depression which we’ll try to debunk. People with depression face prejudice and due to the stigma of depression, fewer people disclose that they’re suffering from it or that they feel they might be suffering from it. Therefore, it becomes important to learn the facts of depression.

Fact- Quite a few people believe that depression means being sad most of the time and it’s nothing serious. People suffering from it are called lazy, and that it is in their heads and nothing more. However, this is far from the truth. It’s an illness of the brain. The imbalance of brain chemicals takes place in people with depression which is why medication is also required alongwith depression counselling. And, it’s a culmination of social, biological, and psychological reasons. Genes, hormones, neurotransmitters, illnesses, stressful events can all lead to depression.
Fact- While anti-depressants might be necessary and will help with the chemical imbalance in the brain this does not deal with the deep-rooted psychological and social issues which might need to be treated too which is why depression counselling is also necessary for people suffering from depression.
Fact- Will you ask a person with a broken leg to get up and run? No, right? As it will be difficult for them to do so. Similarly, depression is an illness that affects a person’s motivation, energy levels and mood which makes it hard to do even the simplest of chores. Such a statement would only make them feel guilty and they might overwork to get rid of it resulting in other problems such as burnout.
Fact- This statement couldn’t be more wrong. Like any other illness, depression can happen to anybody rich or poor, physically healthy or weak, extraverts and introverts, young or old, etc. It can be sudden or gradual. Nobody wants to get sick but they might, the same is with depression, it can occur to people but treatment always helps to get better.
Fact- this is false as prescription of medication depends upon the intensity of depression, like with any other illness, medication might be provided but after a point of time, once things get under control, the doctor will advise stopping the medication. Psychotherapy for depression is important along with medication for better treatment and sometimes even depression counselling would be enough to treat it and make it manageable.
Fact- this is not necessarily true, yes people with depression will experience sadness but sometimes they can also go numb and are unable to experience any intense emotion. Their emotions can also get mixed not knowing what to feel and feeling perplexed. In men, one of the symptoms of depression is anger and this could be due to how men are told to not cry or experience sadness so they find it easier to be angry and frustrated rather than sad. People with depression can talk to people, do things they used to enjoy, but still feel worthless, hopeless and empty inside.
Fact- This one is quite common and completely false as there is research to prove otherwise. Due to certain symptoms of depression, people find it more ‘acceptable’ to attribute it to women not knowing how it affects men. Due to such misconceptions, men are less likely to seek help and more likely to die by suicide when they have depression because they find it easier to ignore it or die rather than be honest about how they are feeling.
Fact- There is a genetic component involved in depression but this is not necessarily true as it’s not always the case that people who are diabetic their children will also be the same. But genes alone do not determine the onset of depression. Focus on the factors you can control such as psychological and social.
Fact- The opposite of this is true as suppressing your feelings and keeping what you’re experiencing to yourself can make it worse as sharing and talking about it with the right person is the first step towards treating it. Discussing it with someone you trust, someone who can lend a sympathetic and non-judgemental ear will help. Consulting a therapist for depression is always the best option.

These are a few of the many misconceptions surrounding depression. It’s important to acknowledge and accept that such an illness exists and is as real as any other physical disease. There’s nothing to be ashamed of. A depressed person can start feeling better with depression counselling and treatment and it is important to be understanding and empathetic towards such a person so that they are encouraged to seek help rather than suppressing their emotions or engaging in unhealthy coping behaviour such as substance abuse. Sometimes people also use the word ‘depressed’ for anything trivial or small and this can create trouble as there is a difference between feeling low or sad due to some event and being depressed. It’s important to be sensitive towards certain psychological terms as it can only prolong the stigma and myths associated with depression and other psychological disorders.


Role of Psychotherapy in Depression

Along with various medical interventions (medications or drug therapy) that are responsible for maintaining the chemical balance in our brain to help us feel better, it is important to take up psychotherapy as well. Psychotherapy for depression, often referred to as talk therapy, unlike popular belief is not just about talking. Depression therapy involves much more, various techniques are brought to play to help the client feel at their best. Depression therapy provides a non-judgemental, unbiased and free space to discuss their concerns. Talking to a psychotherapist is not the same as talking to a family member. These psychotherapists are well versed with various techniques and are skilled to look at things from a very neutral perspective without any preconceived notions or making assumptions or judgements about the client based on the information they are sharing and keeping confidentiality as a top priority.

Counseling for Depression

Often Counseling and Psychotherapy are interchangeably used. While there are similarities, there are differences as well. Depression counseling usually refers to a short-term treatment plan for recent past or current situations while psychotherapy offers a more comprehensive and detailed intervention. Depression counseling helps in identifying the negative depressive thinking patterns so that we can engage less in these patterns and think more from a realistic perspective. Depression counselling also helps us identify unhealthy methods of trying to deal with the symptoms such as isolation or use of drugs or alcohol and helps us to make positive changes in the respective areas. Along with identifying the unhealthy coping strategies, counselling for depression also helps with formulating certain healthy coping strategies.


What can you achieve from therapy for depression

  • Awareness of thought and behaviour patterns - Depression therapy allows a therapist to gain knowledge about one’s distorted thought and behaviour patterns help to identify, understand and break that chain that contributes to depression.
  • Behavioral activation - Depression therapy can help to activate behaviours that will activate a positive emotional state, improving symptoms of depression.
  • Healthy coping mechanisms - Through the course of depression therapy healthy coping mechanisms and personal self care activities are planned and practiced to cope with stressful situations and prevent relapse.
  • Positive, productive thought patterns - With the help of depression therapy, client is equipped to consciously gain awareness about their unhelpful patterns of thinking and are armed with tools to challenge these thoughts.
  • Emotion regulation - Techniques are learnt to express and channelize negative emotions in a productive manner thereby increasing positive mood.
  • Prevent relapse - Depression therapy also aids in helping you to prevent relapse and manage healing and progress.
  • Become your own therapist - The ultimate goal of depression therapy is to help you become your own therapist, therefore we focus on making you the master of your emotions/thoughts!

To help you, let us understand Depression in more depth -

Signs and Symptoms of Depression: There are various signs and symptoms of depression that can help you be aware and can be treated accordingly. Let us understand it by the reference of Mira, Click here

We often don't pay attention to how we feel, but doing that and being aware can help us to take our step for well being accordingly.

FAQ (Frequently Asked Question)

Depression can be treated through the intervention of psychotherapy. Psychotherapists can help identify the intensity of depression and accordingly lay out treatment goals that will meet individual needs.
Depression is a mood disorder and mental health condition/illness that is treatable with the right kind of intervention. It can affect any individual regardless of their age, and gender.
There are many causes that can increase the chance of developing depression like Age, Abuse, Trauma, Death or loss, Conflict, Certain Medications, Substance use, Disability, Gender.
There are many types in psychotherapy that can treat depression for eg, Cognitive Behavioral Therapy is one of the types of Psychotherapy that has a good success rate in terms of treatment.
Counseling Psychologists are trained in treating depression. However, a depression counselor cannot prescribe medications in depression counselling process and in case of high severity, clients are referred to clinical psychologists.
If depression is left untreated, it can impact interpersonal relationships, their careers and jobs, and the overall quality of life suffers.

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