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Psychological DepressionThe Psychology Service

What is Depression?

We are used to talking about feeling “depressed” when we are fed up and feeling low in mood. However, a formal diagnosis of Depression suggests much more serious and enduring symptoms, often needing treatment. In such cases we talk of the sufferer being “clinically depressed”.

Depression can occur after very stressful events, particularly if these involve loss e.g. a bereavement. It can also occur when there is no actual trigger. A predisposition to Depression tends to run in some families. It is now thought that either spontaneously, or in response to a stress, there are chemical changes in the brain, which lead to Clinical Depression, which can then go on even after the stressful period is over.

What are the symptoms?

Depression can present in a number of ways but the following symptoms are important in making the diagnosis.

There is very low mood which can fluctuate throughout the day, commonly being a lot worse in the morning, but which is always there, even when there appears to be no reason for feeling like it. The sufferer will usually tend to blame themselves for things that are not their fault, and they experience loss of confidence and lowering of self-esteem. There is loss of interest and enjoyment in normal activities. In severe cases, suicide or acts of self-harm are a risk.

Sleep is affected, most commonly with a pattern of wakening in the very early hours and being unable to get back to sleep. Other disturbed sleep patterns can occur, however, such as excessive sleeping. There is usually loss of appetite, and often significant weight loss. Alternatively, there may be comfort eating.

In some cases, there is preoccupation with worries about ill health, sometimes with actual symptoms of physical illness such as headaches or stomach upsets. Other common preoccupations include irrational worries about money.

In mild to moderate cases the sufferer will still be in touch with reality, but in severe cases they can develop psychotic symptoms such as delusions or hallucinations.

How long does it last?

The duration of a Depressive Episode can vary a great deal, but most will resolve within two years. Recovery is quicker with appropriate treatment. However Depression tends to be a recurring condition, with 50-60% of people suffering a first episode going on to suffer a further episode. After two episodes, the likelihood of more episodes in future increases to 70%.

What is the treatment?

Depression is usually treated using a combination of anti-depressants and CBT.

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