Depression can often be misunderstood. That’s not surprising considering how rarely people talk about it. But…that’s ironic because “depressive disorders”, as they’re formally called, are extremely common. Approximately 1 out of every 20 people worldwide experiences some sort of diagnosable depression. If you don’t personally have depression, you undoubtedly have had contact with someone who does. It could be a family member Or a friend A coworker Or your favorite actor? Everyone experiences sadness from time to time. But just because someone is sad, doesn’t mean that they have a disorder. So when does it tip the scales? When do we call something “depression”, exactly? Well, the Diagnostics and Statistics Manual, which is the tool that mental health professionals use to diagnose, defines Major Depressive Disorder as this. We’re usually referring to Major Depressive Disorder when we think about depression, but there are other diagnoses. In general, they all have features of sadness and emptiness, as well as physical and cognitive symptoms that affect the person’s capacity to function for at least a two week period. But what causes depression? Well, Alie talked all about the genetics of depression and what depression does to your brain and I strongly suggest you check out that video right here. I’ll link to it at the end if you want to check it out. Psychologists, unlike neuroscientists, place a lot of focus on cognitive and social factors that may play a role in depression. For example, how a person thinks can say a
lot. In particular, there are a couple of questions that can indicate whether someone is susceptible to depression. First, how do they view themselves or others? And second, do they cope with problems or avoid them? Let’s say you have negative expectations about your ability to cope with problems. Or maybe you think others are purposefully imposing problems on you. At any point in your life, if you have repeated failures trying to solve problem, you’re more likely to feel hopeless, helpless, or abandon your usual ways of solving problems. These factors are all predictive of depression. Or let’s say you run into an issue. What do you do? If you’re the kind of person who wants to fix it right away or you use your active coping skills like reaching out to others for help or using meditation to calm down, congratulations! You are less likely to become depressed than someone who uses passive coping skills, such as distraction or avoidance. Life stressors can also make you susceptible to depression. In fact, most people report a severe life event or difficulty in the 6 months leading up to the onset of their depression. Now, not everyone who faces difficult problems becomes depressed, but prolonged exposure to stressors can preempt a depressive episode. This is particularly true for people who do not have strong social supports like family, friends, or a community to help them. If you don’t have that external support, then you only have your internal coping skills to rely on. Now, if you’re feeling depressed just hearing about all this, don’t fret! There is hope. Depression can be treated! Like so many disorders, prevailing research says that the combination of medication and therapy is the most effective way to treat depression. Different studies have looked at medication and therapy independently of each other to see which one works better. And they found that they’re more or less equally effective at treating symptoms. Although therapy has longer-lasting effects after completing treatment compared to medication. Alie talked about medication for depression in the last video and I’m gonna suggest once again that you go check that out. Personally, I think that while medication does a good at treating the symptoms, therapy can do a good job at addressing the underlying cause of depression. What led them to feel that persistent and ongoing feeling of sadness and loneliness? The two most commonly used therapies for depression are Cognitive Behavioral Therapy and Interpersonal Psychotherapy. Cognitive Behavior Therapy, or CBT, takes a two-pronged approach to address how you think and how you act. On the cognitive side, it specifically addresses negativistic thinking. This is depression’s best friend. It’s essentially a takeover of your thoughts that is overly pessimistic and critical. A person who engages in negativistic thinking expects failure and disappointment at every turn and focuses on past failures as a way to confirm that belief. It is so common for these two things to go together, that a lot of people wonder, What comes first? Does depression cause negativistic thinking? Or does negativistic thinking cause depression? Well, research indicates that pessimistic
thinkers and optimistic thinkers are both at risk of depression after exposure to stressful
life events, so it seems like negativistic thinking is
probably the result of depression, not the other way around. CBT tries to challenge and modify these thoughts. And by changing the thoughts, it relieves the symptoms. And on the behavioral side, clients are encouraged to engage in pleasant activities to treat the numb and anhedonic symptoms they may feel. About 1 in 3 people find that CBT alone helps them with their depression. Interpersonal Psychotherapy, or IPT, on the other hand, is a therapy that was specifically developed for Major Depressive
Disorder. It theorizes that how we interact with others affects our mood. As such, by helping a depressed person improve their relationships and interactions in social situations, it relieves the distress they may feel. Depression can often be sustained or preempted by interpersonal problems. For example, social isolation, unresolved grief or loss, life transitions, and disputes with family, friends, or coworkers can all be part of that. Unlike CBT, IPT does not examine internal conflicts or personality traits. And the therapist doesn’t even really address depressive symptoms directly. Instead, they focuses on relationship patterns and improving them to improve the person’s overall satisfaction, incidentally relieving depressive symptoms. These aren’t the only two therapies that are effective, though they are currently the two most supported by evidence. There are other therapies that have shown some effectiveness in treating depression symptoms, including Social Skill Training, Behavioral Activation, and Psychodynamic Therapy. I’ll talk more about these theories in future videos. And finally, because my friend mentioned it the other day, there is some preliminary evidence that controlled sleep deprivation may reduce depression symptoms. Though we’re not exactly sure why yet. Thanks Brandon. None of these may be the right form of therapy for you. But there is a wide range of therapies that can help just about anyone. If you or someone you care about is struggling with depression, please don’t
wait. And reach out for help and seek treatment. I’ve placed resources in the description below for more information about depression and finding treatment. Remember, you are not alone and things can get better. Thanks for watching this episode of Micah
Psych on Neuro Transmissions. If you learned something new about depression, then hit the thumbs up button. And subscribe if you want to be the first to see our new videos as they come out. If you really want to help us out, then head on over to Patreon and throw a few dollars our way. It really goes a long way and we’re so grateful to all of our Patrons, particularly Carrie McKenzie, Ryan Shaver, and Raymond Chin. You guys rock. Until next time, I’m Micah. Think about it.