If you or someone you care about is feeling depressed,
perhaps this can be the first step to feeling better....
Are you ready to make some changes and thinking about getting help?
If so, consider the folowing when looking to finding the right therapist and interventions :- 1. Find a therapist who has an
up-to-date and accurate clinical understanding
of what depression is.
(You can check this by learning yourself through reading the FAQ below
and downloading the free ebook the Depression
Learning Path. )
2. Find a therapy which is time-limited, active and focused on learning skills,
not personality change.
3. Find a therapist who can teach you effective techniques for managing anxiety and reducing emotional arousal.
4.Find a therapist who can safely and quickly identify and remove emotional arousal linked to past trauma (de-condition).
5. Know that there should be a significant improvement in symptoms within 6 sessions,
(I always say between 2 and 6).
4. Find a therapist who you feel you can work with.
I am able to offer all of the above using an integrated approach. If I'm not the 'right therapist for you I am happy to recommend someone else who might be...
Take the second step to feeling better and give me a call today...Frequently Asked Questions (FAQ)Depression 1. Am I Likely to Develop Depression?Depression knows no barriers. It affects all classes and groups. Depression is more than anything else to do with the way you think about things, and how you approach life. However, men and women have different rates of depression, which is explained by their different thinking styles and emotional makeup.
Depression in men Over the course of a lifetime a man in Western society (USA, Europe, Australasia etc.) has about a one in ten chance of experiencing a major depression. However, a depressed man is much more likely to deal with his depression by committing suicide.
Depression in womenOne in four women will experience a significant depression at some point in their lives. This statistic also accounts for reporting and awareness, which may be greater in woman. This dramatic difference has been shown to be due to womens' different biological, sociological and psychological makeup. In general, women display greater emotional awareness than men and have a greater propensity to explore feelings, which can make for great empathy with others.
The disadvantages of being ‘more in touch with your emotions’ include greater rates of depression. The strategy of thinking 'why do I feel this way?' is an example of a depressing thought pattern. Women are more likely to introspect than men.
Familial depression Depression, it appears, runs in families. It could be assumed that this is due to a genetic basis for depression, but this appears to rarely be the case. Although a small proportion of depression has its roots in biology, it is much more likely that depression running in families is due to children learning depressive strategies from their parents.(1)
1 - Yapko, M.D. Hand-me-down Blues. (1999) St Martin's Griffin
2. Anti-depressantsThe most commonly prescribed type of anti-depressant now prescribed is the SSRI, which stands for Selective Serotonin Reuptake Inhibitor, an example of which is Prozac. These work on the levels of serotonin, a brain chemical which controls arousal levels, feelings of wellbeing, sleep and pain perception. They also, as do all antidepressants, decrease the amount of REM sleep you get, which as you will learn from the Depression Learning Path, is essential is lifting depression. (However, there are much quicker ways of doing it than with drugs.)
During depression levels of serotonin are drop as a result of over-arousal from negative introspection and lack of participation in pleasure-giving activity. However, if after a course of anti-depressants, the person then goes back to negatively interpreting their life and what happens to them then there it is likely that at some stage, depression will return, (although the relief from suffering is of course welcome).
Most anti-depressants, if they are going to work for a particular individual, will begin to work within three weeks of starting to take them. Side effects vary from drug to drug but may include drowsiness, anxiety, and sexual dysfunction as well as insomnia. Contrary to the impression given by some advertising, no single anti-depressant has ever been shown to be more effective than any other in lifting depression. The Depression Learning Path contains a comprehensive review of anti-depressants and their effectiveness.
3. Childhood and Teenage DepressionThe Depression Learning Path contains a page devoted specially to childhood and teen depression. However, if you are concerned about this for yourself, your child, or a friend, reading the whole Depression Learning Path will enable you to understand all about depression and how it works.
4. Depression and DreamingWaking up exhausted after many disturbing dreams is a common experience for many depressed people. It has been shown that depressed people dream up to three times as much as non-depressed people but why should this be? And does this have anything to do with feeling so short of energy first thing in the morning? The answer is yes, it does, and we know exactly why. The latest scientific understanding of dreams tells us that we dream for specific biological and psychological purposes. Emotionally arousing ruminations which are unfulfilled at sleep onset (i.e. the concern is still a worry) get ‘dreamed out’ metaphorically during dreaming. This is done to leave the ‘higher brain’ (neo-cortex) free for dealing with the next day's events. (1)
Dreaming literally takes the ‘charge’ out of a concern. However dreaming is a very distinct part of sleep. It’s called ‘paradoxical sleep’ because it is not the part of sleep which provides us with rest. During the dream phase of sleep (REM), we actually have more of the ‘stress hormones’ such as adrenaline in our systems. So over-dreaming stresses the system leaving us exhausted when we awaken. If a depressed person is woken every time they show rapid eye movement (which generally coincides with dreaming) then the symptoms of clinical depression can lift. But they may become extremely anxious or manic as the negatively arousing ruminations are still occurring but no longer being ‘flushed out’ by the dream process.
Nature sometimes tries to prevent the person over-dreaming by causing them to awaken in the early hours of the morning so that they spend less time in dream sleep. This is known as early morning waking syndrome.
So why do depressed people dream more? Depressed people dream more because they have more emotional arousal to ‘dream out.’ Depression causes (and is caused by) a lot of emotionally-arousing introspection, or rumination, that endless sort of worrying that never seems to go anywhere and just makes you feel bad.
The importance of this discovery cannot be overstated. We now know why most of the symptoms of depression occur, and what to do about them. If you are depressed, there are clear things you must do:
1. Learn about depression, so you can stop worrying about that (follow the Depression Learning Path).
2.
Get some deep relaxation as often as you can to help your system recover from the effects of over-dreaming. (When we use relaxation techniques in our clinic, depressed people will often stay in a deeply relaxed state for up to an hour and a half, often needing to be 'woken up'. This shows clearly a missing need. They regularly report afterwards feeling 'better than they have in months'.
3. Do anything that stops you ruminating. This may include seeing a good therapist, who can help you get some perspective on your problems, and recommend a course of action.
Depression can make things seem hopeless, in fact convince you of it, when in fact they are not. The help of a trained professional can make all the difference, as long as they use the right approach. You will learn about this on the Depression Learning Path.
Antidepressants have the effect of reducing dreaming, but as a consequence of the reduced REM, the person may then experience more anxiety or agitation. The arousal-dreaming-exhaustion cycle is not properly broken because as soon as drugs are discontinued the person then dreams even more. 1 - Griffin. Origin of Dreams. (1998).
5. Helping Depressed Friends, Spouses or Family MembersBeing around someone who is depressed can sap your energy, try your patience and put great strain on your relationship with them. Typically, all your attempts at cheering them up will be rejected. Women with depressed husbands often feel that they are failing as wives and can become depressed themselves. Men living with depressed wives may try to help by giving advice or suggestions and become frustrated and angry when their recommendations are not acted upon.
The first thing to understand is that depression makes people behave in ways that don't fit with their normal personality. The depression keeps them keenly on the lookout for anything that suggests that people around them don't take it as seriously as them, or for people trying to cheer them up. You can avoid trying to cheer the person up, and even perhaps complain a little about your life to them. This can have the effect of making them feel a little less alone. You can try to convey to them that depression is a temporary state and that it is curable.
If they are able, having them complete the Depression Learning Path would be a very good idea, as it shows them what is happening to them and gives them a way forward. Most importantly, you need to show them that you understand how bad they are feeling, and perhaps help them find professional help if appropriate. Completing the Depression Learning Path will ensure that you get the right kind of help.
6. How Long Does Depression Last?The average spell of clinical depression, if left entirely untreated, will last around 8 months. During a depression, the sufferer will normally be convinced that it will never go away, but this is a classic feature of the way depression makes us think. Certain psychotherapies can actually worsen depression, which is why it is vital that you are well informed about depression treatment. Take the Depression Learning Path.
Read The Depression Learning PathThe right sort of psychotherapy can make a great difference very quickly however. International guidelines for the treatment of depression state that a significant change should be seen within 6 sessions, or the patient should be referred elsewhere. Often, change is even quicker.
7. Is depression caused by chemical imbalance?All emotional responses have a chemical consequence. When we laugh, for example, there is a greater amount of chemical endorphins (natural painkillers) released into the blood stream. Endorphins do not cause laughter however, they are a consequence of it.
Until recently, and partly because of drug-company marketing, the widespread belief was that depression was a biological illness. It’s even been called a ‘disease.’ Bear with us if you have completed the Depression Learning Path already, as you will have already read this, but it really is so important.
Depression is 10 times more common in people born since 1945 compared to people born before 1945. So, ten times as people are becoming depressed now as compared to fifty years ago (and this research takes into account increased reporting and public awareness).
Biology doesn't change this fast. Genes don’t alter this rapidly - so this is a clue that clinical depression and its increase are more to do with the way society and lifestyles are changing.
Depression is not an inevitable consequence of adverse life circumstances either, as only a minority of people exposed to difficult situations go on to develop clinical depression.So what is depression if not a result of chemical imbalances - the physical symptoms are real enough! Depression is actually a state of high arousal. Depressed people have higher concentrations of stress hormones (cortisol, noradrenaline) than non-depressed people.(1) The apathy and exhaustion seen in depressed people is a consequence of too much arousal, and the way the body and mind respond to this arousal. The way we respond to situations (with thoughts of hopelessness, helplessness, anxiety, anger, etc.) effects the emotions we feel which, in turn effect the chemicals which are released. But the emotionally aroused brain and the presence of stress hormones in turn affects how we think and feel - so it is a ‘two way street’. Thoughts and emotions affect chemical composition and chemical composition affects thoughts and emotions.
So, to sum up, beating depression is not about bad things happening to us but rather how we have learned to respond to life events - god or bad. Thyroid problems, food intolerances and other physical illness can lead to feelings of depression but less than 10% of clinical depression is thought to have a chemical basis.
Appropriate psychotherapy has still been shown to be more effective than drug treatment alone in the treatment of chemically based depression, and far more effective in preventing relapse. By far the majority of depressions are learned phenomena not chemical ones. To learn more about how arousal affects physiology and depression, take the Depression Learning Path. 1 - Nemeroff, C. B. (1998) The neurobiology of depression. Scientific American, 278, 6, 28–35.
8. Is Depression Hereditary?Depression is not primarily a biological disorder. However, as we grow up, we do learn life attitudes and behavioral habits from those around us, so from this point of view depression as a way of seeing and behaving can be passed on. However, we can also unlearn attitudes, learn new skills and become more flexible in our approach to life.
9. Light Therapy & Depression - particularly SADScientists at the Department of Psychiatry, St. Goran's Hospital, Stockholm, Sweden monitored ninety patients with major depressive disorder who were classified according to seasonal depression (60 patients of which 50 were women) and non-seasonal (22 patients of which 17 were women). All of the patients were also clinically evaluated and rated before and after morning (0600-0800) or evening (1800-2000) light treatment for ten days in a room with a luminance of 350 cd/m2 (approximately 1500 lx) at eye level. The patients’ mood ratings were assessed using both the Comprehensive Psychopathological Rating Scale and the Hamilton Depression Rating Scale.
The results showed that depressed patients with seasonal pattern improved significantly more than those with a nonseasonal pattern suggesting a specific therapeutic effect of light treatment in depressed patients with seasonal pattern. There were no significant differences in outcome when light treatment was given in the morning or in the evening, and neither were there differences between patients with and without atypical symptoms such as carbohydrate craving or increased appetite. Researchers at the University Hospital, State University of New York (3) found that variability in pain intensity, demoralization and range of mandibular motion among patients suffering from myo-fascial face pain is associated with seasonal variations.
Evaluating 273 patients whose conditions were measured in each of 10 monthly interviews, the researchers found that the patients’ pain intensity and demoralization were significantly greater in the peak dark months than in the peak light months. The researchers concluded that the data suggested that myo-fascial ( face) pain and depressed moods are related and may be affected by common risk factors including seasonal variations relating to the number of light hours in the day
.
10. Self Help for Clinical DepressionThe first thing to realise when looking at self help for depression is that the very nature of depression can make it hard to help yourself. In this case, your best option is to get help from a trained professional. [If you are going to go this route, take a look at the Depression Learning Path before you do so, to make sure you get someone who knows how to treat depression.] However, if you feel up to helping yourself, here is a comprehensive list of what you need to do.
1. Get a good understanding of what depression is. Self help for depression is much more effective once you know what you are dealing with. Complete the Depression Learning Path and ensure you know clearly what is going on.
2. Regulate your sleep patterns. Get up no later than 8am and go to bed no later than 11.30pm, even if you can't sleep. If you have problems getting up in the morning, get someone else to rouse you, or have a friend call.
3. Eat 3 meals a day, whether you are hungry or not, at the right times.
4. Ensure you get outside early to make sure you get enough bright light to help regulate your sleep patterns.
5. Do things to occupy your mind. If you have nothing to do all day, you will tend to ruminate over your problems.
6. If you are facing a big problem, make the decision to put off thinking about it for, say, 2 weeks, or whatever is appropriate in your case. If you cannot put it off, speak to someone else who you know to be a good practical problem solver.
7. Begin a 'depression diary'. In this rate each day from 1 to 10, where 1 is the worst kind of day, and 10 the best. This will help break down the 'all or nothing' thinking that depression can cause.
8. Get as much exercise as you can. Make yourself walk briskly every day, at least. If you have any concerns about your health, see your doctor before beginning this. Research shows that exercise can lift depression.
9. Get some kind of relaxation during the day. If you know how to do meditation, self hypnosis, tai chi or some other mind-calming technique, do it. It will help reduce the physical effects of the depression greatly.
10. Start challenging your own thinking about things. If you find yourself thinking about things in a depressive way, as outlined in Thinking Styles that Cause Depression, deliberately think in a new way. A good way to do this is to write down the original thought, then generate some alternatives.
11. Understand that depression is not part of you, it is due to a set of symptoms. These symptoms cause you to feel, think and act differently to normal. Once depression goes, things will be different. And when you have the skills to beat it, it is more likely to stay away.
11. Serotonin - Responsible for Depression?Well not exactly, it's more like serotonin is involved in depression. Serotonin is responsible for depression in the same way that food is responsible for hunger. If you have more food, the hunger will go away, but it didn't cause it in the first place!
Serotonin has come to the public's attention mostly because of the meteoric rise of SSRIs - Selective Serotonin Reuptake Inhibitors, a type of antidepressant. However, this has led to the unfortunate and inaccurate idea that a lack of serotonin causes depression.
Serotonin is produced in the brain on an ongoing basis and in response to pleasure-giving experiences, in a normally healthy system. But if that system becomes less than healthy, if it is depressed for example, serotonin levels can drop. But low levels didn't cause the depression! (In a small percentage of people - estimated at less than 10% of depression cases, a low baseline level of serotonin can contribute to low mood.)
If you want to know what does cause depression, take the Depression Learning Path.
Serotonin, orgasm and SSRIs One of the more depressing side effects of SSRIs is the inability to reach orgasm. This is because, when men or women have an orgasm, the levels of serotonin in one particular part of the brain have to drop quickly - the serotonin has to be 're-taken-up'. But SSRIs inhibit the reuptake of serotonin - hence the problem. Serotonin also plays a role in modulating your sleep patterns and controlling how much pain you perceive.
Less than 5% of the body's total amount of serotonin is found in the brain, the rest being distributed throughout the body. Therefore, SSRI's do not affect only the brain, by any means.
12. Suicide and Clinical DepressionIt’s not surprising that up to 80% of suicides are associated with clinical depression. Let's look at what clinical depression does to you:
• It leaves you with no energy, so you feel helpless in tackling tasks or problems
• It makes you feel as if things will never get better (this is called a 'stable' attributional style)
• It can make you feel physicall unwell
• It can make you feel guilty, so not only are you depressed, but you feel guilty for feeling depressed!
• It warps your memory so you feel as if your whole life has been a failure and that others would
be better off without you But remember this...
This is depression talking. It stops you from seeing things as they really are. It is if it steals your history, your present and your future, and plays them back to you painted black. Depression stops you being yourself. It stops you seeing, remembering and thinking clearly.
And depression will go away. Think about this. If you had taken a pill a week ago, which someone said would make you feel bad for 2 months, how would you feel about the next 7 weeks? Bad probably, but not hopeless, because you would know it was going to get better. Depression will get better too.
There is good reason for hope. Even if you have been searching for a long time for a way to feel better,
there is help. Recent advances in our understanding of depression are making it easier and easier to treat to it won't come back. If you haven't done so already, go through the Depression Learning Path. It will take about half an hour. If you don't feel up to it at the moment, bookmark this page and come back to it when you do.
Thinking of suicide is natural when you feel trapped in a horrible and inescapable situation. It is depression that makes you feel this way. Don't let depression cheat you and others out of the rest of your life.
13. The Physical Effects of DepressionMost depression is not caused by a chemical imbalance but most depression will result in a chemical imbalance. Although depressed people may seem lethargic, samples of their blood show a raised level of stress hormones such as cortisol and noradrenaline. This causes (and is caused by) over-arousal and agitation (anxiety is often a co-feature of depression) leading eventually to exhaustion and chronic fatigue.
Depressed people often need to experience regular relaxation as part of their recovery.
In addition, appetite changes often accompany depression. Sufferers may eat much less than normal or much more. Likewise we may sleep less or more both of which could lead to other physical symptoms such as headaches or dizziness.
Sometimes a feature of depression is a morbid preoccupation with one’s health. Constantly monitoring for symptoms can, in some people, produce symptoms. Any physical symptoms should be thoroughly checked out medically however. There is much more on how the psychological aspects of depression lead to the physical symptoms in the
Depression Learning Path.
14. Therapy that works for depression, and therapy that doesn'tWell over one hundred thousand separate pieces of research have been carried out into what depression is and the most effective methods for treating it. Findings tell us that the most effective therapies for clinical depression are therapies that aim to teach skills rather than merely attempt to ‘uncover’ origins of and reasons for depression.
The most effective therapies are those that are ‘solution-focussed’ that is they seek to alleviate suffering and teach skills which can prevent future relapse.
According to the international guidelines for the treatment of clinical depression, therapy should be ‘time limited’ - that is to say if no improvements have occurred within six weeks of the start of the therapy the person should be referred on to another practitioner. The best combination for the treatment of depression is a combination of cognitive therapy, behavioral therapy and interpersonal therapy.
• Cognitive therapy looks at how we think and interpret events in our lives.
• Behavioral therapy looks at what we do.
• Interpersonal therapy looks at how we relate to others and how good our communication styles are.
These are all skills based therapies and have been shown to be effective with treating clinical depression. (If it seems difficult to believe that something that feels as awful as clinical depression can be caused by these things, do the Depression Learning Path and see how they affect your body and mind.)
So called psychoanalytical therapies or ‘psycho-dynamic’ approaches which attempt to ‘go back’ and discover reasons for things - focussing on what went wrong rather than building on resources are contraindicated for depression and several therapists in the USA have been successfully sued for using this approach for depression.
Depressed people often look back and mull over past hurts too much anyway, so common sense tells us that any therapy that extends this process is unlikely to be of lasting help. A depressed person may feel better in the short term when seeing a ‘psycho-dynamic’ therapist simply because of the support.
However, thousands of pieces of research show us that lasting symptom relief is unlikely to come from these ‘pathology-focused’ approaches.
Depressed people need hope, new skills and different ways of thinking to prevent future bouts of depression. It may be important to address issues from the past but the client has to become equipped and confident for living in the future. This type of therapy has been said to cause 'Paralysis by Analysis', and will often worsen depression.
Unfortunately, many doctors, therapists and counselors are unaware of this. This may seem hard to believe, but in most countries, information travels slowly through huge health systems, and health professionals are a busy lot!
When seeking help for depression, you must be an enlightened consumer of therapy and counseling!
15. Thinking Styles and Clinical DepressionThinking styles are so central to depression that there is a large section of the Depression Learning Path devoted to this topic. If you suffer from depression or treat depressed people, it is absolutely essential that you understand the relationship between depressive thinking styles, emotional arousal and exhaustion. With this knowledge, you will be able to help yourself with depression, or choose a good therapist or counselor who can help you.
16. Using St John's Wort for DepressionSt Johns Wort, or hypericum, a type of herb, is often sold in capsule form in health shops and some pharmacies as treatment for mid to moderate depression. It may affect the neurotransmitters in the brain in a similar way to SSRI antidepressant drugs.
There is a significant amount of research to show that St John's Wort is effective as an antidepressant, with fewer side effects than medical drugs. However, it has been known to affect some prescribed medicines including anticoagulant drugs and the contraceptive pill so check with your medical practitioner.
Remember that using St John's Wort is still relying on an external agent to manipulate body chemistry. It is important to understand that in order to cure depression properly and prevent relapse, the skills outlined in the Depression Learning Path are essential.
Research into the use of St John's Wort to treat depression St John's Wort and depression.
St John's Wort was tested in a double-blind study of 105 patients suffering from mild-moderate depression. The patients were male and female , 20 to 64 years of age, and diagnosed as having neurotic depression or temporary depressive mood. They were then divided into two groups and monitored over a period of four weeks. One group were given 300mg of St John's Wort extract, three times daily, and the other group were given a placebo. All of the patients were given psychiatric evaluations before the start of the study , and after two and four weeks of treatment.
The results revealed that, after the four weeks, 67% of the Hypericum group had responded positively to the treatment without any adverse side effects whereas only 28% of the placebo group showed any signs of improvement.
The authors of the study state clearly that the study was deliberately confined to patients affected by mild forms of depression because, for those patients, the possible risks of traditional antidepressants often outweighed any expected benefits. Indeed many patients within that category were known to refuse medications because of the possible side effects. Therefore, whilst there was no evidence to suggest that Hypericum would be of any benefit to patients suffering from the more serious forms of depression, in relation to the lesser but more common forms of depression, the researchers recommend: 'Hypericum should be used as a remedy of choice'.
Harrer. G, and Sommer.H., Treatment of Mild/Moderate Depressions With Hypericum, Phytomedicine, Vol. 1, 1994, pp 3 - 8.
St John's Wort (Hypericum) beats depression The number of visits to alternative medicine practitioners in this country is estimated at 425 million, which is more than the number of visits to allopathic primary care physicians in 1990. Patients' use of St. John's Wort (SJW) has followed this sweeping trend.
The purpose of our study was to examine the reasons people choose to self-medicate with SJW instead of seeking care from a conventional health care provider.
The researchers used open-ended interviews with key questions to elicit information. Twenty-two current users of SJW (21 women; 20 white; mean age = 45 years) in a Southern city participated. All interviews were transcribed, and descriptive participant quotes were extracted by a research assistant.
Quotes were reviewed for each key question for similarities and contextual themes. Four dominant decision-making themes were consistently noted. These were:
(1) Personal Health Care Values: the patients had a history of alternative medicine use and a belief in the need for personal control of health;
(2) Mood: all SJW users reported a depressed mood and occasionally irritability, cognitive difficulties, social isolation, and hormonal mood changes;
(3) Perceptions of Seriousness of Disease and Risks of Treatment: SJW users reported the self-diagnosis of "minor" depression, high risks of prescription drugs, and a perception of safety with herbal remedies; and
(4) Accessibility Issues: subjects had barriers to and lack of knowledge of traditional health care providers and awareness of the ease of use and popularity of SJW. Also of note was the fact that some SJW users did not inform their primary care providers that they were taking the herb (6 of 22).
Users reported moderate effectiveness and few side effects of SJW. SJW users report depression, ease of access to alternative medicines, and a history of exposure to and belief in the safety of herbal remedies. Users saw little benefit to providing information about SJW to primary care physicians.
Wagner PJ, Jester D, LeClair B, Taylor AT, Woodward L, Lambert J Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500, USA. pwagner@mail.mcg.edu
Hypericum & depression - a review of the research
A comprehensive evaluation of the benefits and adverse effects of newer pharmacotherapies and herbal treatments for depressive disorders in adults and children was undertaken..
Literature published between 1980 to January 1998 was identified from a specialized registry of controlled trials, meta-analyses, and experts. The registry contained trials addressing depression that had been identified from multiple electronic bibliographic databases, hand searches of journals, and pharmaceutical companies. The search, which yielded 1,277 records, combined terms "depression," "depressive disorder," or "dysthymic disorder" with a list of 32 specific "newer" antidepressant and herbal treatments.
Randomized controlled trials were reviewed if they (1) were at least 6 weeks in duration; (2) compared a "newer" antidepressant with another antidepressant (newer or older), placebo, or psychosocial intervention; (3) involved participants with depressive disorders; and (4) had a clinical outcome. 315 trials that met these criteria.
Data was independently abstracted from each trial by two persons. The researchers looked at the response rate, total discontinuation rates (dropouts), and discontinuation rates due to adverse events. Response rates were defined as a 50 percent or greater improvement in symptoms as assessed by a depression symptoms rating scale or a rating of much or very much improved as assessed by a global assessment method.
There were 264 trials that evaluated antidepressants in patients (adults and children) with major depression. Of these, there were 14 trials evaluating hypericum (St. John's wort), and a review of these studies revealed that the herb was more effective than placebo in treating mild to moderately severe depressive disorders (risk ratio 1.9, 95% CI 1.2 to 2.8).
However, the question as to whether hypericum (St. John's wort) is as effective as standard antidepressant agents given in adequate doses was not established.
Mulrow CD, Williams JW Jr, Trivedi M, Chiquette E, Aguilar C, Cornell JE, Badgett R, Noel PH, Lawrence V, Lee S, Luther M, Ramirez G, Richardson WS, Stamm K. Treatment of depression--newer pharmacotherapies. Psychopharmacol Bull 1998;34(4):409-795
17. What are the main types of Depression?The popular media is packed with articles on different types of depression, which can be a bit confusing.
Clinical-Depression.co.uk deals mainly with what is known as 'unipolar' depression, where the sufferers symptoms are all depressive.
Manic depression Manic Depression, otherwise known as Bipolar Disorder, has a much greater biological base than normal clinical depression, although psychological interventions can still be very helpful. The manic depressive experiences extreme swings from elation and euphoria and acute depression. During the 'manic phase' they may spend recklessly and pursue wild and improbable schemes, sleeping little and often being very productive.
At the opposite 'pole', the person appears and feels lethargic, unmotivated and exhausted. In this phase the person may be unrecognizable as the same formally manic individual. The swing may take place daily or after many months at one pole.
Over time the condition often gradually becomes less severe and pronounced. Manic depression is often treated with Lithium which may be discontinued by the sufferer as he or she enters the manic phase.
Despite the more biological nature of manic depression, the information in the Clinical Learning Path will be useful, particularly the new discovery about REM sleep and depression.
Seasonal adjustment disorder ‘Seasonal Adjustment Disorder’, or ‘SAD’ is a pattern of feeling depressed during the winter months. It is most commonly treated with ‘Light Therapy’ whereby the person is exposed to strong artificial light every day until their symptoms lift. This can be continued throughout short daylight hour periods to keep the SAD away.
Postnatal depression Postnatal depression (sometimes called postpartum depression) occurs in the mother in the weeks or months following childbirth. It has long been thought that this is due to hormonal changes within the mother.
However, postnatal depression does not differ in any way to normal clinical depression. It may have more to do with a lack of adaptation to new circumstances or lack of support and social instability.
Pregnant woman who have little faith in their future abilities to provide effective care for their future babies and who feel generally ill-equipped to become mothers have a very high risk of going on to develop depression after the birth of their child.
The information in the Learning Path will be extremely useful to those suffering from, or worried about Postnatal Depression.
18. What is Clinical Depression?'Clinical Depression', as opposed to 'just' depression, is a term used to describe a collection of physical and psychological symptoms. (For every day use, they are the same thing.)
If you, or someone you know, suffers from depression, it is vital that you understand what it is and how it works.
For that reason, we recommend that to answer this question fully, you read the
Depression Learning Path.
19. Which Therapy is Best for Depression?Whatever the therapy happens to be called, therapy for depression must incorporate the following elements:
1. A therapist who has an up-to-date and accurate clinical understanding of what depression is. (You can check this by learning yourself through the Depression Learning Path. )
2. A therapy which is time-limited, active and focused on learning skills, not personality change. 3. There should be a significant improvement in symptoms within 6 sessions, and usually earlier. 4. A therapist who you feel you can work with. There are well over 400 different types of psychotherapy on offer for clinical depression. This can be confusing to say the least.
Luckily, there has been more research into therapy for depression that any other problem, and we know exactly what works, and why.
20. Why am I depressed if my life is fine?Sometimes, feelings of depression can seem a complete mystery. Everything in life seems to be ‘in place.’ A person might have supportive friends, a good job, financial security and a loving family yet still feels unhappy or as if life is not worth living.
Regardless of a person's external circumstances, it's their internal ones that are important when it comes to depression. It is not simply enough to have pleasant experiences in life, you must be able to extract the appropriate emotional satisfaction for them to have the required effect!
If every time you achieve something, you think "Oh well, anyone could do that", or "I was just lucky", you are missing an opportunity. Although this may seem like a small thing, on an ongoing basis, and in conjunction with other depressive thinking styles, it can lead to a lack of meaning and self confidence.
Adapting to change Life circumstances can change abruptly and drastically, and it is at these times that our ability to adapt is most tested. There is a natural tendency to want things to continue the way they have been, but new circumstances require new responses, and depressive thinking patterns and the resulting emotional arousal can make it difficult to adapt.
Also, if you have faced an adverse situation for a time which resulted in your feeling depressed, you may not be able to change your 'life view' once circumstances change. Habit patterns of thought can be hard to break when you don't have a clear idea of what to do. At these times, help from a appropriately trained professional can help. (Make sure it's the right kind of help though - see the Learning Path.)
Living in the past
It is common for depressed people to dwell on past times past that were not so good. ‘Where did I go wrong? How could that have happened?" However understandable, this is often a dead-end.
Living in the past rather than the present can maintain depression even when things are currently good.
If someone is traumatized by a time which keeps resurfacing leaving residual feelings of fear then they need to find a professional who is skilled at deconditioning trauma and who understands what depression is. Life can seem as if it is meeting all of our needs but if you take a long hard look is there anything that is missing? Life can seem perfect and, even if financially secure, we still have very human needs such as working towards goals, feeling connected to others in meaningful ways, the feeling that we contribute, the feeling that we are understood on an intimate level whether by friends or a partner. A prime example of this was a man who worked very hard all his life and, at the age of fifty, retired a millionaire! He very rapidly became extremely depressed. What was missing from his ‘perfect life’ was that his very strong need to create and build something up was no longer being met.
He later got into Trans-Atlantic yacht sailing and started a charity which went from strength to strength. This met his needs and his depression lifted.
Are you overcoming your depression & thinking of coming off anti-depressants?
If so, always seek the advice of a medical practitioner first
and check out the website below How to get off psychosomatic drugs safely