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ONSEN® BLOG / About health

What is depression and how is it treated?

25 listopada 2023
Depression, cyclothymia, melancholy, anhedonia, dysthymia
Contents
Types of affective disorders
Depression at its core
Symptoms of depression and its diagnosis
Depression and biopsychosocial functioning
High-functioning individuals with depression
The role of psychotherapy in combating depression
The role of pharmacotherapy in treating depression
The healing process in depression
Depression is one of the mood disorders, which encompass not only depression but also cyclothymia or dysthymia. However, depression is often the most frequently diagnosed mood disorder in many countries. It may also be associated with anhedonia, an unpleasant loss of the ability to experience pleasure in everyday life.

 

 

It is a disorder that affects the thinking, emotions, feelings, and daily functioning of the affected person and often their environment as well. Common symptoms of depression include feelings of emptiness and hopelessness, and in severe cases, it can lead to suicidal thoughts, which may require hospitalization. Depression has biological, psychological, and social roots, making it necessary to approach treatment holistically.
Mood disorders, low spirits, autumn blues

Types of affective disorders

Mood disorders, or affective disorders, encompass a broad range of emotional difficulties that strongly impact the ability to experience and express emotions, as well as the biopsychosocial functioning of an individual. As noted by psychologist, Mr. Mateusz Nesterok, depression, cyclothymia, and dysthymia are the most commonly diagnosed. Alongside them, bipolar affective disorder (ChAD) is becoming increasingly prevalent among patients.

Depression is one of the most frequently diagnosed mood disorders. It manifests primarily as an unpleasant feeling of overwhelm and sadness, as well as a decreased interest in life. Individuals diagnosed with depression may also experience other symptoms such as fatigue, insomnia, or loss of appetite, as well as pessimism.

More subtle is cyclothymia, as it does not have a continuous character. It may resemble bipolar affective disorder, abbreviated as ChAD, but it does not involve episodes of mania or hypomania, allowing for differentiation. Individuals with cyclothymia experience periodic mood swings, most often in the fall and winter. However, these are not as extreme as in depression or dysthymia, and individuals with cyclothymia may also.

On the other hand, the aforementioned dysthymia is a type of chronic mood disorder characterized by chronically low mood. Individuals with dysthymia may persist in this state for a long time, as chronic feelings of sadness and apathy accompany them every day or almost every day, making it more difficult for them to function.
The most specific symptom of mood disorders is anhedonia.
Anhedonia is the loss of the ability to experience pleasure from activities that previously brought joy. Individuals experiencing anhedonia may feel emotionally detached. Often, anhedonia is associated with partial or complete loss of interest in what was previously significant to the individual.

The struggle with anhedonia involves the identification and treatment of the underlying mood disorder that triggers it, most commonly depression or BAD, but also other conditions. It's worth noting that anhedonia can be caused by somatic illnesses, including hormonal imbalances or cancer.

It is essential to remember that mood disorders can take various forms and affect an individual's life in diverse ways. Understanding the nature of affective disorders is crucial, as is undergoing treatment. It is advisable to follow the guidance of a specialist, whether it be a psychologist or psychiatrist. Humanity has effective therapeutic methods that can help regain health.
Depression, cyclothymia, melancholy, anhedonia, dysthymia

Depression at its core

Depression is a serious disorder that profoundly affects the way an individual thinks, feels, and functions every day. Understanding the basic aspects related to depression is crucial to effectively prevent or treat it. It's essential to recognize that depression is not just momentary sadness or feeling down; it is a chronic affective disorder lasting for at least two weeks continuously.

Individuals affected by depression experience a sense of emptiness and hopelessness that is not under their voluntary control; it is a medical condition. It's not just another bad day but requires treatment. It may last for an extended period, impacting all aspects of life. Therefore, collaboration with professionals such as a psychologist and psychiatrist and a willingness to engage in open conversations about feelings and emotions are crucial steps towards regaining emotional balance.

If you notice symptoms of depression in yourself or someone else, do not hesitate to seek professional help promptly to overcome it. The diagnosis of depression is primarily based on the observation of its symptoms. These may initially include insomnia, reduced appetite, or difficulty concentrating, among other nonspecific symptoms described by the ICD-11.

Depression has various origins, but they all revolve around biological, psychological, and social factors, necessitating a holistic approach. It's essential to remember that depression is a disease. Like other illnesses, it does not result from a lack of mythical willpower or character weakness. Treating depression is a process that always requires support and professional help, providing the right motivation.
Affective disorders, poor well-being, winter blues

Symptoms of depression and its diagnosis

According to the ICD-11, the latest and most up-to-date version of the International Classification of Diseases, typical symptoms of depression primarily include low mood or decreased interest in activities, which occurs for most of the day, every day, or almost every day for at least two weeks. Alongside these, accompanying symptoms are also listed, including:
  • feelings of hopelessness;
  • feelings of worthlessness or excessive guilt;
  • difficulty concentrating;
  • recurring thoughts of death or suicide;
  • changes in appetite or sleep;
  • psychomotor agitation or retardation;
  • decreased energy or fatigue.
Sometimes it is noted that depression in men may have a slightly different course. Symptoms may include even aggression, most commonly verbal. They are prone to outbursts of anger, and in addition, men with depression often exhibit somatic symptoms, such as palpitations or chest tightness. Other symptoms of depression in men include impotence, bloating, and constipation or diarrhea, occurring individually or together.

Depression is a mood disorder manifested in various symptoms that affect the daily biopsychosocial functioning of an individual. Diagnosing depression undoubtedly requires knowledge and understanding of these symptoms, as well as their professional assessment. Therefore, the diagnosis of depression should be made by a professional, such as a psychologist or psychiatrist.

A properly selected experienced psychologist and psychiatrist will conduct a thorough interview and analyze the patient's life history. This includes symptoms of depression as well as the intensity of their impact on the daily biopsychosocial functioning of the affected individual. Various questionnaire tools are also available to assess the severity of depression.

During the diagnosis of depression, it is important to exclude possible causes of symptoms, such as somatic illnesses or other mental disorders, which may require additional tests. For this purpose, blood tests or imaging may be necessary to rule out hormonal or organ-related conditions. Sometimes depressive symptoms can even lead to disturbances in heart rhythm.
Depression, low self-esteem, concentration problems, loss of appetite

Depression and biopsychosocial functioning

Depression is not just a psychological difficulty, but a comprehensive disorder that affects all aspects of biopsychosocial functioning in the person experiencing it. Analyzing the impact of depression on the overall biopsychosocial functioning of the affected individual helps to understand its actions. It also allows for the implementation of holistic solutions to overcome it.

Each depressive episode directly affects the biological functioning of the human body. Changes in the brain's neurochemistry, especially in neurotransmitters, can lead to sleep disturbances and decreased appetite, but also significantly affect the level of energy and motivation. Additionally, individuals with depression may experience more health issues, such as pain or infections.

Depression strongly influences the psychological sphere of the individual. Feelings of hopelessness and sadness or loss of interest in life shape thinking heuristics that govern behaviors. It is also important to note that pessimistic thoughts, low self-esteem, and cognitive decline are also common among people with depression, and these are associated with sleep and appetite disturbances, creating a vicious cycle.

Affective disorders also affect the social sphere of the individual. People with depression often experience difficulties in maintaining family and social relationships. The picture of this disease includes isolation and avoidance of contacts, which, in turn, can exacerbate other symptoms of a psychological and somatic nature through mutual dependencies. Understanding and support from the patient's environment play a crucial role in the healing process.

Therefore, depression treatment, if it is to be lasting and effective, should include a holistic approach that takes into account literally all dimensions of human functioning in the biopsychosocial dimension, i.e., holistic. A professional, such as a psychologist and psychiatrist, can help identify and tailor treatment that will consider all aspects of the patient's life.
Stress eating, holistic approach, depression treatment

High-functioning individuals with depression

Although the socially perpetuated stereotype of a person with depression often depicts an individual as sad and withdrawn, failing to fulfill their responsibilities, there is also a group of people who, despite having depression, function very well. They are referred to as high-functioning individuals with depression, which perfectly captures their condition. These individuals are often perceived by those close to them as completely healthy, making it difficult to provide assistance.

Individuals who function highly during a depressive episode experience literally the same symptoms as other individuals with depression. It may be all or part of these symptoms. However, they have such self-control that they function normally. Hence, people in their environment do not perceive the suffering that the patient undoubtedly experiences. This condition can last for even years, further complicating the situation.

People with depression who function highly suffer internally and do not show it to the outside world. Although they demonstrate self-control and responsibility, this should be seen as their mask. Such individuals often struggle with getting out of bed in the morning, resulting from sleep disturbances. Evenings, on the other hand, can be more difficult when such individuals may feel profound sadness, sometimes without an apparent reason.

In general, a high-functioning individual with depression can be lively during the day, giving the impression of being cheerful, thereby misleading those around them. Once back home, they are unable to perform other activities, or they engage in less demanding ones. They improve their well-being with several days off, which do not yield long-term effects. It happens that desperation and irritation turn into self-aggression in such individuals.

Therefore, each of us should be vigilant. It is worth paying attention to our family and friends to be able to react appropriately and promptly. Particularly concerning is a situation in which someone from our circle starts talking about their difficulties seemingly neutrally or with a smile. Most often, this is an expression of inner sadness that the person is feeling. It should definitely not be taken as a joke, but as a silent cry for help. A smile does not indicate that the person with depression is coping well.

The role of psychotherapy in combating depression

Understanding the causes of depression is crucial for effectively eliminating them. In this, psychotherapy plays a significant role, serving as a tool to support both understanding and learning how to cope with stress, emotions, and mood in the future.

Properly conducted psychological therapy enables a person with depression to understand the deep-seated causes of this mood disorder. Through conversations with a therapist, the patient can identify and analyze difficult experiences and find possible traumas or thought patterns contributing to the development of depression.

The therapist helps individuals with depression identify unwanted thoughts and beliefs that sustain depression. In the course of well-conducted cognitive-behavioral therapy, the person learns to change thoughts and behaviors, creating healthier thinking patterns.

Psychotherapy also provides tools and strategies to help individuals with depression effectively deal with daily challenges they may encounter in life. The therapist supports the client in developing skills to cope with stress, conflicts, and unpleasant emotions. It is important to establish a therapeutic relationship together, which in itself can be a healing factor. This allows for the open expression of feelings, thoughts, and concerns, promoting self-understanding.
The therapeutic relationship itself can have a healing power.
In the case of depression, where the use of pharmacological agents is deemed necessary, psychotherapy is essential to effectively complement the entire treatment process of this disorder. The psychologist monitors progress in the treatment of depression on an ongoing basis and, in addition, helps understand the side effects of the medications taken, with the ability to adjust psychotherapy to the current needs of the individual.

Psychotherapy undoubtedly supports the process of accepting oneself and one's feelings. It effectively helps in dealing with internal criticism and, moreover, in shaping and developing a healthy sense of self-worth to have a positive self-image. This element is indeed crucial for overcoming depression.

Psychological therapy aids in cultivating mindfulness of warning signs indicating a possible recurrence of a depressive episode, as well as in building healthy strategies to prevent recurrences of depression. Clients also learn to recognize various stressful situations and develop coping mechanisms for dealing with them.
Depression therapy, psychologist, therapeutic relationship

The role of pharmacotherapy in treating depression

Depression is mainly associated with pharmacotherapy, which is the treatment of symptoms with medications. Although it is said that causes of depression can also be treated in this way, a large portion of specialists still disagree. However, in moderate and severe depression, pharmacotherapy is necessary to achieve the desired therapeutic effects. It is also worth considering for mild depression.

Pharmaceuticals used in the treatment of depression help stabilize mood by regulating the levels of neurotransmitters such as serotonin, norepinephrine, or dopamine. This can contribute to the improvement of well-being and relief of depression in individuals suffering from it. The three main groups of antidepressant drugs are monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

The first of these, monoamine oxidase inhibitors (MAOIs), inhibit monoamine oxidase, which is responsible for the breakdown of neurotransmitters such as serotonin, norepinephrine, and dopamine. Blocking the action of this enzyme increases the amount of available neurotransmitters in the synaptic space. This improves signal transmission between nerve cells. They include: phenelzine, tranylcypromine, or iproniazid.

More commonly used are selective serotonin reuptake inhibitors (SSRIs), which block the reuptake of serotonin, increasing its availability in the synapses between nerve cells. This contributes to the improvement of mood, sleep regulation, appetite, and emotion control in the person taking them. They are often used in the treatment of depression and anxiety disorders, among other conditions. They include: fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram, or escitalopram.

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are also used, which block the reuptake of both norepinephrine and serotonin, leading to an increase in the amount and availability of both of these neurotransmitters in the synapses. They therefore directly influence mood regulation, and additionally, they have a stimulating effect, which can be beneficial for patients experiencing fatigue and lack of energy. They include: venlafaxine, desvenlafaxine, duloxetine, or milnacipran.
Antidepressants are divided into three main groups: MAO, SSRI, and SNRI.
Properly chosen pharmacotherapy can contribute to effectively shortening the duration of a depressive episode in patients. Antidepressant medications require patience because they act gradually, and only their regular use can help alleviate depressive symptoms in a relatively short time.

Pharmacological treatment can significantly improve the social functioning of individuals affected by depression. Reduction of depressive symptoms can facilitate maintaining social relationships and participating in social activities, as well as lead to the resumption of daily responsibilities in individuals with depression. It can also be effective when a patient experiences a strong feeling of hopelessness. Antidepressant medications can help create space for the psychotherapeutic process.

Pharmacology also prevents recurrence of depression because regular use of medications in accordance with the doctor's recommendations helps maintain emotional stability after the end of a depressive episode. It is important to remember that pharmacotherapy is an effective tool in the treatment of depression. However, it is crucial to treat each case individually.
Antidepressant medications, MAO, SSRI, SNRI

The healing process in depression

The healing process for patients with depression is comprehensive and, therefore, requires a holistic approach, which includes psychotherapy and pharmacotherapy, but should also involve careful attention to sleep hygiene, even after treatment. The collaboration of these elements constituting the treatment of depression can yield the best results. A holistic approach to the treatment of depression is an effective and prevailing trend.

As indicated by Mr. Mateusz Nesterok, a health and rehabilitation psychologist and a member of the ONSEN® team, the proper combination of psychotherapy and pharmacotherapy yields the best treatment outcomes. In many cases, pharmacotherapy is essential to calm the symptoms of depression, providing the opportunity to introduce changes in thinking and behavior. These changes are introduced during psychotherapy, especially cognitive-behavioral therapy.

Psychotherapy, mainly in the cognitive-behavioral approach, plays a crucial role in the healing process for patients with depression. This type of psychological therapy helps individuals effectively and correctly identify inappropriate thought patterns, beliefs, and strategies that contribute to depression. The psychologist supports them in introducing positive changes, including promoting the development of healthy stress and emotion coping strategies, sometimes teaching clients key life skills used in everyday life.

Taking antidepressant medications, i.e., pharmacological treatment, may be necessary to effectively alleviate the symptoms of depression. Antidepressant medications, such as SSRIs or SNRIs, help regulate neurotransmitters, contributing to improved mood and well-being, as well as better functioning. Collaboration with a properly chosen psychiatrist allows for the adjustment of the type of medication and its dosage to the individual needs of each patient.
Treating depression requires a comprehensive approach.
The sleep hygiene plays a significant role because healthy sleep directly affects information processing and regeneration, both in the brain and the entire body. Therefore, regular deep sleep is crucial for mental and physical recovery. Sleep hygiene principles include not only maintaining regular sleep hours but also creating a peaceful environment in your comfortable bedroom. This also involves choosing a mattress that is functional and comfortable, as well as avoiding caffeine and screen use before bedtime.

It is essential to keep in mind that the healing process in depression is a highly individual matter. Therefore, it is important to tailor therapy to the specific needs of each patient. It is advisable for a psychologist and psychiatrist to collaborate throughout the entire treatment. This helps to address the patient's needs and develop an effective and long-term treatment plan considering various aspects.

We also encourage you to explore other articles on the best sleep and health blog, as well as the Encyclopedia of Healthy Sleep prepared by the ONSEN® team of specialists. For those who care about spine health, we recommend a set of spine exercises prepared by our physiotherapist.
Sleep hygiene, mattresses, insomnia treatment, night fears

FAQ: Depression

How to know if you have depression?

According to the latest International Classification of Diseases (ICD-11), symptoms of depression include a lowered mood or decreased interest in activities that persists for most of the day. It should occur daily or almost daily for at least two weeks. Additionally, symptoms such as a sense of hopelessness, lowered self-esteem, difficulty concentrating, suicidal thoughts, changes in appetite or sleep patterns, psychomotor agitation or retardation, and decreased energy or fatigue may also be present.

What are the three phases of depression?

Depression can be divided into three main stages. The first phase is mild depression characterized by a lowered mood for most of the time. In the second phase, it progresses to moderate depression, where the individual ceases to experience joy in daily life. The most advanced phase is severe depression, which leads to a significant deterioration in the patient's functioning in biological, psychological, and social aspects.

Does depression always have to be visible?

No, depression is not always visible at first glance. People with depression can hide their emotions and feelings behind various masks, making it difficult for others to perceive the symptoms. They may laugh and pretend that everything is fine, even though internally they are experiencing intense suffering and emotional tension.

Can you cure depression on your own?

No, depression is a serious disorder that requires professional help. Self-treatment can be dangerous and ineffective. It is important to consult with a psychologist and psychiatrist who will help determine an appropriate treatment plan. Just as we do not attempt to self-treat somatic diseases such as cancer or heart attacks, mental illnesses should not be ignored either.

How does depression differ from anxiety disorders?

Depression is an affective disorder, directly related to mood. Meanwhile, anxiety disorders, formerly known as neuroses, belong to a completely different group of mental disorders. Although both groups may occur together, for example, as depressive-anxiety disorders, they differ in symptoms and mechanisms of occurrence. Moreover, patients with depression are often critical of their symptoms, while those with anxiety disorders often do not accept them as part of themselves, employing various defense mechanisms to avoid thoughts of having the disorder.

Contents
Types of affective disorders
Depression at its core
Symptoms of depression and its diagnosis
Depression and biopsychosocial functioning
High-functioning individuals with depression
The role of psychotherapy in combating depression
The role of pharmacotherapy in treating depression
The healing process in depression
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