My father was diagnosed with lung cancer last January, and within weeks, he was gone. Shortly after that, I got laid off at work. It didn’t take long to burn through our savings, and the financial pressure started to impact my relationship with my wife.
I felt hollowed out and empty. This wasn’t just grief or stress; it was something more. I wasn’t sad, I wasn’t angry– but something was wrong. I started to think maybe things would be better if I wasn’t here. If there’s an afterlife, I could see my father again. My life insurance would relieve my wife’s financial pressure, and she could move on and maybe even marry again.
One morning, my wife sat on the edge of our bed, gently laid her hand over mine and told me: “We’re going to get you some help.”
Together, we searched for a mental health counsellor in our area. She even came with me to the first session and supported me through the ongoing weeks and months of therapy.
My counsellor put a name to what I was feeling – depression. She gave me the tools to identify the source of my pain and helped me unpack years of hurt that I’d kept buried until the events of the past year had exposed them.
My wife saved my life by giving me the courage to take that first step. If that’s where you are today, I promise it doesn’t have to be this way. There is hope, and real happiness and contentment are within your reach. Don’t wait another day.
Symptoms must last at least two weeks for a diagnosis of depression.
The four most common types of depression are: major depression, persistent depressive disorder, bipolar disorder, and seasonal affective disorder.
Major depression is a state where the individual’s mood and demeanour are persistently dark, causing them to lose interest in activities once found pleasurable. Common symptoms are insomnia or excessive sleep, changes in weight unrelated to diet, and feelings of worthlessness or guilt. Often, the individual has thoughts about suicide or death. Most commonly treated with psychotherapy and medication, and in some cases electroconvulsive therapy may be effective.
Persistent depressive disorder refers to a “low” mood that has spanned at least two years, though it may not have been classified as major depression. Many individuals with PDD can carry out their day to day lives, but they experience a persistent, underlying feeling of sadness. They may experience sleep issues, unexplained weight gain or loss, and hopelessness.
Individuals with bipolar disorder—once known as manic-depressive disease—experience periods of depression (lows) as well as periods of high energy or activity (highs). Manic and depressive episodes are at opposite ends of the spectrum. For example, where depression is low self-esteem and energy, manic is grandiose ideas and unnaturally high self-esteem. While being manic is associated with positive feelings, it is still emotion out of balance and often includes self-destructive behaviour leading to depression. Individuals with bipolar disorder can manage their illness with medications that stabilize their moods, and coupled with psychotherapy can lead active, fulfilling lives.
Seasonal affective disorder (SAD) is as its name implies, tied to the change in seasons. It mainly afflicts people as days get shorter in the fall and winter. An individual with SAD experiences changes in mood related to changes in the body’s natural rhythms and the impact of changes in light on chemical messengers like serotonin and melatonin. One of the most effective and least invasive treatments is light therapy, where the individual sits close to an intense light source. Psychotherapy and medication may also be included in the treatment plan.
Women are at higher risk for general depression than their male counterparts. Additionally, women are at risk for two different types of depression influenced by reproductive hormones—perinatal depression and premenstrual dysphoric disorder (PMDD).
Perinatal depression includes both major and minor depressive episodes occurring during pregnancy or in the first 12 months after delivery (commonly referred to as postpartum depression) — one in seven women who give birth experience perinatal depression. Its effects can be devastating for the woman, her infant, and her family. Treatment includes counselling and medication.
PMDD is a severe form of premenstrual syndrome or PMS. PMDD symptoms generally begin shortly after ovulation and end once menstruation begins. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), may be effective in reducing symptoms.
Depression is one of the most common mental disorders in Canada. The causes are as varied as the individuals who experience its sometimes debilitating effects.
Studies on twins, adopted individuals, and family studies have linked depression to genetics, though there is much still to be learned and understood. There is, however, evidence to suggest having parents or siblings with depression may increase your risk.
Scientists agree that depression is most likely caused by an imbalance in the neurotransmitters which are involved in the regulation of our moods. Neurotransmitters serve as conduits that enable different areas of the brain to communicate with each other. If the supply of neurotransmitters is interrupted or in short supply, an individual may experience depressive symptoms. Studies have also shown that people with depression may have physical differences in their brains, though further research is necessary before conclusions can be drawn.
Women suffer from major depression roughly twice as often as their male counterparts. The incidence of depressive disorders peaks during a woman’s reproductive years and this has led researchers to believe hormonal fluctuations such as a result during menstruation, childbirth, and perimenopause may be the cause. The good news is that the risk of depression in women declines after menopause.
Hormones may also be out of balance because of thyroid conditions. This can trigger depression, particularly in people who are already susceptible because of other risk factors.
Some individuals develop situational depression, or “adjustment disorder with depressed mood,” as a response to highly stressful situations or trauma.
Your doctor may diagnosis you with depression based on several, often interrelated, factors. Often, your doctor will begin with a physical exam as depression may be linked to an underlying physical health problem. Based on your responses, they may order additional tests such as a complete blood panel or test your thyroid function.
Your doctor or psychologist will also do a psychological evaluation. They will ask you questions or have you fill out a questionnaire about your symptoms, thoughts, feelings and behavior patterns. Based on your responses, they will use the criteria for depression as listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Depression manifests in different ways. Some of the most common signs are:
There are many treatment options available for depression, but how well the treatment works is dependent on the type of depression and its severity as well as your body chemistry.
Many clients turn to psychotherapy to deal with their depressive disorder, though most people find a combination of psychotherapy and medication brings better results than either as a standalone approach.
There are several different types of psychotherapy to choose from, and your therapist will discuss a treatment plan for you, customized to your specific needs and symptoms.
Cognitive behavioural therapy (CBT) helps the client identify and assess so they can then change negative thinking patterns associated with depression. CBT is generally a short-term approach, sometimes limited to 8-16 sessions.
Interpersonal therapy (IPT) focuses on identifying and working on problems in personal relationships or other significant life change that may be contributing to the depression. Therapists teach individuals to evaluate their interactions and to improve how they relate to others. Like CBT, IPT is often time-limited and prepares the individual to assess their interactions and apply tools learned in sessions to improve their interpersonal relationships.
Psychodynamic therapy focuses on recognizing and understanding negative feelings and patterns of behaviour from past experiences and learning to resolve them. This approach can be short or long term. Your therapist may also suggest psychoeducation and support groups for both the individual struggling with depressive disorder and their family.
Psychoeducation teaches individuals about depression’s symptoms and effects, as well as how to recognize negative thought patterns and avoid relapse. Support groups offer participants the opportunity to share their experiences and learn effective coping strategies, while others may be peer-led.
Medication: Some individuals find antidepressants help reduce or control their symptoms. Be aware, medications often take two to four weeks to metabolize, and some take as many as twelve weeks to reach their full effect. Everyone’s body chemistry is unique, so you and your doctor may have to try varying doses or medications to find the one that works for you.
There are many misconceptions about what therapy can and cannot do. Perhaps you have had some of these thoughts yourself:
Not only are these statements blatantly false, but they also stand in the way of individuals with legitimate mental health struggles getting the help they desperately need and deserve.
There are several different types of psychotherapy to choose from, and your therapist will discuss a treatment plan for you that is customized to your specific needs and symptoms. Cognitive behavioural therapy (CBT) helps the client identify and assess so they can then change negative thinking patterns associated with depression. CBT is generally a short-term approach, sometimes limited to 8-16 sessions.
Time and again, CBT has proven effective for a range of mental health issues, including depression, anxiety disorders, addictions, marital problems, even eating disorders and other severe forms of mental illness. Many studies have found CBT to be a better tool in treating these issues than other types of therapy or psychiatric medications.
CBT is based on several core principles. First, mental health issues are based, in part, on faulty or unhelpful ways of thinking. The resulting problems can be traced to learned patterns of destructive behaviour. The good news is that individuals struggling with their mental health can learn strategies to help them cope and in some cases, overcome their symptoms.
CBT therapy is focused on changing broken or misleading thinking patterns. Your therapist will teach you to recognize distortions in your thinking that are creating problems, and then provide the tools to help you evaluate them in light of reality. Through this skillset, you’ll get a better understanding of both your own as well as others’ behaviour and motivation. As you grow and utilize these skills, you’ll become more confident in your ability to tackle your fears. You’ll learn how to face rather than flee your problems, and learn to calm your mind and relax your body.
The most important thing to remember is that CBT is a collaborative effort between you and your therapist. Together you’ll work at identifying the problem, set goals, and create a strategy to accomplish them. You’ll take these tools and apply them in real-world situations, enabling you to take back control of your life and move forward with confidence in your ability to face whatever lies ahead.
It takes courage to make that call to ask for professional help. Sometimes, figuring out which type of mental health professional you should see can make the task even more daunting.
How you feel about talk therapy versus medication, or if you’re interested in using a combination of both. If your goal is medication-based treatment alone, or alongside counselling, you will need to see a medical professional like a psychiatrist. If, however, you’re looking for talk therapy, a psychotherapist or psychologist may be the best choice.
Using these skills and strategies is the first step in taking control of your mental health, which is essential for long term success.
There is much research demonstrating that talk therapy can be useful in treating depression. Talking to a mental health professional can help you identify negative thought patterns and equip you with the tools to manage your symptoms.
For individuals with mild to moderate depression, talk therapy may be sufficient to help you overcome your battle and feel better. However, those with severe or clinical depression may need medication along with talk therapy to get back on track.
The two most common forms of therapy used for treating depression are cognitive behavioural therapy (CBT) and interpersonal therapy. CBT focuses on how your negative thought patterns impact your mood. Your therapist will work with you to identify these patterns, then take action by making positive changes in your thoughts and behaviour. Interpersonal, as its name suggests, centres on how you relate to others. Your therapist will help you identify pitfalls and bad habits in your relationships and make positive changes in those relationships.
In your first session, your therapist will ask you what prompted you to seek help. It’s vital that you be honest about your reasons so your therapist can help you set the appropriate goals. For example, are you trying to improve your relationship with your partner, or are you hoping to set goals and change your thought patterns and behaviour?
Like medication, talk therapy may not make you feel better right away. In fact, initially you may feel a little worse as you uncover the source of your pain. But take heart because every step you take is a step toward healing and hope. If you do the work, then over time you should start to see changes in the way you think, feel, and act. Your relationships will become healthier and you will become stronger.
Individuals facing a diagnosis of depression face a dilemma in how to proceed with treatment. Therapy? Medication? Both?
The first consideration is the severity of the depression. When a person is mildly depressed or hasn’t been depressed for a prolonged period of time, Cognitive Behavioural Therapy (CBT) is equally effective with or without medication. However, individuals with moderate to severe depression often find greater success through a combination of CBT and medication. This is particularly true for individuals with chronic depression (defined as lasting at least two years). Based on these and other studies, clinicians recommend psychotherapy or medication as first-line treatment for persons with mild to moderate depression and a combination of the two for individuals with more severe or chronic depression.
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