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Let’s Deal with Depression

By Michael Mandrusiak, PsyD


What is depression?

Major Depressive Disorder and Dysthymic Disorder are the clinical names for conditions that most people simply refer to as depression.  Major Depression refers to depression experienced as intense times of low mood lasting from several weeks to several months.  In some cases, people can experience recurring episodes across their lives.  Dysthymia refers to lower level experiences of depression that are longer lasting in nature. 

According to one commonly used clinical reference, between 5-12% of men and 10-25% of women will experience depression at some point in their lives1.  On average in Canada, 10.8% of people are thought to experience depression at some point in their life, though a much smaller percentage (1-4%) would experience it at any given time2.  Depression remains one of the most common reasons for medical leave from work. The good news is that there are several proven treatment options for depression.  Unfortunately, only 30% of people experiencing depression receive the treatment they need. 

If you have depression, you may experience some of the following symptoms:
  • Lasting period of feeling down, sad or blue for two or more weeks.  Some people also feel more    irritable.
  • Less enjoyment or desire to engage in previous activities that you found fun
  •  Weight loss or gain
  • Difficulty falling or staying asleep OR sleeping more than usual and difficulty getting up
  • Loss of energy and feelings of fatigue
  • Thoughts and feelings of worthlessness, self-criticism and guilt
  • Recurring thoughts of death or suicide
  • Difficulty functioning in life tasks that were previously manageable

What causes depression?

Several causes are thought to often contribute together to the onset of depression:
  • Lower levels of or reduced sensitivity to certain chemicals in the brain can make a person more vulnerable to depression. 
  • Stressful life events such as losses or overwhelming role demands.
  • Early experiences that were experienced as traumatic and that led to feelings of shame, inadequacy
  • Persistent self-critical thought patterns which can occur as brooding and rumination

What treatments are there for depression?

There are many potential barriers to seeking help.  Some people do not realize that help is available.  Many people who experience depression feel hopeless about ever changing and may have a hard time believing that there is something that could work for them.  Others feel ashamed, thinking that the depression represents something that is wrong with them and have a hard time realizing that it is actually a medical condition.  Like bronchitis or pneumonia, depression is not something intrinsically wrong with you as a person but a medical condition for which help is available.  The following treatments have been found to be effective for treating depression:

Therapy:  No particular form of therapy has been conclusively shown to be most effective.  However, there are thought to be several helpful elements including:
  • Therapy using behavioural activation and goal setting to help a person to begin resuming life tasks in a manageable way
  • Therapy that targets and addresses unrealistic negative and excessively self-critical thinking
  • For chronic depression, mindfulness and acceptance based therapies have been shown to be effective when working with a person between acute episodes of depression.

Medication:  There are several medications that have been shown to effective for dealing with depression.  One of the more commonly prescribed class of medications are Serotonin Reuptake Inhibitors (SSRI’s) such as Prozac.  Talk with your family physician or a psychiatrist about the possible risks and benefits of taking an antidepressant medication.

Taking a quick lifestyle inventory: Targeting the following areas of your life can help you to start to feel better:
  • Sleep – regular, adequate sleep is important.  Napping or staying up until 3am may leave your mind exhausted.  Sleep hygiene tips (do a google!) can help if you are having trouble falling asleep.
  • Diet – regular, balanced meals are vital to a healthy mind.  Really, it makes a bigger difference than you might think.
  • Exercise – 30 minutes of cardio three times a week is a natural antidepressant
  • Social connection – when people feel depressed, they want to withdraw from relationships.  Take time to reach out to and be around other people.
  • Fun – take time to remember what is fun for you.  Even if you do not feel like it, get yourself to do some of things you used to enjoy.

Where do I find help?

You can view the profiles of the following therapists at BCG that treat depression by clicking on their names below.  You can also call 604-430-1303 to schedule an initial session at BCG.

In B.C., Canada, you can locate a therapist at the following links:

Check out the following helpful books:
  • Feeling Good by David Burns
  • The Mindful Way through Depression by Mark Williams, John Teasdale, Zindel Segal & Jon Kabat Zinn

References

1.    American Psychological Association.  (2002).  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision.  Author: Washington, D.C.
2.    Patten, SB, Wang, JL, Williams, JVA et al.  (2006).  Descriptive epidemiology of major depression in Canada.  Canadian Journal of Psychiatry, 51, 84-90.
3.    Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services.  National Healthcare Quality Report, 2008.  Retrieved January 12, 2010 from http://www.ahrq.gov/QUAL/nhqr08/nhqr08.pdf
4.    Roth, A. & Fonagy, P.  (2005).  What Works for Whom?  A Critical Review of Psychotherapy Research.  New York: Guilford.