Depression treatment & counselling therapy

Experiences of depression can vary from mild cases to the more severe. If you are suffering from depression, you may relate to the idea of feeling stuck in your sadness; a sense that you cannot imagine being happy again. Psychologists and counsellors often describe the symptoms of depression as living with a future that seems hopeless and a sense of being helpless to do anything about it. Some people begin to lose sleep while others may sleep all day, struggling to get out of bed in the morning.

You take little pleasure in your day, your appetite changes and in many cases, you begin to feel worthless and perhaps as if others might be better off without you. Suffice it to say, depression can be a devastating state of mind. In extreme cases, you may be unable to get to work, your relationships suffer and you isolate yourself from others; perhaps you find it hard to get the motivation to get dressed in the morning or to wash and feed yourself.

For too many people, depression is their everyday state of mind. So it can be surprisingly hard to recognise in others. Moreover, as people with depression often feel unattractive or worthless, they tend to keep their problems to themselves, preferring not to ‘burden’  others with their problems. People with depression often suffer in silence, unaware that help is available.

However, many models of counselling therapy as commonly provided by a trained counsellor or psychologist are clinically proven treatments for depression. If you are depressed, you do not need to suffer, and you do not need to suffer alone. We urge you to speak up and get help and give yourself the chance you deserve for a more fulfilling future. (This article is electronically protected – Copyright © Associated Counsellors & Psychologists Sydney PTY LTD)

Psychologists and other mental health professionals describe two diagnosable types of depression, Dysthymia (Chronic Low Mood) and Major Depressive Disorder.

Not everyone’s experience of depression will correspond with the rather extreme form described above. Indeed, whilst a strong bout of what psychologists call ‘Major Depression’ may last for a couple of weeks or months and truly debilitate a person, other types of depression tend to be lower lying, although they can be chonic.

Chronic Low Mood, or Dysthymia, is described as being a form of depression which is mild to moderate in its impact – a person with dysthymic depression will generally be able to function in their lives, they just wont get much pleasure from it. They may find it hard to genuinely have a laugh; they may wonder how everyone else is able to enjoy the things they get nothing from. They often don’t feel good about themselves or their future and share the same features of major depression in terms of disturbed sleep, appetite and difficulty concentrating, albeit at lower levels.

One of the other defining features of Chronic Low Mood or Dysthymia is its chronic nature, that is, it is long lasting and tends to be present most of the time. Indeed, in order to be formally diagnosed as Dysthymic by a psychologist or psychiatrist, a person must have had at least two or more of the following symptoms, most of the time, for a two year period, with no more than one month free of such symptoms:

• poor appetite or overeating
• insomnia or hyper-somnia (excessive sleeping)
• low energy or fatigue
• low self-esteem
• poor concentration or difficulty making decisions
• feelings of hopelessness

Unlike Dysthymia, which describes people who feel mildly depressed most of the time, Major Depressive Disorder describes a situation in which a person who is not usually depressed experiences a sudden change in mood which leaves them in a substantial state of depression for at least 2 weeks. (This article is electronically protected – Copyright © Associated Counsellors & Psychologists Sydney PTY LTD)

A person with a Major Depressive Disorder will have either a depressed mood or a loss of interest or pleasure in daily activities, consistently, for at least 2 weeks. This low mood will be a change from the way you normally feel; you are likely to notice a change in your ability to socialise, work or study, or perhaps to perform in another important area in your life. Major depressive disorder is characterised by the presence of at least one such 2 week or longer major depressive episode (however such a depressive episode is not in itself evidence of major depressive disorder).

A major depressive episode includes the following symptoms:

• depressed mood most of the day, nearly every day, whether noticed by yourself or someone else who knows your normal mood
• significant decrease in interest or pleasure in all, or almost all, activities, most of the day, nearly every day
• significant changes in your weight (be it weight loss or weight gain), or a series of daily change in your eating patterns and appetite.
• Consistent trouble sleeping or feeling more sleepy than usual (insomnia and hypersomnia)
• Feeling ‘charged’ or fidgety (psychomotor agitation) or listless (retardation) nearly every day
• Feeling fatigued or experiencing a loss of energy nearly every day
• feelings worthless or inappropriately guilty nearly every day
• finding it harder to think or concentrate, or make decisions, nearly every day
• having repeated thoughts of death, considering or thinking about suicidal themes (be it with or without a specific plan to suicide).

As you can see from the above list, a person with Major Depressive Disorder will experience these symptoms during an episode almost every day, and most of the time during that day.

In addition, a person experiencing a significant bout of depression will not normally be diagnosed as suffering from Major Depressive Disorder unless the symptoms continue for at least 2 months and/or are combined with a functional impairment of some sort (for instance you can not work, or participate in your normal activities ), or the person is found to  be morbidly preoccupied with worthlessness, suicidal thoughts, or suffering from psychomotor retardation (where the body and mind slows down and the person has difficulty undertaking simple tasks).

If the symptoms of major depression has been caused by the death of a loved one (bereavement) then the episode will not usually be characterised as one indicative of Major Depressive Disorder. Likewise, depression caused by substance use (such as drugs, alcohol, medications) is not usually considered a major depressive disorder, nor is a depressive episode caused by a general medical condition.

Finally the condition of Major Depressive Disorder will not be diagnosed if you have other mood related symptoms such as mania (as may occur in bipolar disorder – see our separate information page) or if the depressed mood is better accounted for by other mental health issues, for instance, psychosis. (This article is electronically protected – Copyright © Associated Counsellors & Psychologists Sydney PTY LTD)

In order to help you determine whether you have depression and whether treatment by a counselling professional or psychologist may benefit you, you can look at some of the diagnostic criteria for the symptoms common to Dysthymia and Major Depressive Disorder as described above.

You can also take a simplified test for depression by completing our depression checklist to see if you are a likely depression sufferer.

Please note that making a diagnosis of symptoms is a complex undertaking. Moreover, it does not take into account the cause of the condition and it does not in itself indicate a particular type of treatment.

You should consult with a mental health professional like a counsellor, psychologist, psychotherapist or psychiatrist for further advice if you feel the symptoms described in this article may be of relevance to you or a loved one.

Professional Counselling, Psychologist and Psychotherapy services are proven treatments for depression and Associated Counsellors & Psychologists Sydney represents a team of experts trained in working with depression.

Please note that if you feel the urge to harm yourself you should immediately present to your local hospital emergency department, or call 000 or call Lifeline 24 hours a day.

Associated Counsellors & Psychologists Sydney provide access to therapists who can help you work on your depressed mood over time. We do not provide an emergency crisis counselling service.

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