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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.”
The term depression derives from the Latin deprimere, to press down, and captures the oppressive quality of this condition. It can be mild, moderate, or severe, and tends to creep up rather than announce itself. Tell-tale signs include low mood, loss of interest in previously pleasurable activities, fatigue, disturbed sleep and appetite, and a pervasive sense of worthlessness.
Cognitively, depression organises itself around automatic negative thoughts in three directions: about the self ("I am worthless"), about others ("no one appreciates me"), and about the future ("things will never change"). This pattern, known as the Cognitive Triad, is complemented by a distinct emotional signature — heightened negative emotion, marked by emotional instability, vulnerability to stress, and pessimism. Depression is therefore best understood as a compromise of both cognitive and emotional functioning.
Therapy addresses both. It examines the historical factors that produced this pressed-down state, revises outdated views of self and other that the depressed mind treats as fact, and gradually restores the emotional range that depression flattens. The aim is not only relief of symptoms but a durable shift in the patterns that produced them.
References
Beck, A., Rush, A., Shaw, B., & Emery, G. (1979). 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.