Signs and Symptoms of Depression

Signs and Symptoms of Depression

Am I or my loved one depressed?
Depression is often called the common cold of mental problems because it is so widespread.
You can screen for depression using these criteria:

  • Do you have a depressed mood or a loss of interest or pleasure in daily activities for more than two weeks?
  • Is your social, occupational or educational functioning impaired as a result of your depressed mood?
  • Do you experience at least 5 of the following 9 symptoms nearly every day?
  1. Depressed mood or irritable most of the day , nearly every day. This can be indicated by your own feelings of sadness or emptiness or by observations that others make (eg that you appear tearful).
  2. Decreased interest or pleasure in most activities most of each day.
  3. Significant weight change or change in appetite.
  4. Change in sleep: Insomnia (lack of sleep) or hypersomnia (excessive sleep).
  5. Change in activity: Passivity or feeling an urge to be overly active.
  6. Fatigue or loss of energy.
  7. Feelings of guilt or worthlessness: Feeling worthless or excessive or inappropriate guilt.
  8. Concentration: Diminished ability to concentrate or think or increased indecisiveness.
  9. Suicidal: Thoughts of death or suicide or has suicide planned.

Is Depression genetic?
Depression often runs in families, yet it is not clear to what extent this is transmitted genetically and to what extent parents behave in ways that cause depressive tendencies in their children.

What are the typical triggers that start a Depressive episode?

  • Feeling unloved and alone: Disappointment in love can lead to a feeling that the world is empty and the idea that “I have lost love because I do not deserve anything” and “nobody can love me therefor I hate myself”. All people need to feel loved, special and cared for. We all long for a reassuring warmth.
  • Death of a loved one or being separated from a loved one.
  • Lack of self-esteem: When self-esteem is lowered as a result of a failure or loss of love this can trigger a feeling of worthlessness and depression.
  • Fear of a lack of money or poverty.

What are the deeper roots of Depression?
An important factor in depressive tendencies is the experience of premature loss. Depressive individuals are understood to often have suffered some early frustration or loss that was experienced as too overwhelming. The life event most associated with a person’s development of depression later in life is losing a parent before the age of 11. Children tend to emerge from an experience of premature loss with a tendency to idealize the loved person and to internalize badness. So in stead of feeling: “I am angry at my father for leaving or at my mother for expecting me to function independently too early” the child internalizes the feeling: “I must be bad, that is why people leave”. These dynamics create a feeling of being bad, of having driven away a loved one (normally a parent) and of having to try very hard to prevent this from happening again. If a child takes in him/herself a sense of badness it gives a sense of control (if the badness is in me, I can change the situation and prevent this from happening again). These individuals thus believe that their source of sadness lies within themselves (their own badness). This turning against the self is a typical outcome of a childhood that has been emotionally insecure. These individuals experience early and sometimes repeated losses ranging from being weaned too early and being expected to function too independently too early; divorce; rejection; abandonment; death of a parent; various forms of separation from primary caregivers etc. Early loss is not always concrete (as with death of a loved one) it can be more emotional and internal (as with parents who pressure children to give up dependent longings and behavior before the child is ready for this). Young children do not have the mental abilities to process loss and therefore losses at a young age almost always cause some depressive dynamics.

In families where mourning losses are discouraged depressive tendencies are stronger. When parents deny grief (e.g. after divorce or death) so that loss can not be processed, mourning does not happen and eventually takes the form of the child believing that there is something wrong with him-/herself.

The combination of early loss and critical parental attitudes increase the likelihood of depressive dynamics and a sense of badness within the child. Significant depression in a parent, particularly in a child’s early years, also increase the possibility of depression for that child (depression in a parent is often experienced by the child as a from of emotional abandonment by the parent). Children with a depressed parent feel guilty about their normal needs and demands and fear that they are bad and too needy and exhaust their parents.

People with depressive personalities fear that they are bad and that they will therefore be abandoned by others. “Depressive people are agonizingly aware of every sin they have committed, every kindness they have neglected to extend, every selfish inclination that has crossed their minds” (Nancy McWilliams, 1994, p230). They long for love and attachment. Depressive people’s anger is mostly conflicted, thus they tend to feel guilt when angered (they turn anger inward and feel they are bad).

Stressors that are experienced by patients as reflecting negatively on their self-esteem are more likely to produce depression. Children who do not feel admired, validated and affirmed by their parents struggle to develop a sense of self-esteem that protects a child against the later development of depression.
Many people benefit from psychotherapy to work through losses and struggles with self-esteem. When depression is very severe medication can alleviate the symptoms.

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