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.
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Until next time, I’m Micah.
Think about it.