What is Depression and How is it Treated?

People may develop depression in their lifetime for a variety of reasons, such as loss of a loved one; unmanaged stress; certain biological factors, such as thyroid disease; and even winter weather (called Seasonal Affective Disorder, or S.A.D.)   

There are a number of theories that are used to help explain depression. Behaviorist Theory states that depression results from an individual’s “faulty learning” in their interaction within their environment. Psychoanalytic Theory posits that depression and other mental health issues have their roots in repressed childhood conflicts that the person may not be conscious of.

One of the most widely accepted theories today is Cognitive Behavioral Theory, first developed by Dr. Aaron Beck as a result of his research on depression (Beck, 1963, 1967). His observations of depressed patients revealed that they held a negative bias in their interpretation of life events, which result in “faulty thinking” (cognitive distortions), which inevitably leads to emotional and behavioral disturbances. These negative “faulty” thoughts often fall into three major themes: “I am not enough”, “Everything I do ends in failure or defeat”, and “The future is hopeless”. Someone whose thinking is dominated by these negative beliefs is, according to Cognitive Behavioral Theory, more likely to develop depressive symptoms.

Luckily, there are a number of treatment options for depression. Many medical doctors prescribe antidepressants, which often work through artificially boosting serotonin, a natural hormone that stabilizes one’s mood and feelings of happiness. In some cases, particularly those where depression is caused by the body’s inadequate production of serotonin, these medications can improve the condition or even bring the individual to a state of remission, for so long as they continue on medication.

Research has shown that the use of medication alone for depression is insufficient as it doesn’t go to the root of the problem.  Research has shown that antidepressants combined with Psychotherapy, or psychotherapy alone, are the most effective treatments.

Stress Management Counseling Center utilizes Cognitive Behavioral Therapy (CBT) (and sometimes a blend of other therapies tailored for each individual client) to treat depression and anxiety. CBT is the most highly effective therapy for these conditions, according to extensive research by the scientific community. This form of treatment is based on the way that behaviors, thoughts, and feelings interact with one another. The objective of CBT is to enable people to be aware of the automatic negative interpretations they make in order to consciously choose to use positive (or even neutral) interpretations, thus reducing psychological distress. They learn to become aware of their automatic negative thoughts, and then are shown how to change them, which leads to mitigating depressive symptoms: Meaning: They will feel better!

The DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; published by the American Psychiatric Association) defines the criteria for major depressive disorder (MDD) and major depressive episodes (MDE) as follows: 

  1. Five or more of the following symptoms are present in the same two-week period and represent a change from the individual’s previous condition. Depressed mood or diminished pleasure must be present. 
  • Depressed mood most of the day, and nearly every day. 
  • Markedly diminished interest or pleasure in all or most activities during the day every day. 
  • Significant weight or appetite change; weight change can be indicated by a shift of more than 5% of body weight in a month. 
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day (beyond feeling sluggish or restless.)
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive or inappropriate guilt (guilt may be delusional, and goes beyond self-reproach or guilt about being sick).
  • Diminished ability to think or concentrate, or indecisiveness nearly every day.
  • Recurrent thoughts of death, recurrent suicidal ideation with or without a plan, or a suicide attempt. 
  1. Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 
  2. The episode is not attributable to the physiological effects of a substance or to another medical condition. 
  3. The episode cannot be better explained by schizoaffective disorder, schizophrenia, or other schizophrenia spectrum or psychotic disorders.
  4. No history of manic or hypomanic episodes. 

If any five criteria of the criteria above are met, an individual can be diagnosed with MDD by a licensed practitioner (i.e., a doctor, psychologist, Licensed Professional Counselor, or Licensed Clinical Social Worker) according to the DSM-5 criteria. A licensed practitioner determines if the patient meets the DSM-5 criteria for a diagnosis of depression through a variety of methods, including psychometric tests, and certain questions and observations made by the provider, and, if available, with observations from people close to the individual. Psychometric tests often ask questions with “yes” or “no” answers that will indicate if an individual has certain feelings or experiences specific symptoms. One example of such a diagnostic test is Beck’s Depression Inventory (BDI), (Beck, 1961, 1978, 1996).   The BDI is a 21-question Likert Scale where a person chooses between at least four possible responses, ranging in intensity.  Based on the responses, the licensed practitioner scores the answers to help determine the presence and severity of the depressed mood.

 

If you are having ANY thoughts of suicide, please immediately call 911 or 988 (FCC’s Suicide Hotline).

 

If you think that you might be depressed, please click on “Email for an Appointment” today and schedule an appointment to see one of our therapists.

By Michael Zamora


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