Depression is one of the most common psychological disorders in our society. According to the World Health Organization, it affects more than 280 million people worldwide and is one of the leading causes of disability. Even so, there are still many myths and misunderstandings surrounding this condition, which makes it harder for many people to seek the help they need.
As a licensed health psychologist with years of clinical experience, I have accompanied many people through their recovery from depression. In this article I want to offer you a complete guide to understanding what depression is, recognizing its symptoms, and learning about the psychological treatments that have been shown to be most effective.
What is depression?
Clinical depression, also known as major depressive disorder, is much more than feeling sad for a few days. It is a mood disorder that profoundly affects the way a person thinks, feels and behaves on a daily basis. This condition alters brain functioning, particularly the neurotransmitter systems such as serotonin, norepinephrine and dopamine.
It is essential to understand that depression is not a personal weakness, nor something you can simply overcome with "willpower." It is a real disorder with neurobiological foundations that requires appropriate professional care. Recognizing this is the first step toward recovery.
Symptoms of depression: how to recognize it
Depression manifests through emotional, physical and cognitive symptoms that can vary from one person to another. To diagnose a major depressive episode, these symptoms must be present for at least two weeks and represent a change from previous functioning.
Emotional symptoms
Emotional symptoms are often the most visible: deep, persistent sadness that does not improve over time, a feeling of inner emptiness, loss of interest or pleasure in activities that used to be enjoyable (anhedonia), feelings of hopelessness about the future, irritability, excessive feelings of guilt or worthlessness, and in severe cases, recurrent thoughts of death or suicide.
Physical symptoms
Depression affects not only the mind, but also the body. The most common physical symptoms include: sleep disturbances (insomnia or hypersomnia), significant changes in appetite and weight, constant fatigue and loss of energy, psychomotor slowing or agitation, headaches, muscle pain or digestive issues with no apparent medical cause, and decreased libido.
Cognitive symptoms
Depression significantly affects cognitive functions: difficulty concentrating and making decisions, memory problems, repetitive negative thoughts about oneself and the future, a tendency toward rumination (going over the same thoughts again and again), and a distorted view of reality marked by pessimism.
Causes of depression
Depression is a multifactorial disorder, which means there is no single cause, but a combination of factors that contribute to its development. Understanding these causes is essential for designing an appropriate treatment.
Biological factors: Genetics plays an important role. People with first-degree relatives who have suffered from depression have a 2 to 3 times higher risk of developing it. At the neurobiological level, imbalances in neurotransmitters such as serotonin, norepinephrine and dopamine are directly involved in depression. Alterations in the hypothalamic-pituitary-adrenal axis, related to the stress response, have also been observed.
Psychological factors: Certain thinking patterns, such as a tendency toward perfectionism, excessive self-criticism or negative cognitive schemas, increase vulnerability to depression. Traumatic experiences, especially during childhood, are also a significant risk factor. In these cases, trauma treatment with EMDR can be essential to address the roots of depression.
Social factors: Social isolation, financial difficulties, the loss of a loved one, work or relationship problems, and a lack of social support are factors that can trigger or maintain a depressive episode. The social environment and life conditions have a direct impact on mental health.
Types of depression
Not all depressions are the same. There are different subtypes that are important to know about in order to better understand your own experience:
- Major depressive disorder: Episodes of intense depression with symptoms present almost every day for at least two weeks.
- Persistent depressive disorder (dysthymia): A chronic form of depression where symptoms are less intense but last for at least two years.
- Postpartum depression: Appears after the birth of a child and goes beyond the usual transient sadness (baby blues).
- Seasonal affective disorder: Depression that recurs at certain times of the year, usually in autumn and winter.
- Depression with atypical features: Characterized by hypersomnia, increased appetite, a feeling of heaviness in the limbs and sensitivity to interpersonal rejection.
Psychological treatment of depression
The good news is that depression is one of the psychological disorders with the best prognosis when appropriate treatment is received. Scientific research has demonstrated the effectiveness of various forms of psychological therapy.
Cognitive behavioral therapy (CBT)
CBT is the psychological treatment with the strongest scientific evidence for depression. It works on the relationship between thoughts, emotions and behaviors. During therapy, the negative thinking patterns (cognitive distortions) that maintain depression are identified and modified, and behavioral changes are promoted, such as behavioral activation, which involves gradually reintroducing pleasant and meaningful activities into daily life.
EMDR for trauma-based depression
When depression has its roots in traumatic or adverse experiences, EMDR therapy (Eye Movement Desensitization and Reprocessing) is a highly effective therapeutic option. EMDR makes it possible to process the traumatic memories that fuel depression, facilitating the emotional resolution of those experiences and significantly reducing the depressive symptoms associated with trauma.
At my practice in Igualada and also through online therapy, I combine different therapeutic approaches, adapting to the specific needs of each person. The goal is not only to relieve symptoms, but also to work on vulnerability factors in order to prevent future relapses.
When to seek professional help?
If you identify with the symptoms we have described and they have persisted for more than two weeks, it is important that you seek professional help. You don't need to wait until you reach your limit to ask for support. In fact, the sooner treatment begins, the better the prognosis tends to be.
Seek help especially if:
- Sadness or loss of interest is affecting your daily life, your work or your relationships.
- You have difficulty sleeping or eating normally for a prolonged period.
- You have lost the desire to do things you used to enjoy.
- You have thoughts of death or self-harm.
- You feel you cannot get out of this state on your own.
If you need guidance, do not hesitate to get in touch with me. Together we can find the path to recovery.