Understanding Depression

What is Depression?
Almost everyone at one time or another has felt down. It is natural to feel sad and unhappy whenever a situation does not work out the way we expected or when we lose an important relationship. Most of the time we can bounce back from adversity within days or weeks of the upsetting event, and during this difficult time we are still able to function in daily life and derive pleasure from activities and relationships which are important to us. However, sometimes there are certain life events that are so painful that we are overwhelmed by thoughts of worthlessness, pessimism and hopelessness, and we are not able to function in daily life. Even though the term "depression" is used frequently in daily conversation to convey unhappiness or dissatisfaction, technically speaking depression is much more than ordinary unhappiness.

What are the Symptoms of Depression?

Emotional/Cognitive Signs

• Crying spells or feeling empty and numb.
• Inability to find pleasure in all or almost all previously pleasurable activities.
• Hopelessness and pessimistic outlook towards the future.
• Thoughts of death and other morbid topics.
• Feelings of inadequacy and worthlessness.
• Feeling stuck and helpless.
• Exaggerated sense of guilt or self-blame.
• Loss of warm feelings toward family and friends.
• Difficulties with attention, concentration, memory, decision-making or ability to think clearly.
• Irritability, lowered frustration tolerance.

Behavioral and Motivational Signs

• Loss of interest in things previously considered interesting.
• Social withdrawal and isolation.
• Neglect of responsibilities and appearance.
• Dissatisfaction about life in general.
• Reduced ability to cope on a daily basis.
• Decreased productivity at school or at work.

Physical/Biological Signs

• Sad facial expression and body language.
• Less talkative than usual.
• Fatigue and loss of energy.
• Changes in appetite and weight.
• Insomnia, early morning wakefulness, or excessive sleeping.
• Loss of sexual desire.
• Changes in activity level, such as becoming restless or sluggish.
• Unexplained headaches, backaches, and similar complaints.
• Digestive problems including stomach pain, nausea, indigestion, and/or change in bowel habits.

An individual does not have to have all of the above symptoms in order to meet the criteria of clinical depression. Students may feel any or all of these, and may not associate these feelings with depression. Also note that depression can be a symptom of a medical condition or illness. Always consult a physician if you are experiencing symptoms of depression.

What Causes Depression?
There is no single cause of depression, as far as scientists can tell. Currently, the most reasonable way to look at depression is that predisposing factors coupled with current stressors result in depression. There are multiple factors that may predispose a person to depression, such as genetic predispositions, biochemical disturbances, sensitivity to seasonal changes, personality traits, negative thinking styles, history of early loss, abuse or trauma and other disturbances in early interpersonal relationships. Each person's depression is different in that predisposing factors and current stressors are likely to be highly unique to the individual. Thus, there appear to be multiple pathways to depression. In terms of current stressors, most often there is some type of perceived failure or loss, such as the death of a loved one or the loss of a job, or the end of a relationship. Other common stressors include life transitions, family pressures, financial instability and interpersonal conflict.

How Can I Cope with Depression?
People try to cope with depression in a variety of ways. Some of these ways of coping are not effective and can cause further damage. The not so effective ways of coping with depression include: ignoring problems in life and hoping that they will go away, self-criticism, heavy drinking or substance abuse, binge eating, isolating oneself, neglecting self-care, avoiding schoolwork, and/or suicidal threats or behavior. Frequently there can be a vicious cycle of negative thinking, such as self-blame, hopelessness and pessimism, leading to further demoralization, avoidance of loved ones, feeling like a failure and feeling depressed about being depressed. Unrealistic expectations that life should go smoothly and perfectly and that one should be perfect do not help.

The following is a partial list of effective ways of coping with depression:

• view depression as a sign that something in your life needs attention.
• talk to someone you trust about what is troubling you.
• recognize and express painful feelings.
• make efforts to address what's not working in your life.
• take a proactive stance in bringing about change.
• reach out for support and assistance in problem-solving.
• tackle one problem at a time.
• make efforts to repair damaged relationships.
• modify your expectations to be more realistic.
• look at your life from a more balanced perspective.
• try and get regular physical exercise, sufficient rest and sleep.
• avoid unnecessary stress.
• seek a change of pace and routine.
• avoid making huge decisions until after the depression lifts.

How to Help a Depressed Friend
There is no one right formula to follow when responding to a depressed individual. What is most important is to approach the depressed person in a calm, gentle manner that conveys genuine concern and a sincere desire to understand and assist. Keep in mind that active listening and being there for your friend is most effective in assisting him or her. Sometimes what your friend wants most of all is to be listened to. Another key aspect of helping your friend is to determine how urgent the situation seems to be. There is an elevated risk of suicide in persons who are depressed, even after they recover. The more apparently life-threatening the situation, the more rapidly you need to intervene in bringing in appropriate resources. If your friend appears seriously suicidal or if the situation appears imminently life-threatening, the best action to take is to call 911 immediately.

The following guidelines apply when your friend does not appear to be in an imminently life-threatening situation:

• Request to speak with your friend privately.
• Describe the behaviors or signs that concern you.
• Listen carefully, avoiding interruptions and asking too many questions.
• Repeat back the essence of what your friend has told you.
• Avoid criticizing or sounding judgmental.
• Refrain from telling your friend what to think, feel or do.
• Assist in identifying options available to your friend, including relevant resources available.
• Reassure your friend that you care and that you will be there with him or her through this difficult period.
• Consider The Counseling Center (CAPS) as a resource for your friend.
• If your friend resists help and you are worried, contact CAPS to discuss your concerns.
• Maintain interpersonal boundaries appropriate to your relationship with your friend. Extending oneself can be a gratifying experience when kept within realistic limits. Short of emergency situations, sometimes there is not much you can do if your depressed friend is not receptive to your efforts to assist.
• If appropriate, you might offer to accompany your friend to CAPS and request emergency services. If you escort your friend to CAPS it is very helpful if you, with your friend's permission and in his/her presence, describe your concerns to the on-call therapist.