Depression ...

"I just don’t enjoy anything anymore."

Most people are familiar with the diagnosis of depression. Depression affects energy levels, the ability to concentrate, and interest in activities that used to be enjoyable. Feeling overwhelmed and hopeless is common and some individuals experience a dramatic weight gain or loss. Depression affects every aspect of life, and severely degrades the quality of life. Depressive symptoms can result from medical problems and can overlap with normal states such as grief or sadness. Common symptoms that accompany depression include anxiety, a tendency to overuse alcohol or other substances, and marital and other interpersonal problems. To formally diagnose depression, Psychologists look for the presence of five, or more, of the following symptoms:

Depressed mood most of the day, nearly every day, as indicated by self-report (e.g. “I feel sad” or empty), or by observations made by others (e.g. person appears tearful).

Markedly diminished interest or pleasure in nearly all activities.

Significant weight loss or weight gain that is not planned or purposeful.

Insomnia or hypersomnia (sleeping for long periods) nearly every day.

Psychomotor agitation (e.g. fidgety, antsy) or psychomotor retardation (e.g. slow moving, hard to get going) nearly every day.

Fatigue or loss of energy.

Feelings of worthlessness or excessive (and inappropriate) guilt.

Diminished ability to think or concentrate or indecisiveness (can’t make a decision).

Recurrent thoughts about death, recurrent suicidal thoughts, or suicide attempt.

These above symptoms have lasted for two, or more, months.

Cognitive-behavioral model of Depression:

Several cognitive-behavioral models of depression have been proposed and are supported by data from scientific studies. All of the models view depression as made up of emotional, behavioral, and cognitive components. In a widely supported model developed by Dr. Aaron T. Beck at the University of Pennsylvania, negative emotions result from negative thinking and dysfunctional behaviors. For example, in response to arriving five minutes late for work, a man might have the thought, "I never do anything right," emotions of worthlessness and inadequacy, and behaviors of repeatedly criticizing himself and focusing on his faults will follow. These emotions, cognitions, and behaviors can feed one another, sending the person on a downward spiral of negative emotions, behaviors, thoughts, and experiences.

Other cognitive-behavioral models point to other factors that can cause or contribute to depression, including:

overwhelming or intractable life problems

poor problem-solving skills

loss of important sources of pleasure and satisfaction

difficulty maintaining consistent action in support of one’s goals and values
All of the models agree that biological factors can also play a key role in causing and maintaining depression.

Cognitive-behavior therapy for Depression:

Teach the depressed person to identify and change the thinking (cognitions) and behaviors that accompany depressed emotions, with the notion that the cognitions, behaviors, and emotions are tightly linked, so that if the cognitions and behaviors change, the emotions will also change.

Develop and use skills to solve overwhelming life problems such as finding new or regaining old sources of pleasure and satisfaction.

Develop skills to maintain consistent behavior in support of personal goals and values.

Because depression is a recurrent disorder, therapy also emphasizes teaching the depressed person to identify and manage early signs of depression in order to prevent or limit new episodes of illness.