Depression

Of all psychological problems and disorders, depression is the most common.

Depression has always existed, but recently the number of people suffering from depression has been rising rapidly. What is especially concerning is that depression is appearing at an increasingly younger age.

Depression has a whole range of symptoms by which we can recognize it. We divide these symptoms into the following groups:

Symptoms we can recognize in the way we think: we are very self-critical and feel helpless. A whole chain of negative thoughts runs through our minds. It seems we cannot calm our own mind. We see ourselves negatively (as less worthy), the world around us negatively (as too demanding, it seems that something negative is constantly happening to us and around us), and we see the future negatively (as hopeless and dark). We may have difficulties with concentration, memory and recall, and in making decisions.

Symptoms in behavior:We withdraw from other people and are less engaged in activities than before, especially the pleasant ones. We do fewer enjoyable things with other people, we complain to them, and we may get into arguments with them, after which we feel guilty.

Symptoms in motivation (will): We feel apathetic, have no will for anything, have less energy and interest in most things, everything seems overly exhausting, nothing makes sense to us anymore, so we no longer feel like doing anything.

Physical symptoms: We have trouble sleeping: most often we sleep too little due to waking early, waking up more often at night, or having difficulty falling asleep. Sometimes we may also sleep excessively, yet still do not feel rested (this is especially true for teenagers). We feel tired and lacking in energy. Appetite is either reduced or greatly increased, which may show up as a significant loss or gain in body weight. We feel somehow slowed down or have a sense of heaviness in the body (especially in the arms and legs). We may also feel extremely tense or restless, like a lion in a cage or as if we are about to jump out of our own skin.

Emotional symptoms: We experience a whole range of negative feelings: sadness, emptiness (the feeling as if we no longer have any emotions at all), irritability (everything gets on our nerves). There is also anger, guilt, nervousness, anxiety, and fear. The experiencing of positive emotions is reduced: we no longer enjoy things we used to enjoy, as if we have lost the capacity for joy.

Women are more susceptible to depression

Over the course of life, every woman has a 26% probability of experiencing a true depressive episode, i.e. major depressive disorder or unipolar depression. For men this risk is 12%, and the average for both sexes is 17%. The more depressive episodes someone has had, the greater the probability that they will experience another one, with an ever shorter interval between episodes.

The reason for the higher frequency of depression in women (besides the fact that women are more willing to admit it and seek help for it, so it may appear that they have more of it) is hormonal: women are exposed to strong hormonal changes during so-called critical biological periods: puberty, changes during the menstrual cycle (PMS), pregnancy, the postpartum period (baby blues, postpartum depression), perimenopause and postmenopause.

Women are somewhat more often than men inclined to be dependent on other people (i.e. they more often see themselves as helpless, which does not mean they truly are) and they find poor interpersonal relationships and problems in partnerships harder to bear, and this can be a vulnerability factor that makes depression easier to trigger in some women. On the other hand, men may hide or "mask" their depression behind other problems, such as alcohol and drug abuse, and "workaholism".

The causes of depression are numerous and complex. All these causes interact with one another, which makes it especially difficult to determine the relatively greater share of any one of these factors. For example, genetics certainly plays a certain role. However, we do not inherit a single gene or a specific group of genes for depression (at least this has not yet been discovered), but at present it is quite certain that we inherit a certain vulnerability to depression. This vulnerability may also be linked to our temperament. Temperament refers to the part of our personality that is largely inherited and is related to the type of our nervous system. For example, there are people with a so-called melancholic temperament: they are more sensitive people who, from childhood, are more inclined to withdraw and to experience sadness, fear and anxiety more frequently. Although they never necessarily have to develop a depressive or anxiety disorder, they are nevertheless more prone to it. However, other factors are needed to trigger depression or an anxiety disorder, for example environmental or bodily ones (some physical illness, hormonal changes, etc.). Among environmental factors, the amount and frequency of stressful situations we are exposed to, traumatic events, and difficulties from childhood are especially important. It has long been known that experiences we have lived through from the beginning of life and throughout life can affect the state of our mind. The relationships we have with others, how we were raised, losses we have suffered, pressures we are exposed to at work, at school and in the family. Prolonged endurance of bad relationships (especially marital, i.e. partner relationships in general) can be a factor that triggers depression.
We humans are very complicated beings, because the brain, as the basis of our psychological life, is definitely the most complex part of the organism.

How to distinguish depression from normal states of low mood?

Today every drop in mood and energy is easily labeled as depression. There are pressures that "push" us to feel happy constantly, to be cheerful, smiling and full of energy. If we could be like that, it would not be normal. Negative emotions are an integral part of life and we need them in order to adapt better to life's demands and changes. All of us feel sad, empty, hopeless from time to time, lack energy, and do not feel like going out socially. Sometimes such feelings are very brief and passing, and then we do not need to pay attention to them, but if they persist, it is worth considering whether they are sending us some kind of message.

Messages such feelings might send us are: “Slow down a bit, your life is in chaos, you work too much, you have no time for yourself, family,…” or “You are doing something that is not in line with your values; in this workplace you are expected to use lies and manipulation. Solve it or find a new job.” or “In this relationship you are being psychologically abused and exploited. You need to solve this problem or get out of such an unhealthy relationship.” and similar.

So, a depressed mood usually prompts us to solve problems and make decisions. If we manage to resolve the problems that this low mood prompts us to address, we will feel better. If that does not happen, we will probably need help to solve the problem more easily. However, if the low mood worsens or is not resolved for a long time, we may be falling into true depression.

Depression and grief

Similarly, the grieving process after losing a loved one may resemble depression, but it is not depression. It is completely normal and important for our mental health to go through the entire grieving process after a loss. Over time, however, grief diminishes, wounds heal, and the person manages to continue with their life and find a new sense of meaning, now without the loved one. If, however, we get stuck in such grief for too long and notice no changes, we may have fallen into depression and should seek professional help. The length of grieving is very individual for each person, and depends on the degree of closeness and connection with the person we lost and on how intertwined our lives were. For some people it is normal to grieve for as long as 2 years, so it is difficult to say when grieving should end. If you are not sure, talking with a professional can help you with this.

Depression and psychotherapy

When you turn to a psychotherapist for help with depressive difficulties, they will first assess the symptoms of your depression and its severity, and probably other accompanying difficulties. If the assessment shows that your depression is severe, the therapist will advise you to contact a psychiatrist, so that you can get the best advice regarding the prescription of the most suitable antidepressant for you. With such medication, your symptoms will ease, and it will be easier for you to get through psychotherapy.

Overcome depression

Together you will agree on which problems you want to work on first, and you will jointly formulate the goals you want to achieve through therapy: e.g., reducing the feeling of sadness, emptiness and apathy, engaging in more social activities, improving skills for better standing up for yourself, increasing the time spent studying, etc.

You and your therapist will consider how certain activities or lack of activities contribute to you feeling bad or good. There are activities you can undertake to start feeling better. You and your therapist will also examine your negative and unrealistic ways of thinking that make you feel depressed. Therapy can give you tools to learn to think more realistically and thus feel better. You will learn and adopt all these techniques and ways of coping with and mastering your problems in a very structured and gradual (step-by-step) manner. The therapist will explain the rationale for applying a particular technique, you will practise it together in the session, and then you will practise it yourself between sessions as homework.