Depression in a nutshellUnderstanding how and why depression is affecting you is the best way to plan the most effective strategies for tackling it. This page shows the framework a counsellor or psychologist might use to help someone understand their depression better and plan appropriate ways forward.
Summarising the symptoms, triggers and vulnerability factors relevant to the individual allows better planning of the most effective short and long-term strategies for tackling depression:
1. Daily functioning
Because depression tends to intensify itself in a self-reinforcing spiral, even a seemingly ‘trivial’ triggering event can quickly set off a range of negative effects in the person’s life which in turn contribute to the downward spiral. Check out the pattern of these effects over a significant recent period and look out for signs in the following areas:
- Disruption to basic daily habits such as sleep patterns, appetite and weight, sexual function and general activity levels.
- General moods, particularly persistently sad, anxious, angry and empty moods.
- Thought patterns – a noticeable increase in negative thoughts, guilt, self-blame, or even suicidal thinking.
- Difficulty engaging with work, daily tasks and leisure activities; problems with concentration.
- Withdrawal from relationships or social activities, increasing social isolation.
Depression does not always have an obvious recent ’cause’, but in many cases it is possible to identify recent circumstances which may have played a role in setting off the downward spiral, such as:
- Experiencing of a traumatic event or loss, such as a bereavement or relationship break up, which has temporarily overwhelmed the person’s ability to cope.
- A major change in circumstances, or difficulty adapting to new circumstances.
- Recent experiences of failure or the fear of failure (as defined by values important in that person’s life).
- Illness or other reason for a period of inactivity or withdrawal from engagement in purposeful tasks.
3. Vulnerability factors
Instead of only looking at present triggers it is important to understand the range of possible biological, psychological and social factors which may be relevant in having created a vulnerability to depression. For example:
- Inheriting a biological vulnerability to depression.
- Difficult childhood experiences or general life circumstances putting strain on the person’s general coping resources.
- Social isolation or lack of social support.
- Difficulty finding a sense of meaning or purpose within the person’s cultural value system.
- Long-standing habits of pessimism, low self-worth and negativity.
4. Useful immediate strategies
Identifying the specific ways in which depression is affecting daily functioning provides a useful starting point to decide on appropriate strategies for tackling it. In general, the most useful immediate strategies for tackling depression are the simplest ones (see ‘Self help first steps’ and ‘Healthier daily routines’ for more on this):
- Getting going with raising activity levels in small steps – trying to do a bit more of some of the activities you used to enjoy
- Focusing outward and setting small, manageable tasks to give yourself an increasing sense of achievement.
- Attending to basic sleep and food needs and working on taking better care of yourself.
- Tackling isolation by increasing social contact and building support networks.
5. Longer-term strategies
Once issues of basic daily functioning have been tackled, longer-term strategies can be planned to deal with the specific vulnerabilities and triggers identified. These longer-term strategies might include:
- The core strategy of challenging the habits of depressed thinking with which depression maintains its hold, especially through learning greater self-compassion.
- Addressing the physiological effects of depression with a course of antidepressant medication.
- Learning techniques to better manage stress levels.
- Consolidating self-care habits and a healthier lifestyle, with regular exercise, good sleep hygiene and healthy eating.
- Identifying areas for personal development and practising positive habits such as mindfulness and assertive communication
- Getting therapeutic support/counselling to address and heal childhood experiences which may have created vulnerability to depression
Applying the framework to yourself and others
You can use this framework as an important step in planning how to tackle your own depression (see ‘Understanding your depression’). It is also useful when reading the student stories on this site (see it applied to Anna’s story in ‘Learning from others’). The student stories offer an important way of gaining a wider understanding of depression. The next section also provides other ideas for a more critical understanding of depression.