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Dr. Beverley Marais DPsych CPsychol CSci AFBPsS UKCP reg. HCPC reg. FDAP
DEPRESSION
‘Feeling depressed’ is often something people say, however clinical depression is not just a low mood. It can be an intense and long lasting problem that makes nearly every aspect of life difficult. Often referred to as the common cold of mental illness, it is the most common disorder in Britain, along with anxiety (according to the Mental Health Foundation). It affects up to 3.5 million people in the United Kingdom.
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Individuals with depression will find themselves often feeling sadness, disappointment, lonely, self doubting and hopeless. These issues can affect work and family life, their relationships and their behaviours. When people feel low in mood, they tend to think negatively about themselves and also evaluate and interpret situations around them in a negative way. This, in turn, would affect how they behave in certain situations as well as how they manage their relationships. It is easy, therefore, to see why depression can lead to a viscous cycle leaving people hopeless and despairing. There may be a number of causes as to why people may experience depression. It can be triggered by drug dependency, hormone or neurotransmitter deficiency, a life event, low self esteem or other areas of an individual’s life. Evidence also suggests that those with a family history of depression may be more prone to this illness.
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Symptoms from depression can include (and or not limited to):
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Disturbed sleep
Anxiety
Lethargic
Feelings of despair
Feelings of hopelessness
Lack of concentration
Lack of sex drive
Suicidal thoughts
Depression is often treated with medication, psychotherapy or both. Individuals can benefit themselves by exercising, eating more healthily, cutting down on alcohol and becoming more actively social.
Cognitive Behavioural Therapy
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Cognitive Behavioural Therapy (also known as CBT), aims to help people become aware of the feelings, beliefs, and thoughts and the effect these have on their behaviour patterns and actions. Once the individual is aware, they can actively work on correcting their perception and they way it affects them. Compared to other methods CBT focuses on the specific problems and aims to change the thinking around it.
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The National Institute for Health and Clinical Excellence (NICE) suggests that CBT is an effective treatment for depression. Guidelines recommend that treatment should last a minimum of six sessions over ten weeks and a maximum of twenty sessions over nine months for the most severe depression.
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CBT invites the client to engage in ‘homework’ outside of the session. This could include the use of CBT diaries monitoring symptoms and behavioural experiments. Sometimes the individual may be asked to write down when they, for example, feel depressed, what caused it and how they reacted. This would help the therapist to focus on the specific thoughts/feelings/behaviours that triggered a particular low mood. The therapist then may utilise 2 methods, cognitive restructuring or behavioural activation. The first involves accessing and identifying the negative thoughts through dialogue between the individual and the therapist and then restructuring these thoughts. Behavioural activation involves scheduling activities for the individual and helping find things they enjoy doing again. A common symptom of depression is a loss of interest in things the person used to enjoy. This generally increases their depression; therefore finding enjoyable activities tends to have a positive effect on their mental health.
For further reading:
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Depression Alliance - http://www.depressionalliance.org/
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CBT for Depression - http://www.webmd.com/depression/guide/cognitive-behavioral-therapy-for-depression
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