Sadness is a human emotion felt during experiences of loss. Psychologists define depression as an extreme form of sadness that includes specific symptoms. Being dumped by a boyfriend or a girlfriend at one time or another is a fairly universal experience. How does it feel? Sad. Most people feel fatigued, unmotivated, and sleepless when they get dumped. But all of these feelings eventually go away. Depression is something different.
When someone is depressed to the degree of needing professional attention, she experiences a majority of the following symptoms of major depressive disorder over a minimum of a two-week period (because anybody may experience these on occasion or for a day or two, or hours):
Depressed mood for most of the day and for most days
Anhedonia (marked disinterest or lack of pleasure in all or most activities)
Significant weight loss or weight gain, without trying, and decreased or increased appetite
Difficulty sleeping or excessive sleeping
Physical feelings of agitation or sluggishness
Fatigue or lack of energy
Feelings of worthlessness or excessive guilt
Difficulty concentrating and focusing
Repeated thoughts of death or suicide
Sometimes, depression can become so severe that the sufferer may think about committing suicide. Many dangerous myths about suicide are floating around. One is that people who talk about suicide don’t do it. This is false! In fact, talking about suicide is one of the most serious signals that someone may actually do it.
All talk about suicide or self-harm should be taken very seriously. If you’re worried about someone or having suicidal thoughts yourself, contact a mental health professional or call a local crisis or suicide hotline immediately.
Depression is one of the most common forms of mental disorder in the United States, occurring on average in about 15 percent of the population. Major depressive disorder can occur just one time in a person’s life or over and over again, lasting for months, years, or even a lifetime. Depression can occur at any point in a person’s life and doesn’t discriminate against age, race, or gender.
Depression’s causes
Depending on whom you ask, the search for the causes of depression can be divided into two camps:
Biological: Biological theories of depression place blame on the brain and the malfunctioning of some of the chemicals that comprise it.
Psychological: The psychological theories of depression focus mostly on the experience of loss.
The biogenic amine hypothesis is the most popular theoretical explanation of the biological underpinnings of depression. According to this hypothesis, depression is a function of the dysregulation (impaired ability) of two neurotransmitters in the brain, norepinephrine and serotonin.
Neurotransmitters are chemical substances in the brain that allow one neuron to communicate with another neuron. The brain contains many different neurotransmitters, each with varying functions, in specific regions. The parts of the brain seemingly most affected in depression are those involved with mood, cognition, sleep, sex, and appetite.
Psychological theories of depression come from several sources:
Object Relations Theory: Melanie Klein in the early 20th century proposed that depression was the result of an unsuccessful child developmental process that may result in a difficult time coping with feelings of guilt, shame, and self-worth.
Attachment theory: John Bowlby’s mid-20th-century theory, which argues that all of a person’s relationships with other people originate from the initial attachment bonds he forms with primary caregivers as an infant. A disruption in the attachment relationship may prevent a healthy bond from forming, thus making the child vulnerable to depression when faced with future losses and relationship difficulties.
Learned helplessness theory: Martin Seligman in the 1960s worked with people’s experience of and with failure or an inability to achieve what they desire at some point in their lives. Under normal circumstances, most people can keep on keeping on. But some people may become depressed in the face of disappointing experiences and come to see insurmountable odds in their path.
Cognitive theory: Aaron Beck’s 1960s theory has become extremely popular and is well supported by research. Beck proposed that depression is a type of thinking disorder that produces the emotional outcome of depressed moods and the other related symptoms.
Several cognitive “distortions” may be involved:
Automatic thoughts: Automatic thoughts are statements people make secretly to themselves that produce depressive experiences. For example, if you get in your car in the morning and it doesn’t start, you may consciously say, “Dang, just my luck.” But unconsciously, you may be having an automatic thought (that you’re not even aware of having), “Nothing ever goes right for me.”
Mistaken assumptions and self-other schemas: The assumptions and self-other schemas (beliefs about who you are in relationship to others) that you assume to be true — as well as your views of the world, yourself, and the future — greatly influence how you move in the world.
Cyclical thinking: If you believe that you can’t do anything, then you won’t be fired up when you approach a task; your motivation is affected by your belief about your abilities. Then, you probably make minimal effort because of your lack of motivation, and, in turn, “prove” to yourself that you really can’t do anything right. This twisted and self-confirmatory bias in thinking often leads to depression.
Treatment of depression
Several effective treatment approaches for depression exist. Antidepressant medication, including famous medications as Prozac and Paxil, works for some people. Psychotherapy, specifically cognitive-behavioral therapy and interpersonal psychotherapy, is also helpful for many people. Research also indicates that “activity” — staying physically active and generally busy — makes an effective antidote to depression. The common standard of practice is to utilize both medication and psychotherapy.