Signs and symptoms of depression include: feeling down, tired, lack of energy, lack of motivation to do the things you need or even like to do, and not getting a sense of enjoyment from doing things you usually enjoy doing. Sometimes depression can also include decreased or increased appetite, or eating compulsively when you are not hungry. Insomnia is frequently part of depression, but oversleeping, and not wanting to get out of bed are just as often part of it, too. Reduced concentration and memory, obsessive thinking ("rumination") or worry, and sometimes, thoughts of death and/or suicide are also common. You may also experience - or display - irritability (a "short fuse") and various, vague, physical symptoms.
Although in the medical model Depression is seen as a mental "illness" there is much evidence that it is more useful to see it as a symptom. Depression is to some degree, a fairly normal human experience that can result from a wide variety of situations and factors. These can range from feelings of stress combined with feelings of helplessness in the face of a current situation, to unresolved trauma from the past. Depression can be linked to patterns of thinking, of how we see ourselves in the world, patterns that are often linked to early life experience and learning; but it can also be linked to unhealthy or stressful situations in the present, including relationships, jobs or social/economic environmental factors.
When people come to see me for help with depression, I approach helping them on two core levels. We address current stressors and symptoms, to improve the situation as immediately as possible in present. We look at immediate changes they can make in both resolving problems and enhancing self-care. We look at habitual patterns of thinking and behaviour that contribute to depression, and they learn how to change these to patterns that are more helpful to feeling and functioning well. We will also often explore their experience of depression as a symptom, in order to find the cause. We explore the history and the context of this in family, work and social environments and we investigate underlying causes in order to be able to both really understand what the depression is, and to resolve, or heal, those underlying causes. Ideally, my goal is to help you to realize a long-term solution to the depression.
Medication: for mild to moderate depression, the evidence is not convincing that medication is more helpful than psychotherapy. Some people do experience significant benefit, while for some people, medications can add further stress as a result of their side effects. There is no evidence that medication is a long-term solution that will "cure" depression. Medication is more strongly indicated in cases of severe depression - if a person is so deeply depressed that it jeopardizes their ability to function, to hold a job, to care for themselves, to engage in a therapy process and in the activities that will help them, and/or if they are suicidal. In these cases, medication can sometimes be useful in "levelling out" the depression, in allowing the person to maintain a level of functioning that prevents further downward spiralling, and, hopefully, to engage in getting therapy to help them learn to "beat" the depression by learning long-term skills to manage thoughts, feelings and behaviors and/or to resolve the underlying cause of the depression.