Depression: Background

Most of us have experienced "the blues" - periods of sadness or "down days" where we do not have the energy, enthusiasm and confidence that we do at other times. Perhaps we've experienced more acute sadness as well. Sometimes we may be very aware of the cause of these feelings. If we are grieving over the loss of a loved one, for example, the sadness can be very sharp and very deep. At other times we may not know why we feel the way we do; we just "feel moody."

Some of these moods are normal, even helpful. Grieving, for example, seems to be a universal means by which we come to terms with a loss, understand its meaning in our lives, and prepare to move on. "Down times" can be times of reassessment and contemplation, leading to new insights and perhaps meaningful changes in life direction and priorities. Counseling can be very helpful in understanding and even benefiting from these difficult times. However, seeking outside help becomes increasingly important for the more serious condition that we call depression.

Depression can begin as a reaction to an external event, or to internal body chemistry. Either way, it eventually encompasses the mind, emotions and body. Life seems to lose its meaning, self doubts multiply, thought processes may seem slowed (or perhaps agitated) and often there doesn't seem to be enough energy to complete daily responsibilities. Sleeping, eating and sexual desire are often affected, and the depressed individual frequently tends to withdraw from social interaction (though occasionally there is an increased drive to be with people).

For the depressed person, the future may not hold much hope, and activities that once were pleasurable may no longer seem appealing. Depression can take hold rather quickly and strongly, perhaps in episodes that come and go, or it can be a more nagging, chronic condition that is "always there."

Depression usually is very treatable. Occasionally, it may be due to a general medical condition (e.g., hypothyroidism or a vitamin B12 deficiency); or it can be a reaction to a drug or substance, such as a side effect of a prescription medication. A trip to one's physician is usually important to rule out these possibilities. If a specific medical cause is found, treatment of that condition may be sufficient to deal with the depression.

Even if no specific medical cause is found, depression still represents both a biochemical and an emotional condition. One method of treating it is physiological, most often with the help of antidepressant medication. The other common approach is counseling aimed at characteristic thinking and behavior patterns. Studies show that either approach by itself can be effective in relieving symptoms, and it is very often recommended that an individual pursue both approaches at the same time. In the long run, counseling has the capacity to help a person improve the behavior, thinking and relationship patterns that may be contributing to the depression, making a person less susceptible in the future. Of course, the choice of medication (in consultation with a prescribing doctor), counseling or a combination of approaches is always up to the individual.

The greatest risk of depression is the possibility of suicide. If you or someone you know is considering this possibility, get help immediately. Establish a relationship with a counselor, or if the need is immediate, call a mental health hotline (look in the front of your phone book) or call 1-800-SUICIDE from anywhere in the U.S.

For more on how John works with depression, see:
[Overcoming Depression: Specific Counseling Strategies]