Depression

Depression is the second most common mental health concern, right behind anxiety, with around 10% of us struggling at any given point in time and around 30% of us at some point in our lives.  Depression and anxiety share many common negative experiences, like insomnia, agitation, edginess or irritability and rumination. Indeed, they occur together around one-third of the time. What makes depression distinctive is the way one feels emotionally stuck for weeks at a time.  Being stuck in sadness is the common description of depression, but many people feel a dull achy numbness most of the time. Depression often comes with a high level of self-criticism and, like depression, plenty of avoidance – especially avoiding other people. Unlike the fear of feeling anxious in anxiety disorders, the avoidance of depression is more often to avoid feeling more hurt or embarrassed, especially if someone tries to pry into your mental state, at which point it can be hard to cover up our feelings of sadness or sense of emptiness.  

As with anxiety, depression can be treated effectively with psychotherapy, and there are an even greater variety of ways to tackle the problem.  Also like anxiety, stigma can be a major barrier. It is hard to admit that our moods have gotten stuck out of gear and that we can’t get back to feeling human again without the help of a professional.  The thing is, it’s very important to do just that – to get help for depression as early as possible. Depression involves what are called “kindling” effects, which means that it can get worse with each subsequent episode.  For severe depression, I almost always try to help my clients to link with a psychiatrist for a medication evaluation. But this is always one’s own personal decision to make of course. For mild to moderate depression, psychotherapy works on average about as well as medication – with about a 65% remission rate in 12-20 visits on average.  Medications typically work more quickly, but psychotherapy does a better job of preventing relapse on average. Some people who are open to medications and also to talk therapy opt to use a combined approach, so that they can make the best of a quicker recovery due to medication combined with the long-term resilience building of psychotherapy.