Emily Spargo
July 7th 2020
Everybody has bad days. In fact, all of us have probably said we feel depressed, down, or sad at some point. But what if these feelings lasted weeks on end and were causing significant distress or impairment in your daily functioning? What if you couldn’t seem to kick these awful feelings on your own?
What is it?
Depression, or major depressive disorder, is a psychological disorder characterized by persistent feelings of sadness or a lack of interest/pleasure in regular activities. The disorder entails other symptoms as well, which can include substantial weight gain or loss, excessive sleeping or sleeplessness, lack of focus, difficulty with decision-making, and body aches/pains. In serious circumstances, recurrent thoughts of death or suicidal ideation may be present [1].
What causes it?
There is not one single, simple reason that someone experiences depression. It is common to hear people say that depression is caused by a chemical imbalance, however, the disorder is much more complicated than that. Although neurotransmitters are involved in depression, a combination of factors including genetics, hormones, stress or trauma, gender, substance use, and structural differences in brain anatomy may come together to produce symptoms of depression. [2, 3, 4, 5, 6].
One well-established model that can shed light on why some individuals develop depression is the diathesis-stress model [2]. Diatheses are stable, underlying traits (e.g., genetics, certain personality traits) that predispose an individual to experiencing depression when they simultaneously experience a rise in stress. The interaction between stress and diatheses can mean that someone who is born with a predisposition to depression may not experience a depressive episode until they go through a period of heightened stress. Strained relationships, the injury or death of a loved-one, or a lack of perceived social support are some examples by which an individual’s stress levels may rise, and in-turn this may increase the chance they will
experience depression [2].
How can it be treated?
When someone has depression, it does not necessarily mean they feel depressed all the time. The disorder can manifest in different ways and fluctuate over the lifespan [7]. The good news is that depression is a treatable mental health disorder, and although relapses are common, they can be managed through a variety of behavioural and pharmacological interventions [8, 9].
Behavioural activation (BA) is one example of a treatment within the larger, heavily researched intervention of cognitive behavioural therapy (CBT), in which a therapist works with someone experiencing depression to develop strategies to increase positive reinforcement in their life while decreasing avoidance behaviours [10]. The goal is to allow an individual to recognize the ways in which their environment may be contributing to their depression and help them to harness control over how they manage certain situations and emotions that arise [4, 10]. CBT as a whole, works to apply behavioural activation with a cognitive approach to restructure thought patterns and teach individuals to cope more effectively with their symptoms [4].
Tips for Supporting Someone with Depression
When a friend or loved one is suffering from depression, it can be difficult to know how to help them. Sometimes, despite our best intentions, certain things we say might actually do more harm than good.
Here are some examples of potentially unhelpful responses:
-
- Just snap out of it, don’t let depression win!
- Get some fresh air; you will feel better.
- Just think happy thoughts
- There are so many people in the world who are worse off than you.
These kinds of statements are typically unhelpful despite their positive intent. Although there are strategies that individuals can use to manage depression, this disorder is not something one can just decide to “get over”. Moreover, there are many factors involved in the experience of depression that are not under our immediate control, such as being inflicted with intruding thoughts and negative emotions. Unfortunately, those with depression typically cannot overcome the influence of these factors instantaneously [11].
Suggesting that depression has a quick fix is likely to miss the mark with whomever you are speaking to. Statements such as the ones above can invalidate the person’s experience and may insinuate blame where there is none to be placed.
When trying to communicate that you care, here are a few ideas on how to be helpful, without overwhelming someone who is suffering from depression:
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- I want you to know that I’m here for you if you ever want to talk about anything.
- Can I do anything that might be helpful for you? Please let me know if you change your mind.
- Feeling that way must be really difficult. I am here to listen if you ever need to talk.
- You are not alone. I am here for you and you do not have to go through this without support.
- It is not your fault that you are feeling this way. When you are ready, I would be happy to help
you find some professional help.
Lastly, never underestimate the power of listening. Sometimes all that is needed from you is your undivided attention. Remaining non-judgmental will help the person you are speaking with feel safe when being vulnerable in your presence. It takes a lot of courage to open-up about mental health. A good way to end any conversation is to thank them for being there and confiding in you.
Please see the Resources tab of our website if you or someone you know is in crisis or looking for treatment.
References
[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
[2] Colodro-Conde, L., Couvy-Duchesne, B., Zhu, G., Coventry, W. L., Byrne, E. M., Gordon, S., Wright, M. J., Montgomery, G. W., Madden, P. A. F., Major Depressive Disorder Working Group of the Psychiatric Genome Consortium, Ripke, S., Eaves, L. J., Heath, A. C., Wray, N. R., Medland, S. E., & Martin, N. G. (2018). A direct test of the diathesis–stress model for depression. Mol Psychiatry 23, 1590–1596. https://doi.org/10.1038/mp.2017.130
[3] Harvard Health Publishing. (2019). What causes depression? Retrieved from https://www.health.harvard.edu/mind-and-mood/what-causes-depression
[4] Schimelpfening, N. & Snyder, C. (2020). Causes and Risk Factors of Depression. Retrieved
from https://www.verywellmind.com/common-causes-of-depression-1066772
[5] The Canadian Mental Health Association, BC Division. (2012). What is depression? Retrieved from https://www.heretohelp.bc.ca/infosheet/what-is-depression
[6] The Centre for Addiction and Mental Health (n.d.). Depression. Retrieved from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/depression
[7] Kanter, J. W., Busch, A. M., Weeks, C. E., & Landes, S. J. (2008). The nature of clinical depression: Symptoms, syndromes, and behavior analysis. The Behavior Analyst, 31(1), 1-21. http://dx.doi.org/10.1007/BF03392158
[8] Canadian Mental Health Association, Ontario. (n.d.). Understanding and Finding Help for Depression. Retrieved from https://ontario.cmha.ca/documents/understanding-and-finding-help-for-depression/
[9] Shehzad, A., Rhodes, L., Moreea, O., McMillan, D., Gilbody, S., Leach, C., Lucock, M., Lutz, W., & Delgadillo, J. (2017). How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study. Behaviour research and therapy 94, 1-8. https://doi.org/10.1016/j.brat.2017.04.006
[10]Farchione, T. J., Boswell, J. F., & Wilner, J. G. (2017). Behavioral activation strategies for major depression in transdiagnostic cognitive-behavioral therapy: An evidence-based case study. Psychotherapy, 54(3), 225.
[11] Butcher, J. N., Hooley, J. M., & Mineka, S. (2014) Abnormal Psychology (16th ed). New Jersey USA, Pearson Education Inc.
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