Everyone experiences feelings of sadness, disappointment, or 'the blues' from time to time. Depression refers to a range of mood and other symptoms that are more intense, pervasive and long-lasting, are distressing to the individual, and interfere with their day-to-day life and relationships.
The key symptoms of depression include one or both of the following:
- Feelings of sadness, emptiness or lowered mood that lasts for most of the day, nearly every day
- Loss of interest in activities that were previously enjoyable, like going out, seeing friends, or pursuing interests and hobbies.1
These symptoms are experienced persistently for at least two weeks, along with several other symptoms over the same period. These vary from person to person, but can include:1, 2
- Significant changes in appetite and/or weight in the absence of dieting
- Difficulty sleeping or excessive sleeping
- Fatigue and loss of energy
- Feelings of worthlessness, helplessness or hopelessness, or excessive guilt
- Trouble concentrating or making decisions
- Decreased interest in sex
- Thoughts of suicide or a feeling that life is not worth living.
There is no one cause for depression. In some individuals, stressful life events such as the loss of a job, long-term unemployment, physical health issues, family problems, the death of a loved one, or the loss of a close relationship might trigger depression.3 For other people, there is no obvious cause.
Some factors that might place a person at a higher risk of developing depression include:
Having a close relative with depression can increase a person's chances of developing the condition.4 This doesn't mean that depression is inevitable - other factors increase or decrease a person's risk.
Some people who experience neglect or abuse during childhood might be more likely to develop depression as adults.5-7
Personal psychological factors
People who tend to dwell on negative events, worry excessively, or attend more to negative information about themselves, the world or the future are prone to depression.8-10
Changes in the levels or activity of certain chemicals in the brain like serotonin, norepinephrine, and dopamine play a role in depression, though the specific processes are not fully understood.11
There are many effective psychological treatments for depression. Certain specialised forms of psychological intervention tend to be more effective than general supportive counselling, as they address current issues and symptoms and also aim to reduce the likelihood of having future episodes of depression.12
Cognitive behaviour therapy (CBT)
Cognitive behaviour therapy (CBT) focuses on negative and unhelpful thoughts about the self, others, and the future which may contribute to depression.13 The goal of this type of therapy is to identify, examine, and modify these unhelpful thoughts and the behaviours that follow, and increase behaviours that might improve mood and quality of life. This includes ensuring a balance of enjoyable activities throughout each day, and a range of activities that give the individual a sense of achievement.14, 15 Problem-solving, to help address possible causes of stress and lowered mood is also an important compotent.16, 17
Interpersonal psychotherapy (IPT)
Interpersonal psychotherapy (IPT) involves addressing problems in the individual’s relationships and expectations about others that might be contributing to the symptoms of depression. The aims of this type of therapy include helping the individual to find new ways to develop and nurture relationships, resolve conflicts with others, express emotions and communicate more effectively, adapt to life-role changes, and improve social support networks.18
Short-term psychodynamic psychotherapy (STPP)
Short-term psychodynamic psychotherapy (STPP) can help the individual to overcome internal conflict and resistance by bringing unconscious feelings, desires, motivations and thoughts into awareness. The goals of this therapy are to identify and change unhelpful defences which may be getting in the way of a healthy life, decrease vulnerability to depression, and build resilience.19
The psychologist will ask some questions about the individual's history, circumstances, thoughts, feelings and behaviours. They might also use questionnaires to gather more information.
Together, the client and psychologist work towards an understanding of factors that might be involved in the development and maintenance of depression. A treatment plan is then developed between the client and the psychologist.
The psychologist might use CBT, IPT, STPP, or other psychological strategies such as mindfulness and relaxation to help in the client's recovery.
A medical review with a GP is often recommended to help rule out whether a medical condition might account for the symptoms of depression. Where medication might be of benefit, a review with a GP or psychiatrist might be suggested.
Exercise and diet can be important in the treatment of depression, so a nutritionist, dietician or exercise physiologist might also be consulted.
When low mood persists for over two weeks and is affecting a person's work, school, home life, or relationships, psychological assistance should be considered.
To locate an APS psychologist, call 1800 333 497 or visit www.findapsychologist.org.au. A GP can also organise a referral to a registered psychologist through the Better Access to Mental Health Care items.
Australian Psychological Society
Australia's largest professional association for psychologists
Provides information on anxiety, depression, and related disorders
Australia's National Youth Mental Health Foundation, providing assistance for individuals aged 12-25
A 24-hour counselling, suicide prevention and mental health support service
Telephone: 13 11 14
23 Sep 2013
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington DC: Author.
- World Health Organization. (2008). ICD-10: International Statistical Classification of Diseases and Related Health Problems (10th Rev.). New York, NY: Author.
- Kessler, R. C. (1997). The effects of stressful life events on depression. [Article]. Annual Review of Psychology, 48(1), 191.
- Sullivan, P. F., Neale, M. C., & Kendler, K. S. (2000). Genetic epidemiology of major depression: Review and meta-analysis. The American Journal Of Psychiatry, 157(10), 1552-1562. doi: http://dx.doi.org/10.1176/appi.ajp.157.10.1552
- Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1996). The long-term impact of the physical, emotional, and sexual abuse of children: A community study. Child Abuse & Neglect, 20(1), 7-21. doi: http://dx.doi.org/10.1016/0145-2134(95)00112-3
- Young, E. A., Abelson, J. L., Curtis, G. C., & Nesse, R. M. (1997). Childhood adversity and vulnerability to mood and anxiety disorders. Depression and Anxiety, 5(2), 66-72.
- Zlotnick, C., Ryan, C. E., Miller, I. W., & Keitner, G. I. (1995). Childhood abuse and recovery from major depression. Child Abuse & Neglect, 19(12), 1513-1516. doi: http://dx.doi.org/10.1016/0145-2134(95)00098-6
- Vanderhasselt, M.-A., & De Raedt, R. (2012). How ruminative thinking styles lead to dysfunctional cognitions: Evidence from a mediation model. Journal of Behavior Therapy and Experimental Psychiatry, 43(3), 910-914. doi: http://dx.doi.org/10.1016/j.jbtep.2011.09.001
- Raes, F. (2012). Repetitive negative thinking predicts depressed mood at 3-year follow-up in students. Journal of Psychopathology and Behavioral Assessment, 34(4), 497-501. doi: http://dx.doi.org/10.1007/s10862-012-9295-4
- Beck, A. T. (2002). Cognitive models of depression. Clinical advances in cognitive psychotherapy: Theory and application, 14, 29-61.
- Saveanu, R. V., & Nemeroff, C. B. (2012). Etiology of depression: Genetic and environmental factors. Psychiatric Clinics of North America, 35(1), 51-71.
- NICE. (2009). Depression: The Treatment and Management of Depression in Adults (Updated Edition).
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). The Cognitive Therapy of Depression. New York, NY: Guilford Press.
- Hollon, S. D., & Dimidjian, S. (2008). Cognitive and behavioural treatment of depression. In Ian H. Gotlib & Constance L. Hammen (Eds.), Handbook of Depression (2nd Ed.). New York, NY: Guilford Press.
- Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: A meta-analysis and review. Clinical Psychology: Science and Practice, 16(4), 383-411. doi: http://dx.doi.org/10.1111/j.1468-2850.2009.01178.x
- Bell, A. C., & D'Zurilla, T. J. (2009). Problem-solving therapy for depression: A meta-analysis. Clinical Psychology Review, 29(4), 348-353.
- Cuijpers, P., van Straten, A., & Warmerdam, L. (2007). Behavioral activation treatments of depression: A meta-analysis. Clinical Psychology Review, 27(3), 318-326. doi: http://dx.doi.org/10.1016/j.cpr.2006.11.001
- Brakemeier, E.-L., & Frase, L. (2012). Interpersonal psychotherapy (IPT) in major depressive disorder. European Archives of Psychiatry and Clinical Neuroscience, 262(Suppl 2), 117-121. doi: http://dx.doi.org/10.1007/s00406-012-0357-0
- Driessen, E., Cuijpers, P., de Maat, S. C. M., Abbass, A. A., de Jonghe, F., & Dekker, J. J. M. (2010). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clinical Psychology Review, 30(1), 25-36. doi: http://dx.doi.org/10.1016/j.cpr.2009.08.010
We welcome your feedback.