What Is Depression?
The term “depression” has many different meanings for people. It is very common to get a “touch of the blues” or feel a bit sad, down, or flat for a day or two. Clinically, the term ‘depression’ is more than this, and involves a combination of persistently low (or flat) mood, changes in biological symptoms, and changes in thinking. The low mood also has to be interfering with the person’s life.

The main symptoms of depression are:

• Feeling sad, low, or flat for much of the day. Clinicians generally assess whether low mood has persisted for at least 2 weeks, however this time frame may be shorter in some people and you may simply notice it as a difficulty ‘bouncing back’.
• Energy levels can begin to fall. You might feel lethargic and your limbs might feel heavy.
• Motivation can drop. You might find it hard to initiate things or persist with tasks.
• Sleep may become disturbed. You might sleep a lot more, or a lot less than usual, or wake up early in the morning (like 4 or 5am) and find it hard to get back to sleep.
• Changes in appetite and eating patterns can occur. You might lose your appetite, or eat a lot more than usual, and perhaps gain or lose weight.
• Social withdrawal can occur. You might find yourself withdrawing from social engagements with friends and family or from normal activities that you used to enjoy.
• Losing interest and enjoyment in your usual activities. Things that you once enjoyed or looked forward to might feel like a chore and you wish you didn’t have to do them.
• Poor concentration or memory. It can be hard to think clearly, make decisions or ‘keep your mind’ on tasks.
• Decreased libido and loss of interest in sex.
• Thought patterns become more negative. For example, you might feel hopeless about the future (like nothing will ever change) or helpless (like there is nothing you can do to change things). It is common for people with depression to feel more pessimistic than usual and dwell on negative things from the past or on morbid topics like death. It is also common to feel excessively guilty even when things aren’t your fault.
• Loss of confidence or self-worth. It is common to experience negative thoughts about yourself and your abilities.
• Suicidal thoughts and self harm. Thoughts about hurting oneself or taking your own life can range from a fleeting thought like “I just want to end it” or “Things would be easier if I wasn’t here” (without any intention to hurt yourself) to specific plans and serious intent to hurt yourself.

Importantly, the above symptoms can be unpleasant and begin to impact on your day-to-day activities and general enjoyment of life. If you are experiencing any of the above symptoms and/or feel that depression may be affecting your life it is important to talk to someone.

What Causes Depression?
Many people want to know why they have depression. There are several common causes:

1) Life Events
Depression can occur as a reaction to a specific event. For example, a relationship breakdown, death of a loved one, losing a job, financial stress, diagnosis of a medical illness or disability, failure, isolation and loneliness…just to name a few. Basically, any event that creates stress, and is difficult to cope with or change, can lead to depression.

 2) Biology
i) Genes
Research to date has not found a specific gene for depression. Instead it is currently thought that people inherit a general tendency toward emotionality. Accordingly, research studies have shown that people with depression are more likely than people without depression to have a relative who also suffers from depression or anxiety.

ii) Neurotransmitters
Neurottransmitters are chemicals that are produced in our brains. There are several neurotransmitters that are involved in regulating mood (serotonin is one of these). If the amounts of these neurotransmitters fall too low, or if neurotransmitters become unbalanced, depression can occur.

iii) Hormones
Changes in our hormones can play a role in depression. For example, it is common for women to become depressed after giving birth or during menopause, because of changes in their hormone levels. Changes in men’s hormones can also result in depression.

It is often difficult to pin-point the exact cause of depression. Most often several of these risk factors combine to create depression.

How is Depression Treated?
The best way to treat depression will vary from person-to-person and often depends on the causes and severity of the depression. Two of the most effective and commonly used treatments are described below:

1) Cognitive Behaviour Therapy
Carefully controlled research studies have shown that Cognitive Behaviour Therapy (CBT) is the most effective from of psychotherapy to treat depression. CBT for depression focuses on the role of cognitions (i.e., thoughts, beliefs and interpretations) and behaviour in determining how people feel and their wellbeing. Typical CBT techniques for depression include:

• Psychoeducation about depression (information about the possible causes, factors that are maintaining the depression, and what treatment will involve)
• Increasing pleasant activities and physical activity
• Identifying and changing unhelpful negative thinking patterns that are causing the depression
• Identifying and changing unhelpful behaviours (e.g., social withdrawal, self- destructive behaviours, avoidance).
• Increasing everyday coping skills (e.g., problem-solving skills, strategies to regulate mood, etc)
• Planning for the future and preventing relapse

2) Antidepressant Medication
There are many different types of antidepressants but they all work by restoring the correct levels of neurotransmitters in the brain that regulate mood. They can be particularly helpful when the depression is severe, has lasted a long time, or keeps re-occurring. Your GP, psychiatrist, and psychologist can advise whether they think medication would be helpful for you. Many people believe that they need to choose to “do therapy or take medication”. However, antidepressants are often used in conjunction with therapy to help facilitate your recovery.

If you would like to find out more about our treatment for Depression in adults or children, or to book an appointment with one of our psychologists, please email or call the clinic on 0405 430 530.

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