According to the WHO, depression is the leading cause of disability worldwide, affecting more than 280 million people. Two out of three people with depression do not receive the specialized care they need.
It is considered an emotional disorder, but it’s not that simple. Emotion is not separate from the body or behavior. Therefore, symptoms can take on varied forms across these three areas.
Likewise, the intensity of symptoms is highly variable, and the causes of their origin can be so varied that an exhaustive evaluation by an experienced psychologist is essential. The causes of the origin and maintenance of depression will also define the treatment approach.
A moderate or severe depression could be described as follows: ‘a dense fog that envelops everything. Experiences, relationships, and self-image. All tinted by shades of hopelessness or disinterest’. For someone in this state, it is very difficult to seek the help they need. However, help is possible. Getting out of this situation is possible. I have seen it in many patients who today recall depression as a bad dream and have regained a full life they thought was lost.
Si estás aquí, leyendo esto, ponte en contacto ahora. La recuperación es posible.
Symptoms of Depression
Those suffering from depression may experience profound sadness, lack of energy, loss of interest in previously enjoyable activities, changes in appetite or sleep, and a persistent feeling of emptiness or worthlessness. Hopelessness is another predominant emotion, usually because of being unable to see a promising future.
These symptoms can lead to social isolation, deterioration in work or academic performance, and, in severe cases, thoughts of self-harm or suicide.
Feeling this way can make even the smallest decisions feel overwhelming. Social interaction becomes a daunting task, and keeping afloat in daily obligations can seem like a lost battle.
Depression does not only affect the mind; it can also manifest in the body with fatigue, pain, and general discomfort, making everyday life even more challenging.
Causes of Depression
“Why am I depressed?” It’s common for those suffering from depression to not have a clear answer to this question. Some patients literally tell me they have no reason to be depressed. Therefore, in a psychotherapy process, exhaustive evaluation is crucial. The causes that can lead to depression are many, varied, and sometimes invisible to the eyes of the depressed individual.
It is often said that genetics is a cause. Therefore, family history is looked into. However, genetics alone is not enough, and heritability can also be linked to context, learned behaviors, or factors related to early family relationships. Depression often has complex causes. Some of the factors related to the origin of depression can be:
- Chemical imbalances: alterations due to illness, medications, genetic predisposition.
- Prolonged stress: living under high levels of stress for extended periods can deplete emotional and physical reserves, leading to depression. (related to Burnout)
- Self-esteem issues: Negative self-perception and lack of self-esteem can be both causes and consequences of depression. (related to Impostor Syndrome, ADHD, HIA).
- Isolation: a lack of social support and isolation can increase feelings of loneliness and hopelessness, triggering depression.
- Traumatic life events: the loss of a loved one, divorce, or childhood or adult trauma can trigger depressive episodes. (related to Grief, PTSD)
- Substance abuse: the use and abuse of alcohol, drugs, and other substances can lead to a destructive cycle, where depression encourages substance abuse and vice versa, exacerbating both problems.
- Abusive relationships: toxic romantic relationships, as well as harassment in other social spheres such as work, school, or any other, can lead to depression mediated by low self-esteem and hopelessness.
- Chronic pain: pain is a stressor, and when it is continuous over time, it can generate feelings of despair and hopelessness.
- Dysfunctional beliefs: some of the mentioned factors can establish beliefs about oneself, others, or about the world and the future, that irreparably affect the ability to cope with negative situations or emotions.
- Cognitive biases: cognitive biases are automatic tendencies of the brain’s executive functions (attention, memory, etc.) that, in the case of depression, direct them over and over again towards negative stimuli.
Treatment for Depression
Given the variety of causes behind depression, it’s understandable that there isn’t a one-size- fits-all approach to addressing it. For severe cases, a multidisciplinary intervention is common, involving the administration of medication while applying psychotherapy. For resistant cases, other noninvasive techniques such as TMS (Transcranial Magnetic Stimulation) are also applied.
However, in general, the treatment with the best scientific evidence is psychotherapy. It is effective both for reducing symptoms and for preventing relapses. There is a variety of techniques and extensive research regarding the treatment of depression with psychotherapy.
Conducting a correct evaluation is extremely important, considering that the same symptoms of depression can have different causes. The causes can be for the onset of the depression, but also for the maintenance of the depression episode.
Cognitive-behavioral therapy, relational therapy, acceptance and commitment therapy, brief strategic therapy, psychodynamic analysis, desensitization and reprocessing of traumatic events are some of the most common approaches used in therapy to address depression.
Some therapists adhere to a single methodology. In my case, I prefer an integrative approach, using techniques from different perspectives according to the specific needs of the person in front of me. And although I bring the technical knowledge as a psychotherapist, the practical knowledge is brought by the patient. Therapy and improvement occur as a team, between the two of us. With constant feedback about what works and what doesn’t, what is more comfortable or appropriate.