What It Is, How It Manifests, Symptoms, and Treatment
What is Depression?
Depression is a reaction to life events: a crisis often triggered by difficult phases of life or events that have marked it, such as losses, bereavement, illnesses...If these life difficulties lead to a psychological process that allows us to overcome the difficult moment and find new solutions, we are dealing with āreactiveā depression.However, when the depressive phase extends and intensifies, it can transform into a psychiatric disorder, sometimes quite severe.
Types of Depression and Mood Disorders
Depression falls under what are defined as mood disorders.There are many ways in which depression can manifest itself. To simplify, we can differentiate:ā¢ Minor Depressive Episode: a single, transient episode of mood deflectionā¢ Major Depressive Disorder: characterized by stability and greater pervasiveness of the symptoms, as well as impairment in social and work functioning.ā¢ Dysthymic Disorder: characterized by chronically depressed mood, but in a less severe form (a sort of permanent and accentuated low mood).ā¢ There are also depressive disorders that manifest at certain events (e.g., postpartum depression, which affects women in the months immediately after childbirth).When depressive episodes tend to recur, it is referred to as recurrent depression.There are also disorders with specific clinical characteristics, such as bipolar disorder, which is classified as a mood disorder like depression but characterized by severe alterations in emotions, thoughts, and behaviors, where major depressive episodes are followed or preceded by phases of excessive and disordered euphoria (manic phase). Those affected may be on top of the world at one moment and in despair at another, with no apparent reason, shifting from heaven in the manic or hypomanic phase to hell in the depressive phase, often quite frequently.
Symptoms of Depression
The milder forms of depression manifest with a lowering of mood, feelings of sadness, guilt, anxiety, insomnia, decreased self-esteem, excessive criticism, and increased emotional dependence. In the more severe and pathological forms, depression affects the person's psychophysical well-being: the past and present are lived with pain, sadness, and lack of meaning, while the future seems without prospects.Physically, one suffers from recurring headaches or bodily discomfort, leading to a decrease in immune response.The most severe forms of depression may lead to the desire or attempt to end oneās life with suicide.
The DSM (Diagnostic and Statistical Manual of Mental Disorders), developed with the challenging goal of classifying all mental disorders, is one of the most widely used diagnostic tools in the world.Letās now look at the criteria the DSM (specifically DSM-5-TR, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, revised in 2023) provides for the DIAGNOSIS OF MAJOR DEPRESSION.
Diagnosis of Major Depression (DSM-5-TR):For diagnosis, at least 5 of the following symptoms must have been present for a 2-week period and represent a change from the previous level of functioning; at least one of the symptoms must be either depressed mood or loss of interest or pleasure.
Depressed mood for most of the day, nearly every day, as reported by the individual (e.g., feeling sad, empty, hopeless) or observed by others (e.g., appearing tearful).
Marked decrease in interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss or gain (e.g., more than 5% of body weight in 1 month) or decrease or increase in appetite nearly every day. Note: In children, consider failure to achieve normal weight.
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or slowing down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional), nearly every day (not merely self-blame or guilt for being ill).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (as reported by the individual or observed by others).
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a specific suicide plan, or a suicide attempt.
Additional criteria:
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The episode is not attributable to the physiological effects of a substance or another medical condition.
Treatment of Depression
Depression, like other mood disorders, can be managed and overcome.Data indicates that various types of therapy can yield excellent results in this regard, including:
Pharmacological treatments
Psychotherapeutic treatments
Among the primary treatments for depression is Cognitive Behavioral Therapy (CBT).CBT for depression works at various levels. At the cognitive level, individuals learn tools to correct dysfunctional negative thoughts and begin to think more realistically.Regarding the depressed mood, techniques for self-control are learned to contain and manage unpleasant emotions. At the behavioral level, the focus is on activity planning, and learning more constructive ways of acting.
There are also techniques that can be very useful in cases of depression, including:Autogenic Training (AT): A relaxation-desensitization technique used to obtain measurable psychophysical responses, especially for treating anxiety, depression, and uncontrolled psychosomatic reactions.
Hypnosis can also provide many benefits in the treatment of depression. It is a natural therapeutic tool that can help in developing greater awareness and change.Its effectiveness in treating depression is supported by various studies and clinical trials. Hypnotherapy benefits from its ability to work on mood, behavior, and sensations. Hypnosis reduces depressive symptoms by addressing dysfunctional beliefs, despair, feelings of emptiness and helplessness, and especially by improving the ability to manage anxiety, stress, and the confusion between realistic and unrealistic expectations. Trance is also effective in controlling psychophysical symptoms associated with depression, such as sleep disturbances, fatigue, headaches, etc.
Conclusion
As weāve seen, depression can be a highly debilitating issue, negatively affecting the quality of life of those who suffer from it. It is important not to underestimate the symptoms we notice in ourselves or others. The first step is always to acknowledge and not deny the difficulties we face, so that we can address them personally and seek the help we may need.
Written by
Dr Elizabeth Moore, Psychologist
(consultation only in Italian)
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Bibliography
American Psychiatric Associatio,DSM-5-TR Manuale diagnostico e statistico dei disturbi mentali, Test Revision, Masson, Milano
Arieti S. Bemporad J. La depressione grave e lieve. L'orientamento psicoterapico, Ed Feltrinelli 1981
Beck A. Cognitive Therapy and Emotional Disorders, Internetional Universities Press, 1978
Canil M., Depressione sintomi e cura, 2016
Colombo G., Manuale di Psicopatologia generale, Cleup Ed. 2001
Freud S., Lutto e melanconia, Bollati e Boringhieri, 1917
Lisotti A., Sintomi cause e cura della depressione, 2015
External resources
"If you wish to explore the topic of psychological manipulation further and find relevant articles and studies, consider these important academic and institutional resources.
American Psychiatric Association (APA)Ā L'APA ĆØ una delle principali organizzazioni al mondo per la salute mentale. Offre numerose risorse e articoli sulla depressione, i suoi sintomi, e le modalitĆ di trattamento piĆ¹ efficaci. Collegamento: [AmericaAssociazione psichiatrica americana
Istituto Nazionale di Salute Mentale (NIMH)Ā Il NIMH ĆØ uno dei principali enti di ricerca mentale negli Stati Uniti. Fornisce articoli basati su studi scientifici riguardanti la depressione e il suo trattamento. Link: Istituto Nazionale di Salute Mentale