Counselling and Psychotherapy for Depression
What is Depression?
Negative emotions, such as sadness, disappointment and despair, are not unfamiliar feelings to most people. These feelings are unpleasant when we are experiencing them, but usually do not last long. When people face painful, but common life events such as grief and loss, it is normal and even natural for one to feel sad.
However, depression is more than just feeling sad. It is characterized by a pervasive low mood that lasts for a long time, which is not influenced by external events. Some people describe depression as a suffocating grey cloud that follows wherever one goes.
Depression can have a debilitating effect on those who experience it. Individuals lose interest in their lives and find it hard to engage in activities that they previously enjoy. This has negative consequences on work or school, family, and social relationships. In severe cases, individuals may also harbor suicidal thoughts, and may sometimes act on it.
According to the World Health Organization, 350 million people worldwide suffer from depression. In Singapore, depression is the most commonly diagnosed mental disorder, and affects 6.9% of the adult population in their lifetime.
Signs of Clinical Depression: Symptoms to Watch Out For
Individuals who have clinical depression experience depressed mood or a loss of interest or pleasure in everyday activities every day for more than two weeks.
In addition, they also experience at least 5 out of these 9 specific depression symptoms nearly every day:
- Depressed mood most of the day, nearly every day
- Decreased interest or pleasure in most activities, most of the day
- Difficulty in thinking, concentrating, and making decisions
- Fatigue, or loss of energy
- Feelings of worthlessness and excessive guilt
- Changes in sleeping patterns: Insomnia or hypersomnia
- Changes in activity levels
- Significant weight change, or changes in appetite
- Thoughts of death or suicide
Children and adolescents may exhibit irritability instead of a low mood.
What are the Treatment Options for Depression?
01 | Psychotherapy
Psychotherapy is an extremely effective form of treatment for individuals with mild to moderate depression. Common forms of psychotherapy for depression include Cognitive Behavioural Therapy (CBT), Interpersonal Therapy (IPT), and Psychodynamic Therapy.
Psychotherapy helps the individual to build skills and gain insight into their difficulties. The individual builds up internal resources to cope with and prevent a relapse in the future.
02 | Medication
Anti-depressants are commonly used for treatment of individuals with moderate to severe depression, or if it has persisted for a long time. Anti-depressants help to correct the functioning of the brain’s neurotransmitters, leading to a relief of the symptoms of depression.
Medications that are commonly used to treat depression include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants. Common recognizable brand names include Prozac and Zoloft, which are SSRIs.
03 | Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy (ECT) has also been shown to be an extremely effective form of treatment. ECT is often used when psychotherapy and medication has not shown an effect, or when depression is severe and potentially life-threatening. It involves the sending of an electrical pulse through the brain, and is administered under general anaesthesia.
A course of ECT typically involves 6 to 12 treatments, which is administered every other day.
04 | Psychosocial Interventions (Children and Adolescents)
In addition to psychotherapy and medication, psychosocial interventions are also important for treatment in children and adolescents. This refers to increasing support for the child within the family and in school, and working on increasing self-esteem, coping skills, and relationship skills.
For children and adolescents, psychotherapy and psychosocial interventions should be explored first before medication is used.
Tips for Depression Treatment
01 | Seek treatment early
Clinical depression is diagnosed when symptoms persist over two weeks. However, most people only seek help after months, or even years of struggling with depression.
Our metabolic system gradually slows down with the lack of activity, which occurs when individuals experience a loss of interest in previously enjoyed activities and withdrawal from social life. It then becomes even more difficult for an individual to take action after some time.
Seeking treatment early also helps to mitigate the impact that depression has on the different life domains, such as school, work, family, and social relationships.
02 | Do not rely on medication alone
Anti-depressants are useful in delivering time-efficient relief of symptoms by altering chemical imbalances in the brain. This is often useful for individuals with moderate to severe depression, as the relief of symptoms help them function better in their everyday lives. However, medication should not be perceived as a long-term treatment plan.
Medication works best when accompanied by psychotherapy, which involves making lifestyle changes to prevent depression from coming back.
03 | Treatment takes time
Finding the right treatment takes time. As one client aptly describes, the process of recovery is similar to the process of trying to lose weight. Seeking recovery in the shortest time possible is like going on a crash diet, and that often does not have a positive impact in the long run.
As different people experience depression in different ways, there is no ‘one size fits all’ treatment. Depending on individual needs, treatment may entail medication, psychotherapy, a combination of both, or participation in a support group.
04 | Treatment also takes commitment
Likewise, treatment also entails commitment. It takes effort and commitment to make the necessary lifestyle changes, such as engaging in regular exercise, making new friends, and learning to manage stress. Some of these changes may seem overwhelming at first, but working with a doctor or a therapist will help you make these changes more manageable.
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