Going DEEP:
UNIPOLAR DEPRESSION SYMPTOMS OF UNIPOLAR DEPRESSION
UNIPOLAR DEPRESSION SYMPTOMS OF UNIPOLAR DEPRESSION
Depression is widely regarded as a disorder of mood, but this is an oversimplification.
There are actually four sets of symptoms in depression. In addition
to mood symptoms, there are thought symptoms, motivational
symptoms, and physical symptoms. An individual does not have to have all
these symptoms to be correctly diagnosed "depressed," but the more symptoms
he has and the more intense is each set, the more confident we can be
that the individual is suffering from depression.
Mood or Emotional Symptoms
When a depressed patient is asked how she feels, the most common adjectives
she uses are: "sad, blue, miserable, helpless, hopeless, lonely, unhappy,
downhearted, worthless, humiliated, ashamed, worried, useless, guilty."
Sadness is the most salient and widespread emotional symptom in depression.
One person's life was so dominated by sadness that she cried during
almost all her waking hours. She was unable to carry on a social
conversation because of excessive crying. This occurred even in therapy to
such an extent that almost no therapy was taking place (Beck et al., 1979).
This melancholic mood varies with time of day. Most commonly, depressed
people feel worse in the morning, and the mood seems to lighten a bit as the
day goes on. Along with feelings of sadness, feelings of anxiety are very often
present in depression (Gersh and Fowles, 1979).
Almost as pervasive as sadness in depression is loss of gratification, the
numbing of the joy of living. Activities that used to bring satisfaction feel
dull and flat. Loss of interest usually starts in only a few activities, such as
work. But as depression increases in severity, it spreads through practically
everything the individual does. The pleasure derived from hobbies, recreation,
and family diminishes. Gregarious individuals who used to enjoy
party going avoid social gatherings. Finally, even biological functions, such
as eating and sex, lose their appeal. Ninety-two percent of depressed patients
no longer derive gratification from some major interests in their life, and 64
percent of depressed patients lose their feeling for other people (Beck, 1967).
Thought Symptoms
A depressed person thinks of himself in a very negative light. He has low
self-esteem and views the future as being hopeless.
NEGATIVE VIEW OF THE SELF
A depressed individual often has low self-esteem. He believes he has failed and that he is the cause of his own failures.
He believes he is inferior, inadequate, and incompetent. He believes
that he lacks the qualities necessary to succeed in those areas of his life that
are important to him, be they intelligence, attractiveness, wealth, health, or
talent. These views of failure and incompetence are often distortions.
One patient managed to wallpaper a kitchen although very depressed.
MEASURING DEPRESSIVE SYMPTOMS
Aaron T. Beck of the University of Pennsylvania has developed the most widely
used inventory of depressive symptoms. Each of the questions describes one of
the symptoms of depression, and each question provides a severity score of 0
through 3 for that symptom. The person circles the answer that best describes how he or she feels right now. The symptoms divide into mood, thought, motivational, and physical sets. The statements below show responses to eight of the twenty one in the Beck Depression Inventory.
This test is designed, not as a way of diagnosing depression, but as a way of
knowing how many symptoms are present and how severe they are once depression is clinically diagnosed. A high score alone is not diagnostic of clinical depression or mental illness. Generally speaking, research has shown that the average score (for the total of the numbers from the eight questions) in a North American college population is about 3 or 4, and students who score below this can be considered non-depressed. Mildly depressed students typically have scores from about 5 to 9, and scores of 10 or higher suggest moderate to severe depression.
If an individual scores 10 or more for a period of one or two weeks, it would probably be in his best interest to seek help. If he has serious or persistent thoughts of suicide, regardless of his total score, it is imperative that he seek aid.
For a depressed individual, making a decision may be overwhelming and
frightening. Every decision seems momentous, of make or break significance,
and the fear of the wrong decision can be paralyzing.
Physical Symptoms
Perhaps the most insidious set of symptoms in depression are the physical
changes. As depression worsens, every biological and psychological joy that
makes life worth living is eroded.
This passivity or lack of response initiation undermines working
and loving. An advertising executive loses his initiative in planning a major
sales campaign; a college professor cannot bring herself to prepare her lectures;
a student loses the desire to study.
One depressed man who was hospitalized after a suicide attempt merely
sat motionless day after day in the lounge. His therapist decided to prepare a
schedule of activities to get the patient engaged:
THERAPIST: I understand that you spend most of your day in the lounge. Is that
true?
PATIENT: Yes, being quiet gives me the peace of mind I need.
THERAPIST: When you sit here, how's your mood?
PATIENT: I feel awful all the time. I just wish I could fall in a hole somewhere
and die.
THERAPIST: Do you feel better after sitting for two or three hours?
PATIENT: No, the same.
THERAPIST: SO you're sitting in the hope that you'll find peace of mind, but it
doesn't sound like your depression improves.
PATIENT: I get so bored.
THERAPIST: Would you consider being more active? There are a number of
Reasons why I think increasing your activity level might help.
PA TIENT: There's nothing to do around here.
THERAPIST: Would you consider trying some activities if you could come up with a list?
PATlENT: If you think it will help, but I think you're wasting your time. I don't
have any interests. (Becket al., 1979)
~~~~~~~~~~~~~~~~~~~~
In extreme form, lack of response initiation is "paralysis of the will." Such
a patient cannot bring himself to do even those things that are necessary to
life. He has to be pushed and prodded out of bed, clothed, and fed. In severe
depression, there may be psychomotor retardation in which movements
slow down and the patient walks and talks excruciatingly slowly.
Lack of response initiation in depression has been seen clearly in the laboratory.
Depressed college students fail to escape loud noise when performing
tasks in which all that is required to turn off the noise is moving the hand
two feet. This lack of response initiation occurs not only in instrumental
motor behavior but also in cognitive tasks as well. Depressed students and
depressed patients fail to solve anagrams that non depressed individuals
solve readily. The more depressed an individual is, the more severe are these
deficits (Miller and Seligman, 1975, 1976; Price, Tryon, and Raps, 1978).
Difficulty in making a decision also seems to be a common symptom of
depression (Hammen and Padesky, 1977). The following case illustrates
how indecisiveness can overwhelm a depressed individual:
Sylvia is a very bright college student whose life is being ruined by her depression.
She finds it increasingly difficult to get on with routine studying because she
can't take the initial steps. Now a major life decision has paralyzed her for the last
three weeks. She has been accepted to two good graduate schools and has to make up her mind which to accept. One school offers a large scholarship, the other is more prestigious. She constantly ruminates over being selfish if she chooses the prestigious one without money, versus the coward lines of giving in to her parents by choosing the other. Sylvia has managed to turn a can't-lose situation into a can't-win situation. (After Becket al., 1979.)
Loss of appetite is common...
A gourmet finds that food does not taste
good to her anymore. Weight loss occurs in moderate and severe depression,
although in mild depression weight gain sometimes occurs. Sleep disturbance
occurs as well. Depressed individuals may experience trouble getting
to sleep at night, or they may experience early morning awakening, with
great difficulty getting back to sleep for the rest of the night. Sleep disturbance
and weight loss both lead to weakness and fatigue. A depressed individual
also may lose interest in sex. Erectile difficulties in men and lack of
arousal in women are common side effects of depression.
Self-absorbed
A depressed individual is often self-absorbed and focused on the present.
His body absorbs his attention, and increased worry about aches and pains
can occur. In addition to more worrying about health, depressed individuals
may, in fact, be more susceptible to physical illness, since depression, as it
becomes severe, may erode basic biological drives. For example, when a flu
swept through an army base, those individuals who had been depressed took
significantly longer to recover (Imboden, Cantor, and Cluff, 1961).
There are actually four sets of symptoms in depression. In addition
to mood symptoms, there are thought symptoms, motivational
symptoms, and physical symptoms. An individual does not have to have all
these symptoms to be correctly diagnosed "depressed," but the more symptoms
he has and the more intense is each set, the more confident we can be
that the individual is suffering from depression.
Mood or Emotional Symptoms
When a depressed patient is asked how she feels, the most common adjectives
she uses are: "sad, blue, miserable, helpless, hopeless, lonely, unhappy,
downhearted, worthless, humiliated, ashamed, worried, useless, guilty."
Sadness is the most salient and widespread emotional symptom in depression.
One person's life was so dominated by sadness that she cried during
almost all her waking hours. She was unable to carry on a social
conversation because of excessive crying. This occurred even in therapy to
such an extent that almost no therapy was taking place (Beck et al., 1979).
This melancholic mood varies with time of day. Most commonly, depressed
people feel worse in the morning, and the mood seems to lighten a bit as the
day goes on. Along with feelings of sadness, feelings of anxiety are very often
present in depression (Gersh and Fowles, 1979).
Almost as pervasive as sadness in depression is loss of gratification, the
numbing of the joy of living. Activities that used to bring satisfaction feel
dull and flat. Loss of interest usually starts in only a few activities, such as
work. But as depression increases in severity, it spreads through practically
everything the individual does. The pleasure derived from hobbies, recreation,
and family diminishes. Gregarious individuals who used to enjoy
party going avoid social gatherings. Finally, even biological functions, such
as eating and sex, lose their appeal. Ninety-two percent of depressed patients
no longer derive gratification from some major interests in their life, and 64
percent of depressed patients lose their feeling for other people (Beck, 1967).
Thought Symptoms
A depressed person thinks of himself in a very negative light. He has low
self-esteem and views the future as being hopeless.
NEGATIVE VIEW OF THE SELF
A depressed individual often has low self-esteem. He believes he has failed and that he is the cause of his own failures.
He believes he is inferior, inadequate, and incompetent. He believes
that he lacks the qualities necessary to succeed in those areas of his life that
are important to him, be they intelligence, attractiveness, wealth, health, or
talent. These views of failure and incompetence are often distortions.
One patient managed to wallpaper a kitchen although very depressed.
MEASURING DEPRESSIVE SYMPTOMS
Aaron T. Beck of the University of Pennsylvania has developed the most widely
used inventory of depressive symptoms. Each of the questions describes one of
the symptoms of depression, and each question provides a severity score of 0
through 3 for that symptom. The person circles the answer that best describes how he or she feels right now. The symptoms divide into mood, thought, motivational, and physical sets. The statements below show responses to eight of the twenty one in the Beck Depression Inventory.
This test is designed, not as a way of diagnosing depression, but as a way of
knowing how many symptoms are present and how severe they are once depression is clinically diagnosed. A high score alone is not diagnostic of clinical depression or mental illness. Generally speaking, research has shown that the average score (for the total of the numbers from the eight questions) in a North American college population is about 3 or 4, and students who score below this can be considered non-depressed. Mildly depressed students typically have scores from about 5 to 9, and scores of 10 or higher suggest moderate to severe depression.
If an individual scores 10 or more for a period of one or two weeks, it would probably be in his best interest to seek help. If he has serious or persistent thoughts of suicide, regardless of his total score, it is imperative that he seek aid.
For a depressed individual, making a decision may be overwhelming and
frightening. Every decision seems momentous, of make or break significance,
and the fear of the wrong decision can be paralyzing.
Physical Symptoms
Perhaps the most insidious set of symptoms in depression are the physical
changes. As depression worsens, every biological and psychological joy that
makes life worth living is eroded.
This passivity or lack of response initiation undermines working
and loving. An advertising executive loses his initiative in planning a major
sales campaign; a college professor cannot bring herself to prepare her lectures;
a student loses the desire to study.
One depressed man who was hospitalized after a suicide attempt merely
sat motionless day after day in the lounge. His therapist decided to prepare a
schedule of activities to get the patient engaged:
THERAPIST: I understand that you spend most of your day in the lounge. Is that
true?
PATIENT: Yes, being quiet gives me the peace of mind I need.
THERAPIST: When you sit here, how's your mood?
PATIENT: I feel awful all the time. I just wish I could fall in a hole somewhere
and die.
THERAPIST: Do you feel better after sitting for two or three hours?
PATIENT: No, the same.
THERAPIST: SO you're sitting in the hope that you'll find peace of mind, but it
doesn't sound like your depression improves.
PATIENT: I get so bored.
THERAPIST: Would you consider being more active? There are a number of
Reasons why I think increasing your activity level might help.
PA TIENT: There's nothing to do around here.
THERAPIST: Would you consider trying some activities if you could come up with a list?
PATlENT: If you think it will help, but I think you're wasting your time. I don't
have any interests. (Becket al., 1979)
~~~~~~~~~~~~~~~~~~~~
In extreme form, lack of response initiation is "paralysis of the will." Such
a patient cannot bring himself to do even those things that are necessary to
life. He has to be pushed and prodded out of bed, clothed, and fed. In severe
depression, there may be psychomotor retardation in which movements
slow down and the patient walks and talks excruciatingly slowly.
Lack of response initiation in depression has been seen clearly in the laboratory.
Depressed college students fail to escape loud noise when performing
tasks in which all that is required to turn off the noise is moving the hand
two feet. This lack of response initiation occurs not only in instrumental
motor behavior but also in cognitive tasks as well. Depressed students and
depressed patients fail to solve anagrams that non depressed individuals
solve readily. The more depressed an individual is, the more severe are these
deficits (Miller and Seligman, 1975, 1976; Price, Tryon, and Raps, 1978).
Difficulty in making a decision also seems to be a common symptom of
depression (Hammen and Padesky, 1977). The following case illustrates
how indecisiveness can overwhelm a depressed individual:
Sylvia is a very bright college student whose life is being ruined by her depression.
She finds it increasingly difficult to get on with routine studying because she
can't take the initial steps. Now a major life decision has paralyzed her for the last
three weeks. She has been accepted to two good graduate schools and has to make up her mind which to accept. One school offers a large scholarship, the other is more prestigious. She constantly ruminates over being selfish if she chooses the prestigious one without money, versus the coward lines of giving in to her parents by choosing the other. Sylvia has managed to turn a can't-lose situation into a can't-win situation. (After Becket al., 1979.)
Loss of appetite is common...
A gourmet finds that food does not taste
good to her anymore. Weight loss occurs in moderate and severe depression,
although in mild depression weight gain sometimes occurs. Sleep disturbance
occurs as well. Depressed individuals may experience trouble getting
to sleep at night, or they may experience early morning awakening, with
great difficulty getting back to sleep for the rest of the night. Sleep disturbance
and weight loss both lead to weakness and fatigue. A depressed individual
also may lose interest in sex. Erectile difficulties in men and lack of
arousal in women are common side effects of depression.
Self-absorbed
A depressed individual is often self-absorbed and focused on the present.
His body absorbs his attention, and increased worry about aches and pains
can occur. In addition to more worrying about health, depressed individuals
may, in fact, be more susceptible to physical illness, since depression, as it
becomes severe, may erode basic biological drives. For example, when a flu
swept through an army base, those individuals who had been depressed took
significantly longer to recover (Imboden, Cantor, and Cluff, 1961).
Post-Traumatic Stress Disorder (PTSD)
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
For the Therapy I recommend click here:
The Liberator Method
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
For the Therapy I recommend click here:
The Liberator Method