We all feel sad from time to time. It is normal to feel down or unhappy in reaction to situations that cause us deep disappointment and emotional pain. This could be the breakup of a relationship, losing a friend, the death of a loved one, losing a job, selling your home, retiring, relocating to a new location (such as moving to South Florida after spending most of your life up North), having no friends, being socially isolated, COVID, being ill, etc.
Sadness by itself is not depression. However, sadness can turn into depression when it is prolonged and begins to permeate your life and interfere with daily living. If you find yourself dwelling on a major disappointment or loss and you are unable to stop thinking about it, this can begin to eat away at your healthy sense of self. When the emotional pain persists and you are unable to alleviate it, you may begin to doubt yourself. If such self-doubt and disappointment begin to make you think you are worthless, you have sunk into a state of depression.
Depression means you are emotionally, spiritually, and physically exhausted. You have lost your motivation to continue in this thing called “life”. You have lost your steam and you do not feel you can regain it. It is at this point that you should seek help from a qualified mental health therapist (i.e., licensed psychotherapist) who has the training and experience to treat depression. This could be a licensed psychologist, a licensed clinical social worker or a licensed mental health counselor.
There are many types of depression. As a generic term, depression refers to some degree of slowing down or shutting down of normal everyday function. It results from some type of system overload resulting in a depletion of internal resources, motivation, and energy. Most people do experience some type of depression in their lifetime.
Depression is serious. It takes away your voice. Untreated depression also predisposes a person to be more vulnerable to various physical illnesses. Therefore, it is important to get effective therapy as soon as possible.
Reactive or situational depression refers to a slowing down or shutdown secondary to a significant loss such as the death of a loved one, a major illness, or the loss of a sustaining source of income or of self-esteem. The latter results from the loss of social status or reputation. In any event, for a loss to result in depression, the loss must signify to the individual a major failure in the person’s ability to continue to function.
Biological, biochemical, or endogenous depression refers to depression that onsets with apparently insignificant precipitating factors. It seems to just arise for no apparent reason. However, there are always reasons – often a multitude of reasons that interactively trigger changes in your biochemistry.
In any event, what is common to all types of depressions is self-degrading and distorted negative thoughts, hopelessness, loss of energy and motivation, fatigue, mental slowing, a shutdown of basic biological drives such as appetite and sex drive, and physical symptoms associated with stress.
Psychiatric research over the past four decades has shown that psychotherapy with a qualified psychotherapist is the treatment of choice for most types of depression. For the types of depression classified as endogenous or biological that fit the criteria for recurrent major depressive episodes, therapy combined with the right type of antidepressant medication seems to have the most effectiveness. A good psychiatrist is the doctor of choice for evaluating the type of depression you have, and for evaluating whether antidepressant medication is indicated in your case.
While a “good psychiatrist” thoroughly understands the biochemistry of depression and the role of antidepressant and ancillary medications, this alone is not enough. A good psychiatrist must also have a good “bedside manner”; that is, good interpersonal skills. And medication by itself is not enough. You will need to talk with a qualified therapist who is compassionate, understanding, knowledgeable, and who has the therapeutic skills to help you get through the “dark tunnel” and come out on the other side into the sunshine.
The psychotherapy research reveals that most “good” therapists can help people recover from depression so long as they provide an atmosphere of unconditional positive regard, empathy, warmth, and compassion. However, these interpersonal factors alone are not sufficient. A good therapist must also teach you effective coping skills.
Depression responds to good short-term therapy so long as the therapy provides a compassionate interpersonal relationship along with appropriate behavioral and cognitive coping skills training. But we must distinguish between being better vs feeling better. You can feed a hungry person a fish, but you are helping that person more if you teach him or her to fish.
Depression is a recurrent illness. With each recurrence, each episode increases vulnerability to further relapses. Relapses that are untreated tend to get worse and worse. Therefore, it is important to get effective therapy for depression as soon as possible.
In summary, clinical depression of all types has a biological component, a psychological component, and a social component. But, the more we learn about the biology of depression, the more we discover the power of human relationships to either increase or decrease one’s vulnerability to depression.
Remember no medications can teach you more eﬀective coping skills, more realistic thinking styles, healthier relationship styles, appropriate problem-solving skills, more eﬀective decision-making strategies, how to build and maintain a support network, how to transcend an adverse personal history, and how to build a realistic and motivating future. You can get these things by working with a good therapist.
Are you ready to begin working with a good therapist? At Delray Beach Psychiatry, we have caring and compassionate depression therapists. We have a licensed psychologist, licensed clinical social workers and licensed mental health counselors on staff who have the training and experience to help you recover from your depression. Contact us today.