Ask some one to explain what a mood is, and you most often get some form of weather metaphor, versus a psychological definition. People use terms like “feeling grey today” to describe a flat or low mood, or “stormy” to imply being agitated or frustrated. Like the weather, our moods may change unpredictably or lack stability. Moreover, weather can impact our mood, and it is not unusual for people to use the sound of rain to help relax them. This is further encapsulated by seasonal affective disorder (SAD), where people may experience depressive symptoms for one part of the year, each year, more particular in winter periods.
One of the most common mood disorders is depression and impacts all ages. For some people depression feels like having the weight of the world on their shoulders akin to the mythological character Atlas that bore the weight of the world on his shoulders as punishment from Zeus. While the weight of the world is metaphoric for having stress on one’s mind, this mental state would bring around reduced physical activity, feelings of despair, helplessness and thoughts and feelings associated with negativity. For other people, it may be a persistent feeling of the “blues” or “feeling grey” which may impact personal relationships, work, school, and homelife.
Approximately 1 in 20 people suffer from clinical depression (WHO, 2012). Depression may include the following symptoms:
Clinical depression is a complex mental illness, with numerous causes, including a combination of: (1) genetic, (2) environmental, and (3) psychological factors. People from all ages, cultures, and backgrounds, may suffer with depression, but the likelihood often increases with puberty or exposure to life stress (e.g., academic or friendship stress).
Previous research suggests loss of something perceived as valuable (e.g., marriage, employment, or death) may result in distress, grief and lead to a depressive state. However, while the Diagnostic Statistical Manual for Mental Illness (DSM – V – TR) allows for clinical judgement for bereavement to be considered a depressive disorder, there are some differences. For example, while grief is intense and distressful, there is a tendency for these negative feelings to decrease over time, where emotions in a depressive episode may be more persistent and stable over a specific time course.
During the 1970’s Martin Seligman and colleagues termed the phrase “learned helplessness” to help explain how prior inescapable trauma (e.g., electric shocks) in animal models can lead to a set of unhelpful cognitions that may be associated with depressive episodes (e.g., reduce motivation or hope). While experiments using animal models can differ from what may happen in humans, research shows similarities for humans. Interestingly, 50 years plus, recent research suggests that “learned helplessness” is not actually learned through experience, but a default set of cognitions and behaviors which are the brains natural default.
Moreover, the way learned helplessness is overcome is through more evolved parts of the brain (prefrontal cortex) which inhibit the brains natural tendency to become inactive in the face of stress. What this may suggest, and depending on the severity of the depressive symptoms, that a combination of therapy and medications may assist people reduce their depressive symptoms. For example, some clients may require more familial and social support to get back to doing the things that use to bring them pleasure to weaken the brains natural tendency to become more passive (e.g., more sleep) during a depressive episode.
A reduction in positive emotions (e.g., feeling happy) along with persistent anhedonia, low energy, and feelings of hopelessness, seem to be cardinal symptoms of a depressive episode. To help treat and reduce symptoms, therapy is aimed at getting individuals more active through behavioral scheduling and modifying dysfunctional beliefs (e.g., “I am a failure”) that maintain depressive symptoms. Depressive symptoms and the way a clinical diagnosis is confirmed varies from person to person, meaning that treatments need to be tailored to the individual.
Importantly in recent research, up to 75% people diagnosed with depression meet the diagnostic criteria for an anxiety disorder. If you feel that you have some of these symptoms, they have persisted for some time (e.g., two weeks or more) and you feel distressed or not yourself, seeking professional advice may assist in managing and reducing these symptoms, as there are effective treatments available to assist people living with depression.
Depression can be managed with various therapeutic approaches, where the first line of evidence-based treatment is either: (1) antidepressant drugs, (2) Cognitive Behavior Therapy (CBT) and (3) more commonly a combination of both CBT and antidepressants.
