Depression

• Depression is characterised by low mood and low levels of energy.

  It belongs to the category of mood disorders in the DSM-5.
• What are the behavioural characteristics of depression?


  Activity levels.

  Disruption to sleep and eating behaviour.

  Aggression and self-harm.
• Activity levels:

  Typically sufferers of depression have reduced levels of energy, making them lethargic.

  This has a knock-on effect, with sufferers tending to withdraw from work, education and social life. In extreme cases this can be so severe that the sufferer cannot get out of bed.

  In some cases depression can lead to the opposite effect- known as psychomotor agitation. Agitated individuals struggle to relax and may end up pacing and down a room.
• Disruption to sleep and eating behaviour:

  Depression is associated with changes to sleeping behaviour. Sufferers may experience reduced sleep(insomnia), particularly premature waking, or an increased need for sleep(hypersomnia).

  Similarly, appetite and eating may increase or decrease, leading to weight gain or loss.

  Key point is that such behaviours are disrupted by depression.
• Aggression and self-harm:

  Sufferers of depression are often irritable, and in some cases they can become verbally or physically aggressive.

  This can have serious knock-on effects on a number of aspects of their life.

  For example, someone experiencing depression might display verbal aggression by ending a relationship or quitting a job.

  Depression can also lead to physical aggression directed against the self.

  This includes self harm, often in the form of cutting or suicide attempts.
• What are the emotional characteristics of depression?


  Lowered Self Esteem.

  Anger.

  Lowered Mood.
• Lowered Self Esteem:

  Self Esteem is the emotional experience of how much we like ourselves.

  Sufferers of depression tend to report reduced self esteem, in other words, they like themselves less than usual.

  This can be quite extreme, with some sufferers of depression describing a sense of sense loathing i.e. hating themselves.
• Anger:

  Although sufferers tend to experience more negative emotions and fewer positive ones during episodes of depression, this experience of negative emotion is not limited to sadness.

  Sufferers of depression also frequently experience anger, sometimes extreme anger.

  This can be directed at the self or others.

  On occasion such emotions lead to aggressive or self-harming behaviour.
• Lowered Mood:

  When we use the word 'depressed' in everyday life we are usually describing having a lowered mood, in other words feeling sad.

  Lowered mood is still a defining element of depression but it is more pronounced than in the daily kind of experience of feeling lethargic and sad.

  Patients often describe themselves as 'worthless' and 'empty'.
• What are the cognitive characteristics of depression?


  Poor concentration.

  Absolutist thinking.

  Attending to and dwelling on the negative.
• Poor concentration:

  Depression is associated with poor levels of concentration.

  The sufferer may find themselves unable to stick to a task as they usually would, or they might find it hard to make decisions that they would normally find straightforward.

  Poor concentration and poor decision making are likely to interfere with the individual's work.
• Absolutist thinking:

  Most situations are not all-good or all-bad, but when a sufferer is depressed they tend to think in these terms.

  They sometimes call this 'black and white thinking',

  This means that when a situation is unfortunate they tend to see it as an absolute disaster.
• Attending to and dwelling on the negative:

  When suffering a depressive episode people are inclined to pay more attention to negative aspects of a situation and ignore the positives.

  In other words they tend to see a glass as half empty rather than half full.

  Sufferers also have a bias towards recalling unhappy events rather than happy events- the opposite bias that most people have when not depressed.
• Depression is recognised as a mood disorder in the DSM-5