There are many types of depression. As a generic term, depression refers to some degree of slowing down or shutting down of normal everyday function. It results from some type of system overload resulting in a depletion of internal resources, motivation, and energy. Most people have experienced or will experience some type of depression in their lifetime.
Depression is serious. It takes away your voice. Untreated depression also predisposes a person to be more vulnerable to various physical illnesses. Therefore, it is important to get effective therapy as soon as possible.
Reactive or situational depression refers to a slowing down or shutdown secondary to a significant loss such as the death of a loved one, a major illness, or the loss of a sustaining source of income or of self-esteem. The latter results from the loss of social status or reputation. In any event, for a loss to result in depression, the loss must signify to the individual a major failure in the person’s ability to continue to function.
Biological, biochemical, or endogenous depression refers to depression that onsets with apparently insignificant precipitating factors.
In any event, what is common to all types of depressions is self-degrading and distorted negative thoughts, hopelessness, loss of energy and motivation, fatigue, mental slowing, a shutdown of basic biological drives such as appetite and sex drive, and physical symptoms associated with stress.
Psychiatric research over the past three decades has shown that psychotherapy is the treatment of choice for most types of depression. For the types classified as endogenous that fit the criteria for recurrent major depressive episodes, therapy combined with the right type of antidepressant medication seems to have the most effectiveness.
The psychotherapy research reveals that most “good” therapists can help people recover from depression so long as they provide an atmosphere of unconditional positive regard, empathy, warmth, and compassion. However, these interpersonal factors alone are not sufficient. A good therapist must also teach the client effective coping skills.
Depression responds to good short-term therapy so long as the therapy provides a compassionate interpersonal relationship along with appropriate behavioral and cognitive coping skills training. But we must distinguish between being better vs feeling better. You can feed a hungry person a fish, but you are helping that person more if you teach him or her to fish.
Depression is a recurrent illness. With each recurrence, each episode increases vulnerability to further relapses. Therefore, it is important to get effective therapy for depression as soon as possible.
The biology of depression has been vastly overstated. Social determinants have been understated. Depression is contagious in a social sense. Mood spreads. A depressed parent is a huge risk factor for a child. A depressed person affects at least three other people.
In summary, clinical depression of all types has a biological component, a psychological component, and a social component. But, the more we learn about the biology of depression, the more we discover the power of human relationships to either increase or decrease one’s vulnerability to depression.
Remember no amount of medications can teach you more effective coping skills, more realistic thinking styles, healthier relationship styles, appropriate problem-solving skills, more effective decision-making strategies, how to build and maintain a support network, how to transcend an adverse personal history, and how to build a realistic and motivating future. You can get these things from good psychotherapy.
I specialize in treating clinical depression using counseling, psychotherapy, and hypnosis. I was trained in Cognitive Therapy for Anxiety and Depression at Dr. Aaron Beck’s Mood Disorders Clinic at the University of Pennsylvania. I also trained with the late Dr. Arnold Lazarus in the use of Multimodal Behavior Therapy for Anxiety and Depression. I trained with Dr. Michael Yapko on the use of clinical hypnosis for treating depression. I have treated thousands of depressed clients and patients over the past 34 years. I employ a client-centered mindfulness-based cognitive-behavioral approach that incorporates hypnotherapy when appropriate.
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