Depression
What is depression?
Depression is more than occasional sadness or feeling low. It’s a state of being that’s usually characterised by persistently low mood, negative thinking and feeling, lack of motivation, and negative physical changes, causing significant issues with functioning in social, work, and other important areas of life.
Mood problems can include:
- Depressed/low mood for most of the day, nearly every day
- Feeling sad, empty, hopeless, worthless, and guilty
- Frequent crying
- Irritability
- Increased sense of difficulty coping with challenges or disappointments
Motivational problems can include:
- Disinterest or lack of motivation to engage in regular activities
- Loss of interest in previously pleasurable activities, including socialising, engaging in hobbies, and sexual activities
Negative thinking and cognitive issues can include:
- Seeing yourself, others, and the world in an overly negative light
- Having a dismal outlook and general sense of gloom
- Frequent self-blame and subsequent guilt
- Low self-esteem and self-confidence
- Reduced cognitive ability, including difficulties with attention, memory, and decision-making
- Thoughts of death and sometimes suicide
Negative physical changes can include:
- Negative changes to sleep patterns
- Significant changes to appetite and weight
- Low energy and feelings of lethargy
- Low libido and interest in sexual activities
If you experience many of these problems for more than a couple of weeks, you may meet the diagnostic criteria for a depressive disorder. Even if you only experience some of these symptoms and/or they do not last for a long time, they may represent a problem for you if they cause you distress or they interfere with important areas of your functioning.
How common is depression?
It is estimated that around 20% of Australians, or as many as 1 in 5 people in Australia, will experience clinical levels of depression at some stage during their lives. This equates to over 5 million Australians!
What causes depression?
Depression is a very complex issue and generally does not tend to have a single cause, whether biological, psychological, or environmental. Instead, these factors tend to interact with each other to contribute to depression, and the role of each factor can differ greatly between person to person.
Biological factors can include genetic risks, that is, whether you have inherited genes that increase your vulnerability to experiencing depressive episodes. These genetic risks can result in an over or under production of certain hormones and brain chemicals (neurotransmitters) that are linked to some symptoms of depression (e.g. mood, sleep, appetite). Many antidepressant medications have been designed to increase or decrease the level and activity of specific hormones and neurotransmitters in the brain. It should be noted however, that the ‘chemical imbalance’ theory of depression is a hotly disputed topic in the fields of psychiatry and psychology.
Psychological factors can include your developmental history, your core beliefs and attitudes, and the way you tend to think about things, otherwise known as your ‘thinking patterns‘. These can include focusing on thoughts and beliefs that are overly negative, inflexible, and lead to you behaving in ways that may not be helpful to your situation, resulting in further feelings and thoughts of negativity, creating a vicious cycle. It’s important to note that your core beliefs (and subsequently the way that you think) are strongly influenced by your environment, both current and historical. For example, if you are someone who has grown up experiencing many difficult childhood events, you may adopt more negative beliefs and thoughts about yourself, others, and the world. This way of thinking makes sense in that it can be seen as a product of your repeated negative experiences in life, and even served a functional purpose of some kind, however it may increase your vulnerability to experiencing episodes of depression.
Environmental factors can include negative past experiences and also difficult recent experiences. The inevitable painful events that we all experience in life include losses of things important to us such as loved ones, relationships, jobs, and our sense of identity. On occasion, we will also experience high levels of stress due to expected or unexpected life circumstances, as well as rejections, disappointments and failures. For some people, these events are even distressing to the point whereby they become traumatic experiences. These difficult, painful, and stressful life experiences can sometimes bring on or worsen depression.
Anxiety
What is anxiety?
Anxiety is a natural emotion you experience when facing a perceived threat or uncertainty, usually about the future. This causes physiological and psychological changes that are designed to help ‘prepare’ you to deal with the threat.
When we experience anxiety for short periods at manageable levels, it can actually be useful to us. Anxiety can help us to prepare for perceived threats and plan for the future, and can even motivate us to take action to achieve important goals. However, when the anxiety we experience is too intense, too frequent, or stays for too long, it can have an opposite effect, causing signification disruptions to important areas of our functioning.
Physiological impacts of anxiety can include:
- Increased heart rate
- Faster and more shallow breathing
- Increased blood flow and distribution to the muscles and large organs
- Muscle tension
- Increased sweating
- Widened pupils
- Reduced activity in the digestive system
Psychological impacts of anxiety can include:
- Racing and circular thoughts
- Difficulty concentrating
- Difficulty with learning and memory
- Overwhelming urges to escape or fight, depending on the situation
For some people, anxiety problems can be in related to a specific object or situation, such as that seen in phobias (e.g., an irrational fear of spiders, or of an inability to escape). For some others, it can be related to being scrutinised and judged when engaging in social situations (i.e., social anxiety).
For many other people, their anxiety problem may not be related to anything specific, but is instead persistently present during any life event or activity. This generalised anxiety, as it is known, is usually associated with frequent and excessive worry that is difficult to control.
How common is anxiety?
It is estimated that around 25% of Australians, or as many as 1 in 4 people in Australia, will experience an anxiety condition at some point in their life.
What causes anxiety?
The risk factors for anxiety are similar to those for depression, in that they involve an interaction between biological factors (e.g., genetics), psychological factors (e.g., early life experiences or trauma, thinking patterns), and environmental factors (e.g., stress levels, major life events, cultural factors).
Managing Depression & Anxiety
Are there any lifestyle changes I can make to address my depression and anxiety?
Some lifestyle changes have been shown to boost mood, help with nervous system regulation, and reduce symptoms of depression and anxiety. These include:
- Regular exercise
- A healthy diet
- Achieving adequate sleep
- Maintaining a consistent daily routine
- Engaging in activities that produce feelings of mastery and/or pleasure
- Staying connected with family and friends, or support groups
- Regular meditation and other mindfulness practice
- Using breathing and ‘grounding’ techniques when required for emotion regulation
What are some evidence-based treatments for depression and anxiety?
Evidence-based treatment of depression and anxiety can include psychological therapy, medications, or a combination of both.
Examples of effective therapies for depression and anxiety include cognitive therapies such as Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), both of which help people to manage depressive or anxious thoughts and engage in more helpful behaviours. Other therapies may target specific contributing factors, such as Interpersonal Therapy (IPT) – which is focused on improving relationships and addressing the social factors of depression – and Compassion Focused Therapy (CFT) – which is focused on addressing excessive self-criticism and low self-esteem common in depression and anxiety disorders.
Examples of common medications for depression and anxiety include Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine (Prozac) and sertraline (Zoloft), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like venlafaxine (Effexor) and duloxetine (Cymbalta). These antidepressants are often prescribed by GPs or Psychiatrists for depression, but also sometimes for anxiety too.
For anxiety specifically, it is common for people to be prescribed benzodiazepine sedatives such as diazepam (Valium). However, these are only intended for short-term use, and when taken long-term can cause issues such as dependence, tolerance, and short-term memory loss.
How can Fluid Psychology help with depression and anxiety?
We take a flexible, understanding, and de-pathologising approach to treating depression and anxiety. This means that we’re more interested in getting to know you and learning about the specific factors that have led to your depression and/or anxiety issue, rather than focusing too much on your symptoms, ‘syndromes’, and the diagnostic labels you may been given.
We will also try to help you identify the perpetuating factors that keep your depression and anxiety at a problematic level; sometimes this involves gaining insight into the specific functions depression and anxiety has served you in your life so far (as strange as it may sound!). This allows us to work together to find other, more helpful ways you can achieve the same function when helping you to become ‘unstuck’.
Our flexible and adaptive approach is ultimately grounded in evidence-based strategies and techniques derived from cognitive, behavioural, and experiential therapies such as CBT, ACT, CFT, IPT, and others.
Ready to have a chat about how we might be able to help?
Request a confidential, no-obligation phone call with Fluid Psychology by filling out our contact form or by sending an email to [email protected].