Depression manifests through a variety of symptoms, which include:
- Pervasive Sadness: A consistently low mood that lasts for most of the day, nearly every day, for at least two weeks. This mood can be self-identified or observed by others.
- Loss of Enjoyment: A decreased interest in activities that used to bring pleasure. This can also be self-identified or observed by others.
- Anxiety: Manifests as inner discomfort or fear.
- Fatigue: A feeling of exhaustion or loss of energy leading to lethargy.
- Despair: A sense of hopelessness and pessimism about the future.
- Impaired Cognition: Difficulty in concentrating, thinking, and decision-making.
- Low Self-Esteem: Persistent feelings and thoughts of guilt, worthlessness, and low self-esteem.
- Sleep Disruptions: Insomnia, hypersomnia, or early waking, with difficulty falling back to sleep.
- Appetite Changes: Either weight loss when not dieting or weight gain. The weight change should be greater than 5% of body weight within a month.
- Reduced Libido: A decreased interest in sexual activities.
- Physical Symptoms: Psychosomatic symptoms with no organic cause, such as headaches, back pain, chest pain, difficulty in breathing, and nausea.
- Suicidal Ideation: Obsessive thoughts about death and suicide, often stemming from feelings of despair. Individuals with severe depression are at significant risk of suicide.
For a diagnosis of depression to be made, at least five of the above symptoms should be present, including either the first or the second. The symptoms should significantly impair the individual’s ability to function in various aspects of life, such as personal, familial, occupational, or social interactions (DSM-IV).
Treatment of Depression
A person’s functionality can vary based on the intensity or frequency of their symptoms. Depression, whether severe or mild, is a relatively common condition but it is treatable.
People suffering from depression often revert to a closed-off and isolated way of life, which can make treatment challenging. Both the therapist and the individual undergoing treatment need to address this obstacle. Furthermore, the pessimistic thinking associated with depression can also make the individual skeptical about the success of the therapy. Therapists need to be supportive, emphasizing the individual’s strengths while also allowing them to take responsibility for their life and begin to see their future as less bleak.
Individuals with depressive tendencies usually have a very negative self-image. They often feel unworthy, unsuccessful, and paralyzed by their condition. They may compare themselves unfavorably to others and come up with numerous reasons why they feel inadequate. A common trait is a high level of self-criticism. One of the primary goals of therapy is to help the individual develop a more realistic self-image. This would enable them to gradually recognize their strengths as well as their weaknesses, which, until that point, had primarily defined their identity.
People who struggle with depression often feel like spectators in their own lives rather than active participants. They usually anticipate rejection from others and, as a result, their behavior often serves to confirm this expectation. For example, if someone expects to be rejected, they may withdraw or refrain from expressing their thoughts and emotions, eliciting feelings of anger and rejection from others. Therapy aims to break this vicious cycle—fear of rejection leading to withdrawal, which then confirms the rejection—and encourages individuals to interact with their environment in a way that allows them to express their thoughts and emotions, and take responsibility for their lives.
Moreover, traumatic experiences often underlie depressive symptoms. An important goal of therapy is the emotional processing of these traumas, enabling individuals to move forward freely in their lives.
Regarding medication, it’s clarified that psychologists don’t prescribe antidepressants or any other medications. In severe cases of depression, pharmacological treatment may complement psychotherapy, and this is generally done in collaboration with a psychiatrist, with the agreement of the patient.
In conclusion, the symptoms of depression are specific but can vary in intensity and frequency. Treating depression requires a multi-faceted approach, addressing both cognitive and emotional aspects, and can bring about significant changes in all areas of an individual’s life.