Areas of Focus

Depression

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“I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.”
— NED VIZZINI

The term depression derives from the Latin verb deprimere, to press down, and captures the oppressive quality of this condition. Depression can be mild, moderate, severe or extreme. A depressed state may be difficult to identify as it tends to creep up on you. The following are tell-tale signs to look out for: low mood, loss of interest in pleasurable activities, fatigue, changes in appetite, sleep disturbances, and feelings of worthlessness. 

The Cognitive Triad Model describes 3 key aspects to depression. These include automatic and seemingly uncontrollable negative thoughts about:

  • Self e.g. I’m worthless and ugly

  • Other e.g. No one appreciates me

  • The Future e.g. Things will never change

Complementing the above cognitive model, the Big Five Measure of Personality also found depression to be associated with elevated levels of negative emotion. These involve emotional instability, vulnerability to stress, and pessimism. Depression can therefore be understood to involve compromised areas of both cognitive and emotional functioning.

Therapy aims to alter these cognitively and emotionally compromised aspects by examining the historical factors contributing to this pressed down state, shifting outdated conceptualizations of self and other, as well as shoring up negatively charged emotional states.

References

Beck, A., Rush, A., Shaw, B., & Emery, G. (1987). Cognitive therapy of depression. New York: Guilford Press. 

Kanter, J., Busch, A., Weeks, C., & Landes, S. (2008). The nature of clinical depression: symptoms, syndromes, and behavior analysis. The Behavior Analyst, 31(1), 1–21.

Shedler, J. (2012). The efficacy of psychodynamic psychotherapy. In R. A. Levy, J. S. Ablon, & H. Kächele (Eds.), Psychodynamic psychotherapy research: Evidence-based practice and practice-based evidence (p. 9–25). New York: Humana Press.