Depression is caused by a combination of factors. Often a person’s biology pre-disposes them to depression, so that when negative life events, hormone disruptions, or other events hit, the body goes towards depression as the genetic “fault line”.

The red flag for depression is consistently low energy accompanied by seeing things through a dark lens. Clinicians also look for anhedonia - trouble finding pleasure in things that you used to enjoy. Typically a person has some change in sleeping or eating, which could be either an increase or decrease. For a diagnoses of a Major Depressive Eposide, these things have to take place for at least two week. When everything feels hopeless or overwhelming, it’s possible depression is part of the picture.

Major Depressive Episode:

When most people talk about depression they are referring to a Major Depressive Episode. This means that for at least two weeks, they have had “low mood”, trouble finding pleasure in things they used to care about, and sleep and eating disturbances.

Someone who “has depression” is probably more officially diagnosed as someone who has had one or more of these episodes.

Persistent Depressive Disorder/Dysthymia:

Not all depression is episodic, though. Dysthymia is the official diagnosis when it’s been two years or more of constant, lower-grade depressive symptoms.

Post-Partum Depression:

This is more than just “baby blues”. The sharp change in hormones after having a child can result in severe mood problems. This can impact mothers for several years post-partum and is commonly overlooked.

Seasonal Depression:

For some people, lower light in fall and winter means that the brain produces less serotonin and other energizing/mood stabilizing chemicals. For these people light treatment can help.

Bipolar Depression: For some, episodes of depression exist alongside episodes of quite heightened energy and vitality, often to the point of it being too much. A skilled psychotherapist can help you to carefully look at your more energized periods to see if they might fall under this definition.

Situational Depression:

Sometimes there is something about a situation that makes a person depressed. In these cased, we would expect the depression to shift when the job, relationship, or situation is left. People often need support in changing these situations, though, because the depression can make it difficult to muster the resources to actually make that change.

Because everybody’s depression is different, the best treatment for you will be dependent on your unique situation. That’s why working with a skilled integrative psychotherapist is often helpful.

If your depression has strong cognitive elements, Cognitive Behavioral Therapy (CBT) work might be able to help you look at unrealistically negative or global thinking.

If it registers primarily through the body, support through behavioral activation (a fancy term for slowly starting to do more stuff) can help the dopamine system to re-calibrate. A skilled body-based therapist can also help you to look at issues like diet and sleep schedule to see what adjustments might be easily made without feeling overwhelming.

A skilled therapist can also help you to notice and understand if there are behavior patterns that keep you stuck in depression.

Oh my yes. It may not seem like it based on the vantage point you have right now, but many people after successfully dealing with their depression report that depression treatment was an important part of their lives. They sometimes find that losing access to resources like feeling connected with others, feeling a sense of meaning and purpose, and having the energy to take good care of yourself can inform your understanding of how important those things actually are.