What is depression? What can I do about it?

Most people will experience feelings of sadness or low mood at times which is a normal response to experiencing some form of loss in life (Fennell, 1989). However, for some people low mood experienced alongside other related symptoms can constitute having depression. Depression is common among individuals in the UK and bouts of depression can last for weeks or months at a time. Depression can also contribute to difficulties functioning at work and managing relationships.

Depression is a complex condition and symptoms often differ between sufferers. Depression symptoms often impact on moods, thinking, behaviour and physiologically. Common symptoms can be drawn from the following categories (Greenberger & Padesky, 1995; Fennell, 1989).

Thinking / cognitive symptoms: self-criticism, hopelessness, brooding / rumination, suicidal thoughts, difficulty concentrating, general negativity.

Behavioural symptoms: reduced activity (e.g. not engaging in activities previously considered pleasurable), withdrawing from others and isolating.

Physical symptoms: change of sleeping pattern, change of eating habits, tearfulness.

Mood / emotional symptoms: sadness, guilt, shame, regret, anxiety, irritability, anger.

What can I do to combat depression?

Thankfully a person does not have to simply accept they have depression and then passively ‘ride it out’. There are many pro-active things you can try that might help (Fennell, 1989; Beck, 1995).

Behavioural techniques:

(1) Activity scheduling

It usually helps to increase activity levels. This means making specific efforts to schedule activities which you believe will bring you pleasure. When depressed motivation levels can be low. That is why scheduling a specific time for an activity will make it more likely you will do it!

Also, if possible try to select some activities that you can do with other people. This will help counter the tendency when depressed to isolate. Knowing someone else is involved might provide that extra bit of motivation.

(2) Graded tasks

Often when depressed it is more difficult to follow through with elaborate tasks. Hence, it helps to break tasks down to more manageable steps. This will increase the likelihood you will be successful in completing tasks and not fall into the trap of berating oneself for perceived ‘failures’. Managing tasks can help promote feelings of ‘mastery’ which will likely aid your journey out of depression.

Distraction techniques:

Depressed individuals often brood or ruminate about past events which functions to maintain negative moods over time. Hence, distraction techniques can be used to help break the ‘rumination cycle’.

(1) Focus on an object

Pick an object and focus your attention on it. Try to describe the object in as much detail as possible. E.g. if the object is a painting, then try to describe who is in the painting, or what it is about, what the textures or colours are, the surrounding frame etc.

(2) Sensory awareness

By focusing your present moment awareness on your immediate surrounding try to attend to what your various senses can detect. E.g. noises inside and outside the room, smells in the room, what is available to touch, what can you taste, what can you see?

(3) Absorbing activities

Try engaging in activities that are all-consuming. E.g. sporting activities such as swimming can be good, as well as activities such as computer, mobile phone or board games.

Cognitive behavioural techniques:

(1) Identifying negative thoughts

It can help to get in the practice of identifying the negative thoughts that emerge alongside negative moods. E.g. “I’m no good at this task” or “I’ll never feel better”. Identifying negative thoughts associated with mood changes can be tricky as first. However, with practice it will likely get easier.

(2) Challenging negative thoughts

Recurrent negative thinking is believed to be a major factor in maintaining negative moods. Once you can identify specific negative thoughts you are in the position to challenge them. Developing the ability to challenge and alter thinking will likely influence mood changes for the better! We can challenge negative thinking by:

(a) Examining the evidence

Asking what evidence confirms the thought is true. If evidence is lacking then this could mean the negative thought is an example of  ‘distorted’ thinking and doesn’t withstand scrutiny. Finding ‘disconfirmatory evidence’ will also likely weaken belief in the original negative thought.

(b) Exploring alternative ways of thinking

It can help to try and introduce alternative ways of thinking to help shift our moods. E.g. instead of saying, ‘I’m no good at this task’ a person could say, ‘I’m not very experienced at performing this task. So it makes sense that I’m not great at it presently’. Sometimes it helps to consider how a level-headed friend might view your negative thinking if they were in your shoes.

Note: The techniques listed in this article are integral to cognitive behavioural therapy (CBT) treatment of depression.

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