Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021

Depression: Malignant Sadness

A suicidal depression is a kind of spiritual winter, frozen, sterile, unmoving. (A. Alvarez, The Savage God)

Despair is the price one pays for setting oneself an impossible aim. (Graham Greene, The Heart of the Matter)

Depression is evidence of growth, and health in the emotional development of the individual. (Donald Winnicott, The Family and Individual Development)

Depression is a very common, growing and serious mood disorder. It is characterized by persistent feelings of sadness, helplessness and hopelessness. Those with depression ’turn inwards’ and lose interest in activities they once enjoyed. They also show many physical symptoms associated with eating and sleeping. Many things can make us depressed but in order to be diagnosed with depression, symptoms must be present for at least two weeks.

The latest American Psychiatric Manual, the DSM-5, outlines the criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms (of the eight symptoms given below) during the same two-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

1 Depressed mood most of the day, nearly every day.

2 Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.

3 Significant weight loss when not dieting, or weight gain, or decrease or increase in appetite nearly every day.

4 A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).

5 Fatigue or loss of energy nearly every day.

6 Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

7 Diminished ability to think or concentrate, or indecisiveness, nearly every day.

8 Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

TYPES OF DEPRESSION

Major Depressive Episode and Major Depressive Disorder: This requires two or more major depressive episodes.

Dysthymic Disorder: This is manifest by depressed mood most of the day for more days than not, for at least two years.

Bipolar Episode and Bipolar Disorder: Bipolar disorder is characterized by more than one bipolar episode. It has manic episodes which are distinct periods of abnormally and persistently elevated, expansive or irritable mood, lasting at least one week. Signs include increased self-esteem or grandiosity, a decreased need for sleep, more talkative than usual or pressure to keep talking, distractibility and increase in goal-directed activity.

Substance-Induced Mood Disorder: This is a common depressive illness of clients in substance abuse treatment. This occurs during intoxication from the substance or on withdrawal from the substance.

Mood Disorder Due to a General Medical Condition: This can be a result of a medical condition, such as hypothyroidism or Parkinson’s disease.

Adjustment Disorder with Depressed Mood: This is a psychological reaction to overwhelming emotional or psychological stress, resulting in depression or other symptoms.

There are other candidates for inclusion such as seasonal affective disorder and postpartum depression.

TREATMENT

There are many treatments available. They include healthy diets and exercise as well as other self-help techniques. There are a range of drugs available, namely the major anti-depressants. Most people opt for a ’talking cure’ like CBT, Interpersonal therapy, Psychodynamic therapy and counselling.

The general public (as potential clients) is increasingly faced with a bewildering array of psychotherapy interventions available, although some are clearly similar in theory and practice. These include seeing a therapist, attending training courses or focus groups, observation and/or taking medication, or getting hypnosis. Deciding whether or not to seek help is associated with a range of factors including the availability of services, financial costs and individual socio-demographic and psychological variables.

Public perceptions of psychotherapists and the process of psychotherapy have been speculated to have important implications in terms of the number and type of individuals who choose to seek psychological treatment. In addition to these influences on potential clients and on their actual experience of treatment, popular perceptions of psychotherapy are likely to have significant implications for public policy and mental health reform.

The groups least likely to utilize mental health services are men, older people and people from ethnic minorities, who are all more likely to display avoidance behaviour, resistance to treatment and denial of mental illness. Aside from these influential factors, two major criteria that laypeople factor into their choice or recommendation of a therapy presumably are the perceived efficacy of the treatment and the associated side effects for specific psychological issues. For example, counselling is frequently considered most helpful and expectations of counselling involve talking to an experienced expert who can be trusted.

REFERENCES

American Psychiatric Association. (2015). Diagnostic and Statistical Manual of Mental Disorders (5th ed.) Washington, DC.

Furnham, A., Ritchie, W., & Lay, A. (2016). Beliefs about the causes and cures of depression. International Journal of Social Psychiatry, 62, 415—24.