Understanding Depression | Pivotra Counseling Center

Around the world, depression is a common disorder, yet it is widely misunderstood and stigmatized. While everyone has episodes of sadness, depression is more than temporary emotional low points. It is a deep and complex condition that can affect how a person thinks, feels, and functions daily. The World Health Organization says an estimated 280 million people around the world suffer from depression. That makes it not only a common condition but also one of the leading causes of dysfunction and deep disability.

Major depressive disorder (MDD), also known as depression, is marked by:

a sustained period of sadness,
a disinterest in previously enjoyed activities,
a tiredness that doesn't seem to improve with rest,
an inability to focus,
and either an insatiable appetite or a lack of one (American Psychiatric Association, 2022).

To be diagnosed with MDD, a person must show these signs for at least two weeks, and they must not just be personal roadblocks; these signs must also greatly hinder them in the domains of life that are social, professional, or otherwise meaningful.

When a definite life occurrence—such as sorrow or trauma—does not seem to be the cause of depression, it may come upon a person without any clear or apparent reason. This type of depression seems to arise "out of the blue" or develop insidiously over time. It most definitely occurs within persons of certain biological, genetic, or family backgrounds that make them particularly vulnerable to not just depressive episodes but also to other types of mental disorders.

Neuroscience has made great strides in understanding the biology of depression. Recent advancements in knowledge have increased investigations into the very biological underpinnings of depression. We now know that it is not just a behavioral or psychological ailment, but one that also deeply affects the body—specifically the brain. Structure-function abnormalities in the brain, particularly in the amygdala, hippocampus, and prefrontal cortex (Disner et al., 2011), are consistently found in depressed individuals. Neurochemical imbalances in certain critical neurotransmitters like serotonin, dopamine, and norepinephrine also deeply affect our moods (Stahl, 2013).

Some people are more likely than others to develop depression because of certain risk factors. These include:

A mental illness such as depression in the family a proclivity for depression that is genetic in nature.
The trauma of childhood or emotional neglect
Persisting health problems (e.g., diabetes, heart disease)
Substance misuse
Social isolation or absence of assistance (NIMH, 2023)

Statistically, a greater number of women receive a diagnosis of depression. This is probably because men don't report the kind of symptoms that are diagnostic for depression. They don't report them because they aren't in touch with the kind of emotions that would lead them to say, "I'm feeling x, y, and z," as a vulnerable, emotionally expressive woman would say. (Kuehner, 2017)

Although depression is very treatable, the path it takes varies from person to person. The effective treatments for depression include:

Counseling: Cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic approaches are the most frequently employed counseling strategies. They exhibit a robust track record of effectiveness.
Medications: Patients with mood disorders are often prescribed selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) to help regulate their mood.
Interventions in Daily Living: Clinically significant reductions in symptoms of anxiety and depression have been observed in individuals who engage in consistent, vigorous exercise (Schuch et al., 2016). Maintain an exercise regimen with both cardiovascular and strength-training components for at least 30 minutes a day, 4 to 5 days a week.
Support systems: Interaction with friends, family, or peer support groups can yield a profound sense of community and mutual understanding. Hearing someone say, "I understand what you're going through, I've been there" can be a vital lifeline to continue on a tough day.

Prompt responses are critical. Untreated depression can lead to far-reaching consequences, such as self-harm and fatal outcomes. The National Institute of Mental Health (2023) underscores the importance of recognizing early warning symptoms—and taking those seriously enough to get help from mental health professionals.

It is vital to remove the stigma from mental illness if we are to get more people in treatment and on the road to recovery. A person with depression is not weak or morally lacking. They have a bona fide health problem. Our society thinks nothing of a person going to a doctor for a chronic condition like asthma or a life-threatening illness like cancer. Yet, we cannot seem to get over the idea that it is okay to go to a psychiatrist for depression or anxiety. We must educate the public.

If you or a person you know is having thoughts of self-harm or suicide, contact the Suicide & Crisis Lifeline at 988 (United States), or go to a nearby health facility and seek professional help. Do this without delay..

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). Arlington, VA: American Psychiatric Publishing.

Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., van Straten, A., & Ebert, D. D. (2013). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders, 149(3), 398–405. https://doi.org/10.1016/j.jad.2013.02.029

Disner, S. G., Beevers, C. G., Haigh, E. A., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12(8), 467–477. https://doi.org/10.1038/nrn3027

Kendler, K. S., Gardner, C. O., & Prescott, C. A. (2020). Toward a comprehensive developmental model for major depression in women. American Journal of Psychiatry, 167(2), 1–10. https://doi.org/10.1176/appi.ajp.2020.20020127

Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet Psychiatry, 4(2), 146–158. https://doi.org/10.1016/S2215-0366(16)30263-2

National Institute of Mental Health. (2023). Depression. https://www.nimh.nih.gov/health/topics/depression

Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P. B., Silva, E. S., … & Stubbs, B. (2016). Physical activity and incident depression: A meta-analysis of prospective cohort studies. American Journal of Psychiatry, 175(7), 631–648. https://doi.org/10.1176/appi.ajp.2018.17111194

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.

World Health Organization. (2023). Depression. https://www.who.int/news-room/fact-sheets/detail/depression.

< Older Post