Depression & Mood Disorders

Depression is the second most common psychological problem (anxiety problems are the first). Everyone has experienced feeling down for short periods of time. Sadness which lasts for extended periods of time and interferes with social and occupational functioning is called clinical depression, otherwise known as Major Depressive Disorder.

How common is it?
Depression severe enough to warrant treatment occurs in about 6% of women and 3% of men. Depression can occur although at lower rates among children. The rates gradually increase so that by ages 14 – 15 they equal those of adults.. Among the elderly the rates decrease slightly, nevertheless, depression remains a frequent and serious problem among this age group. Recent national surveys have indicated that clinical depression is more common than once thought, approximately 17% of people will become clinically depressed at some point in their lives.

Types of Depression 
Mood disorders can be of different types. The three primary diagnosis are; Major Depressive Disorder, Dysthymic disorder, and Bipolar disorder. Major depressive disorder tends to occur in ‘episodes’ that begin and end usually lasting about six months. Dysthymic Disorder tends to be milder but can last for years, without distinct episodes. Therefore the primary difference between major depression and dysthymic disorder is the course the symptoms take across months or years. Often people with dysthymic disorder have felt mildly depressed for most of their life and may not believe that there is any other way to feel. People with dysthymic disorder could also go through major depressive episodes, in which case they will have ‘double depression’. Bipolar Disorder (also known as Manic-depression) may include periods of depression, but must include at least some ‘manic’ symptoms. Manic symptoms can vary from mild mania, e.g., chronic irritability, restlessness, insomnia, excessive talking, to more severe mania, e.g. reckless behavior, poor judgement, inappropriate social behavior, explosive anger, spending sprees, impulsiveness, sleeping only a minimum amount of time if at all and grandiose thinking.

Behavioral Characteristics 
Changes in behavior are also part of the primary symptoms of depression. A general slowing down of activities and a lack of interest in normal routines is part of the general fatigue and passivity which accompanies depression. Socializing may decrease and work attendance or performance may suffer. Sufferers may be so fatigued as to feel almost paralyzed. Interpersonal difficulties such as isolation, communication difficulties and strained relations can also develop. These interpersonal problems are more common in depressions that go unimproved or untreated for extended periods.

Cognitive Characteristics 
Often depressed thoughts (cognition’s) are centered around: loss, hopelessness, helplessness and self-criticism. The thoughts that accompany depression are often distorted in various ways, for example; “things will never improve” (fortune telling), “I am a worthless person” (labeling), “other people see me only as a burden” (mind reading), “there is nothing to look forward to” (disqualifying the positive) “it’s my fault that I’m depressed (personalizing). A serious yet common theme in depressive thinking are thoughts of suicide. Of course anyone who has suicidal thoughts should be in treatment. Learning to clearly identify the self-defeating thoughts that occur during depression and learning to change them is the focus of cognitive therapy.