Do I Have Depression?
What is it and how to Spot it.
What is depression?
We all experience ups and downs in how we feel and how motivated we are. However, for some, those experiences can fluctuate much higher, lower or last for much longer. When this happens for a period greater than two weeks and significantly affects a person’s ability to function it’s considered an Affective Disorder. Affective Disorders include Major Depression, Bipolar and Dysthymia. Major Depression is probably the closest to what people think of when people think of depression. Whereas, Bipolar includes periods of hyper or hypo mania (elevated mood and motivation) and Dysthymia is a less severe depression that lasts for much longer than a typical Depressive Episode1.
The Most Common Affective Disorder
Major Depressive Episodes are the most common Affective disorder in Australia and are the third highest overall mental health condition2. A Major Depressive Episode is a period of sustained sadness and/or lack of enjoyment in activities that previously provided pleasure, which lasts longer than two weeks1. It also commonly involves noticeable changes, such as:
- Weight loss or gain, unrelated to diet and exercise
- Reduced thinking and movement speed, observed by others
- Feeling fatigued or low in energy nearly every day
- Feeling worthless or excessively guilty when inappropriate
- Indecisiveness or difficulty concentrating
- Recurrent thoughts of death, recurrent suicidal ideation
How depression might show up or keep going.
Automatic Negative thoughts: ‘I suck, the world is terrible, and it will never change’
People with Major Depression tend to hold negative beliefs about themselves, the world and the future. For example, ‘I am an idiot, everyone is so mean to me and it will never change’. These negative thought patterns can reduce their motivation to engage in behaviours that protect against depression (e.g. exercise or healthy eating). The influence of negative thoughts and unhelpful behaviours have a reciprocal effect which leads to a deeper depression.
If a loved one is experiencing this state, it’s important not to reject or belittle their experience. Obviously, you will disagree that they ‘are an idiot’, however telling them that their belief is wrong may further their feeling of stupidity. Instead try asking what is going on for them and responding with an honest reflection of how hard it must be to be experiencing that.
Attribution: ‘Good things happened by chance, bad things happen because I suck’
An important part of being human is causal attribution. Causal attribution is what we perceive to be the cause of a particular event. In some instances, we can spend a lot of time examining the evidence which indicates the true cause of an incident. However, as this is quite time-consuming, we tend to make a lot of quick assumptions around the causes of most events. People with depressive tendencies tend to skew towards a pessimistic attributional style. This involves believing that positive outcomes are the result of random chance or external causes, whereas negative events are their fault (3). For example, if they get high grades in school or a promotion at work, they will tend to believe it was luck or a mistake, however if they get a low grade or are passed over for a promotion, they will likely believe they deserved it.
Many of the psychotherapy treatments for depression concentrate on understanding and challenging the underlying negative beliefs that can perpetuate depression. These include psychodynamic therapy, cognitive behaviour therapy, and schema therapy. However, they each operate in different ways.
One of the main symptoms of major depression is Anhedonia, the inability to experience pleasure. Specifically in the activities that previously brought pleasure. Oftentimes when someone is experiencing a depressive episode, they might hide the symptoms of sadness or low mood. Whereas anhedonia can be easier to spot in a person’s behaviour. For example, they might stop seeing their friends, exercising or engaging in a hobby. During a depressive episode a person’s negative thoughts and beliefs will make them feel like there is no longer a point engaging in that activity. If they believe they ‘suck’ and that it will never get better, then going for a walk or seeing a friend will feel pointless.
In these circumstances it might be appropriate to suggest alternative activities that could bring them some joy instead of forcing them to re-engage in the activities they previously enjoyed. Psychotherapy and various antidepressant medications can be very helpful in navigating bouts of anhedonia until they are able to re-engage in those activities or find equally beneficial alternatives.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
- National Study of Mental Health and Wellbeing, 2020-21 | Australian Bureau of Statistics. (2022, July 22). Www.abs.gov.au. https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release#prevalence-of-mental-disorders
- Can Attributional Style Impact Depression? (2022, May 13). Psych Central. https://psychcentral.com/depression/attributional-style-and-depression-how-your-explanations-influence-your-mood#definition
- Beyond Blue. (2021). Beyond Blue. Beyondblue.org.au; Beyond Blue. https://www.beyondblue.org.au/