Overcoming Depression: Using Depression in Treatment

Depression is one of the most widespread mental health challenges faced by individuals globally and has become a significant economic burden on society. According to an article by the World Health Organization, 3.8% of the global population is estimated to be experiencing depression. In the local context, an article by DukeNUS Medical School suggests that depression, along with anxiety, could be costing 2.9% of Singapore’s Gross Domestic Product (GDP) through visits to emergency rooms, missing work, and lost productivity, and expanding government efforts to combat the rising numbers.

Depression is not merely a transient feeling of sadness but a complex condition that can have a significant impact on daily functioning and overall well-being. This article explores the evolutionary origins of depression, various psychological perspectives on it, the signs and symptoms to watch for, the potential consequences if left untreated, essential elements for successful treatment, and how therapy can play a pivotal role in helping individuals struggling with depression.

Content:

• The Evolutionary Origins of Depression

• Psychological Perspectives on Depression

• Recognising Depression

• Overcoming Depression: The Hirsch Therapy Way

The Evolutionary Origins of Depression

From an evolutionary standpoint, depression may seem counterproductive, as it decreases motivation, energy, and the capacity to engage with life. However, researchers have proposed that depression may have served a purpose in human evolution. It has been suggested that the depressive state could have been a signal for early humans to withdraw from risky or stressful situations, conserve energy and allow for introspection, problem-solving, and long-term planning. This could explain why, even today, those experiencing depression may isolate themselves and turn inward.

Depression might have also promoted the building and maintaining of social bonds among our ancestors. When individuals displayed signs of distress or vulnerability, it could have signalled to others the need for social support or aid, fostering cooperation within communities. However, while these evolutionary explanations provide insight into the nature of the depressive state, they do not diminish the severe impact depression has in today’s world.

Psychological Perspectives on Depression

Philosophers, physicians, and psychologists have long pondered the construct of depression, from early concepts of melancholy to the modern clinical diagnostic criteria of depressive disorders – producing extensive literature to inform our understanding of depression today.

The Psychodynamic Perspective

From a psychodynamic perspective, depression stems from unresolved unconscious conflicts rooted in early childhood experiences. Sigmund Freud viewed depression as a result of loss, be it the loss of a loved one, a job, or an aspect of the self. Individuals may internalize anger or frustration toward themselves, leading to a deep sense of self-criticism. Psychoanalysts would work with clients to uncover these unconscious conflicts, explore past traumas, and form a deeper understanding of the relationships that shaped their development.

The Jungian Perspective

Carl Jung saw depression as a manifestation of unresolved parts of the psyche, often linked to the "shadow" – the parts of ourselves we repress or deny. Jung believed that depression could be a subconscious invitation for the individual to engage in deeper self-understanding and integration of these shadow elements. In other words, depression forces individuals to confront aspects of themselves they have ignored or neglected, offering the opportunity for personal growth and transformation. For Jung, the therapeutic process involves the integration of these hidden aspects, which can lead to a more authentic and balanced self.

The Existential Perspective

An existential perspective views depression as a confrontation with life's major questions such as meaning, freedom, and mortality. Feelings of depression may arise when our existing conceptualisation is threatened by experiences such as major life transitions, the loss of a loved one, chronic illness, ageing, failure, loneliness, trauma, near-death experiences, or social unrest. Existential therapy focuses on helping individuals explore these concerns, find meaning in their suffering, and reconnect with their values and sense of purpose.

The Philosophical Perspective

Philosophically, depression can be examined as a profound response to the human condition. Thinkers such as Søren Kierkegaard and Friedrich Nietzsche have explored depression as a reaction to existential despair, the absurdity of existence, or the tension between individual freedom and societal constraints. For many philosophers, depression reveals an underlying struggle with how to live a meaningful life in an often chaotic and uncertain world.

The Cognitive Behavioural Perspective

From a cognitive behavioural perspective, depression is seen as the result of distorted thinking patterns and maladaptive behaviours. Negative thoughts, self-defeating beliefs, and cognitive distortions (such as black-and-white thinking or catastrophizing) contribute to the depressive state. Cognitive Behaviour Therapy, thus, focuses on identifying and challenging these negative thought patterns and replacing them with more balanced and rational thoughts. This, in turn, leads to improved emotional regulation and a reduction in depressive symptoms.

Taken Together

Although each perspective offers a fresh viewpoint and an alternative route towards healing, the bottom line is clear – depression is a state that calls the individual towards deeper reflection on their lives. How people respond to this call determines whether the individual maintains the depressive state or learns to grow and evolve from it.

Recognising Depression

There are signs and there are consequences.

Depression manifests in a variety of ways, and while symptoms can vary between individuals, there are some common signs to look out for. In the case of depression, it is crucial to address it as soon as possible.

Signs and symptoms include:

• Persistent sadness or low mood

• Loss of interest or pleasure in activities normally enjoyed

• Fatigue or loss of energy

• Feelings of worthlessness or excessive guilt

• Difficulty concentrating or making decisions

• Changes in appetite or weight (either loss or gain)

• Sleep disturbances (insomnia or oversleeping)

• Restlessness or slowed movement

• Recurrent thoughts of death, suicide, or self-harm

Consequences of Untreated Depression

The depressive condition has a vicious tendency to feed itself into an ever-deepening pit. If left untreated, depression can have severe and long-lasting consequences.

Consequences of untreated depression include:

• Chronic emotional distress

• Deterioration in personal relationships

• Loss of productivity or unemployment

• Increased risk of substance abuse

• Physical health problems, including weakened immune functioning

• Increased risk of suicidal thoughts and behaviours

In the long term, untreated depression leads to a diminished quality of life, making it harder for individuals to re-engage with meaningful activities and relationships. This highlights the critical nature of addressing depression as soon as the individual or loved ones notice it.

Overcoming Depression: The Hirsch Therapy Way

By examining the existing literature and drawing from the different conceptualisations of depression, we have found what is needed for recovery. From that, we can identify key elements crucial to address in treatment.

Essential Elements of Successful Treatment

The Therapeutic Alliance: A strong, trusting relationship between the therapist and the client is critical. It allows for open communication, vulnerability, and a sense of safety. How comfortable you feel with your therapists influences engagement with the process; facilitates the process of exploring core issues; and maintains hope for positive change.

Psychotherapy: Therapy creates the ideal conditions for reflection and examining your life. Choosing to come for therapy is a commitment to the healing process and creates a sense of accountability to yourself. Therapists are also trained to facilitate your inward journey to discover your path of recovery and return to a healthier and more fulfilling life.

Medication: In some cases, antidepressant medications can be prescribed to regulate the internal chemistry of the mind and body to provide an additive effect for psychotherapy. Medications are rarely recommended as a standalone treatment.

Lifestyle Changes: Depression affects both the mind and body. Lifestyle changes address both aspects, promoting a more holistic approach to recovery that can boost the effectiveness of psychotherapy and medication. Incorporating regular exercise, a healthy diet, and good sleep hygiene can significantly improve mood and energy levels. As an added bonus, these lifestyle changes can also offer an increased sense of control and resilience which directly challenge the feelings of hopelessness and helplessness that are common in depression.

Social Support: A strong network of friends, family, and peer groups provides validation, reduces feelings of isolation, and offers encouragement when depression saps motivation. It also serves as a buffer against stress and helps prevent relapse by fostering a sense of belonging and self-worth. Supportive relationships not only enhance the effectiveness of therapy and medication but also promote long-term resilience by helping individuals manage depressive symptoms and maintain positive lifestyle changes.

How Hirsch Therapy Can Help with Overcoming Depression

We have come to understand depression as a call to explore the potential for change, rather than a clinical condition or mental disease. Our approach offers clients a space for self-reflection, growth and healing, and an environment where they can feel safe and supported in their journey. Ultimately, we want to empower our clients to reclaim their sense of purpose, reconnect with meaningful relationships, and rediscover joy in their lives.

If you, or a loved one, are struggling with depression, please feel free to reach out to us. We would be happy to support your journey in any way that we can.

We offer a 15-minute free online consultation for a risk-free opportunity to ask us about any uncertainties or concerns that you may have. This can also help you figure out if you are comfortable to continue working with our therapist in your very own individual therapy sessions.