As you spend more time discussing goals and challenges with your Talkspace therapist, you may have questions or are interested in learning more about specific mental health topics and conditions. The Talkspace Bookshelf offers up-to-date mental health information directly from our behavioral health team to provide a better understanding of condition origins, diagnoses, various forms a condition may take, and different treatment options. Feel free to use this resource as a starting point to open up a dialogue and pose questions for your Talkspace therapist.

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Depression is the most diagnosed mental health condition worldwide. The World Health Organization (WHO) estimates that as many as 300 million people live with depression.

Most often characterized by low mood, fatigue, and lack of motivation, depression can be highly disruptive to a person’s life, work, and relationships. High functioning depression is also relatively common and may not appear as severe as classic depression does.

Some of the most common symptoms associated with depression are:

  • Persistent feelings of sadness or feeling “low”
  • Feeling “numb”
  • Lack of energy and motivation or feeling fatigued
  • Changes in daily activity level
  • Difficulty concentrating or completing tasks
  • Greater difficulty in completing daily self-care tasks such as eating, showering, cleaning, and organizing personal spaces
  • Difficulty sleeping or changes in sleep (sleeping much more than usual)
  • Significant and/or sudden changes in weight (loss or gain)

Some individuals living with depression also experience thoughts of dying or a preoccupation with death. This may or may not include suicidal thinking or thoughts of self-harm or wishing to no longer exist.

Clinical depression comes in many forms and represents a broad range of mental health diagnoses such as:

  • Major Depressive Disorder
  • Postpartum Depression
  • Persistent Depressive Disorder (also known as Dysthymia)
  • Disruptive Mood Regulation Disorder

Major Depressive Disorder (Major Depression)

This is what most people think about when they talk about depression. Major Depressive Disorder is characterized by the symptoms listed above, such as depressed mood, changes in activity level, loss of interest or pleasure in previously enjoyed activities, difficulty concentrating, unintended loss of weight, insomnia or hypersomnia (sleeping more than usual), loss of energy, feelings of guilt or unworthiness and thoughts of death and/or suicide. Due to the individual nature of depression, symptoms can be experienced on a continuum. Some may experience mild depression, while others may live with more severe symptoms.

Postpartum Depression

To date, Postpartum Depression is not a stand-alone diagnosis and is a colloquial term used to discuss depression that is experienced by mothers who have recently given birth. Onset is typically considered to take place within 6 months to a year of birth. Postpartum depression is primarily seen as a specific subtype of Major Depression. The symptoms may closely mirror the classic signs of Major Depressive Disorder.

Persistent Depressive Disorder (also known as Dysthymia)

PDD is a diagnosis that is often thought of as “low grade depression.” It is characterized by ongoing depressive symptoms for a period of at least two years. Symptoms may include classic depression symptoms such as low energy or fatigue, changes in appetite or sleeping patterns and difficulty concentrating.

Disruptive Mood Regulation Disorder (DMDD)

Disruptive Mood Regulation Disorder, or DMDD for short, is a type of depressive disorder reserved for those between the ages of 6 and 18. The condition is characterized by outbursts that are inappropriate for the developmental level of the child and can be verbal (ex. hurling insults, screaming, cursing, etc.) and/or behavioral (physical or destructive towards people and/or property) in nature. Symptoms are observable at minimum of three months out of a year but may be present for twelve consecutive months.

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Treatments

Recommended treatments for depression often include a combination of medication and talk therapy (psychotherapy). A range of different talk therapy approaches may be helpful, depending on the person’s needs and perspective.

Medication or Pharmacotherapy

Medication is a well-established treatment for depressive disorders and often a helpful adjunct to psychotherapy. Those living with depression may want to consult with a primary care doctor, or a mental health specialist, such as a psychiatrist, to explore their best options for medication support. Typical categories of medications available in the treatment of depression may include antidepressants, anxiolytics, selective serotonin reuptake inhibitors (SSRIs), norepinephrine-dopamine reuptake inhibitors (NDRIs),and antipsychotics. Some commonly prescribed medications include fluoxetine, sertraline, citalopram, mirtazapine and bupropion.

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Therapy Approaches

Cognitive Behavioral Therapy

Much like anxiety treatment, CBT-focused therapy for depression may include problematic thinking patterns or automatic thoughts that may negatively impact a person’s daily well-being. Common to depression are feelings of guilt and/or shame. Working with a therapist to practice alternative thinking patterns may help moderate the symptoms of depression. 

Additionally, some therapists recommend the use of affirmations to build self-esteem and confidence throughout the course of therapy. While difficult at first, this practice can be helpful throughout treatment.

The behavioral aspects of therapy may include proposing changes to one’s lifestyle that will help lift depressive moods. Additionally, coping skills are developed throughout therapy to cope with difficult situations as they arise in a client’s life. Skills training and practice is often a focus in sessions. Practicing these skills may also be assigned homework between your sessions with a therapist.

Psychoeducation

Many people with undiagnosed mental health conditions may have received negative feedback from others in their life. Psychoeducation can be a profoundly helpful tool and part of therapy to help educate people on the risk factors, triggers, onset, and behavioral deficits that depression may cause. Therapists are well-equipped to provide information on symptoms, course of treatment and potential therapy outcomes. Therapists may provide hand-outs, assign reading or other media to help reinforce the education about depression and its various forms.

Interpersonal Therapy (or Family Therapy)

As previously mentioned, depression is a condition that often manifests in isolation and withdrawal from other people in an individual’s life. This can lead to a breakdown in an individual’s social network as well as a deterioration in the skills needed to develop and maintain social connections. With a therapist’s help, individuals may learn and practice new skills to reconnect with previous social connections and develop new ways of engaging with people in their lives.

This isolation is not limited just to peer relationships. Often, people with depression have difficulty managing close, intimate relationships as well such as with romantic partners or spouses and other family members like parents and siblings. Family therapy sessions can be an effective — and very helpful — part of treatment to provide education to family members about the condition itself as well as help the family heal, improve communication, and develop new ways of maintaining a connection.

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Lifestyle Changes

Changes in lifestyle are often a recommended adjunct to work in therapy. Due to depression’s nature, finding motivation to engage in healthier lifestyle practices can be particularly challenging. With a lot of patience and a graduated approach with the support of a therapist, and social network, it is possible to make significant progress in the management of depression.

Creating a daily schedule and structure is often paramount in the management of depression and may be part of Cognitive Behavioral Therapy. In addition, a change in exercise routine can be very helpful in working through daily depression, as working out has great biochemical benefits. That is, you will feel better as you get regular exercise. This can include simple exercises such as regular stretching, walking, and yoga as well as running, weight-training. and more.

Limiting alcohol intake can also have a positive effect on a person’s mood. Alcohol is a natural depressant, which means it slows down your body’s nervous system. This can exacerbate the effects of depression on the central nervous system. Additionally, post-intoxication can often include a large down swell in mood and also lead to improper self-care. Dehydration also negatively impacts the body and, thus, our mood. Limiting alcohol intake and intoxication can have a positive impact on depression. For those who have used alcohol or other substances to cope, which is not uncommon, working with a therapist to identify harm reduction and alternative ways of coping is paramount.

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Therapeutic Note

Remember your therapist is here to help you figure out the best way to address your concerns. Therapy works best when it is a collaboration between you and your therapist. It is important to be open, honest, and an active participant in this process. Talk to your therapist about your goals for therapy so that together you can come up with the best plan to achieve your goals.

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Questions You Might Have For Your Talkspace Therapist

  • How do I know the difference between being sad and being depressed?
  • Some days I feel fine and others I don’t, does that qualify as depression?
  • What if I don’t want to try medication?
  • Does depression run in families?

Sources

Association, A.P.. "Depressive Disorders." Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing, 2014. 93-114.

Association, A. P. (2014). Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing.

Organization, W. H. (n.d.). Depression Fact Sheet. Retrieved April 11, 2017