Definition of depression and diagnosis of depression.
People often go through periods of feeling low, but when depressed, people persistently feel sad for weeks or months rather than a few days. Depression can cause symptoms that affect how people feel, think, and handle daily activities, such as sleeping, eating, or working.
Research suggests that genetic, biological, environmental, and psychological factors play a role in depression. Genetic predisposition, chemical imbalance in the brain, stressful life events, and trauma are all potential contributors to depression.
Depression is an illness that is non-biased and can affect anyone regardless of age, race, income, culture, education, and the environment. Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.
Additionally, depression can be linked to other medical conditions, such as chronic illness or substance abuse.
Depression is a common but serious mental health condition characterised by a persistent feeling of low mood, hopelessness, and lack of interest or pleasure in daily activities. Depression affects a person's thinking, feelings, and behaviour, leading to emotional and physical problems.
People with depression often experience difficulty in functioning at work and in social situations or within their family dynamics. Depressive symptoms can include the continuous feeling of sadness or emptiness, fatigue, change in appetite or weight loss and gain, difficulty sleeping or sleeping too much, feelings of guilt or worthlessness, and difficulty concentrating.
With severe cases of depression, individuals may experience suicidal thoughts or tendencies. There are different forms of depression, including major depressive disorder (MDD) and generalised anxiety disorder (GAD).
Cited by Moller and Di Malta (2020), The DSM-5 cluster for depression includes the following diagnostic categories (amongst others): Major depressive disorder (MDD) significantly affects a person's life and is sometimes referred to as clinical depression. Persistent depressive disorder refers to a chronic but lower form of depression. Disruptive mood dysregulation disorder relates to depression in children.
Forming a separate cluster would be bipolar disorder, which historically was referred to as manic depression and associated with upswings in mood as well as severe lows.
Generalised anxiety disorder (GAD) is the most generic and common anxiety diagnosis and includes phobias, social anxiety disorder, panic disorder, agoraphobia and obsessive-compulsive disorder.
Summarised by Moller and Di Malta (2020), the GAD listing previously included post-traumatic stress disorder (PTSD) in the DSM-5; however, now it is included alongside other disorders in a distinct category of trauma and stressor-related disorders.
The diagnostic criteria for major depressive disorder have five or more symptoms being present during the 2 weeks and represent a change from previous functioning as of at least one symptom of the following:
Daily depressive mood.
Daily lack of interest or pleasure in all or almost all activities.
Losing weight without dieting or gaining weight.
Insomnia or hypersomnia.
Psychomotor agitation or retardation nearly every day.
Fatigue or loss of energy almost every day.
The ongoing feeling of worthlessness or the constant feeling of guilt.
Daily diminished ability to think or concentrate or indecisiveness.
On-going recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide.
A. The generalised anxiety disorder, excessive anxiety and worry occurring more days than not for 6 months about several events or activities.
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three or more of the six symptoms being present for days than not for the past 6 months:
The restlessness of feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle tension.
Sleep disturbance.
Explanation of negative thinking patterns of depression.
The frequent association of depression is related to negative thinking patterns that significantly contribute to the development and maintenance of the disorder. Cited by Moller and Di Malta (2020), individuals who tend to think negatively are at greater risk of developing these conditions.
Negative thinking styles can develop from a negative cognitive framework or concept originating from a range of learnt experiences and the tendency to attribute failure to the individual instead of the circumstances.
Individuals with negative thinking patterns tend to engage in distorted thought processes that contribute to their emotional distress, forming what is known as the Cognitive Triad: negative views about oneself, the world, and the future.
Negative views of self: Depressed people often see themselves as worthless, inadequate, or unlovable.
Opposing views on the world: A depressed person perceives the world as hostile, unfair, or oppressive.
Opposing views on the future: A depressed person expects failure and disappointment, believing improvement will never come.
CBT intervention of negative thinking patterns with depression.
Cognitive behavioural therapy (CBT) helps individuals with depression by addressing negative thinking patterns. The core idea of CBT is that distorted or irrational thoughts contribute to emotional distress, and by changing these thought patterns, individuals can experience improved mood and behaviour.
Moller and Di Malta (2020) cite CBT as testing assumptions and integrating new information to improve a person's feelings. CBT intervention focuses on identifying and challenging negative thoughts through exercises. The primary tool used in CBT is identifying cognitive distortion patterns of thinking that reinforce negative emotions.
Psychologists using CBT help people reframe these negative thoughts by encouraging them to consider alternative outlooks. For example, if someone believes they will always fail, the psychologist would support them in exploring the evidence for and against this belief and developing a more realistic and flexible perspective, such as the idea that sometimes mistakes are made and other times success is achieved.
CBT incorporates behavioural strategies where individuals are encouraged to engage in activities that improve mood, such as exercising or socialising, or other avoided activities due to depression. This behavioural activation helps break the cycle of inactivity and isolation that often accompanies negative thinking.
Conclusion.
The constant feeling of sadness, hopelessness, and lack of interest in enjoyable activities describes depression disorder. Depression affects thoughts, emotions, behaviour, and overall well-being. Depression can make it difficult to function in daily life due to a variety of factors, including genetics, life stressors, and chemical imbalances, which can trigger the brain.
Negative patterns refer to recurring thoughts, beliefs, and behaviours contributing to emotional distress. They often reinforce feelings of hopelessness and helplessness. A typical example is negative self-talk and negative thinking, focusing on the worst outcome.
CBT supports depression by addressing and raising challenges and exercises to work with negative patterns such as distorted or irrational thoughts.
Akhtar, (SAC Dip), Lead Counselling Psychologist.
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