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Depression is one of the most common psychological problems in modern Britain. It's also on the increase. More people are seeking professional help because of depressive illnesses than ever before. This handout describes some of the more common symptoms of depression and suggests ways to combat them. These symptoms can be both cognitive (what we think) and physiological (physical changes in the body). It's important to tackle both sets of symptoms in order to successfully overcome depression.

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Physiological Symptoms of Depression

Many depressed people can actually feel a change in their bodies. For some it is a churning feeling, particularly in agitated depression. Others experience a sensation of heaviness with lethargy and even physical pain. Some have difficulty digesting food.

Which is one reason for the appetite disturbance which is a very common feature of depressive illness. Others have difficulty sleeping.

One thing common to almost every form of depressive illness is treatability. The approach may vary depending upon the nature and severity of the illness but the prognosis is usually excellent – so long as the sufferers are prepared to take an active part in their own treatment. In fact most types of therapy are based upon the client's own choices and participation. Even those which begin with little more than medication usually lead up to active client participation. The more the depressed person does to help themselves the greater the chances of continued success.

Cognitive Symptoms of Depression

The cognitive or psychological symptoms of depression – what we think about are just as important as the physiological ones. Some people believe that psychological symptoms are more important but this is not necessarily true. After all there is no such thing as the 'mind/body split'. Actually they are one and the same –just two sides of the same coin. That's why we need to consider both.

Depressed people tend to think in a particular way. They tell themselves the same sort of gloomy, pessimistic things over and over again. This is what psychologists call negative thinking. After a while this pattern of thinking becomes a habit. When that happens it is described as automatic negative thinking. This habit formation is one of the most damaging aspects of depression as it locks the sufferer into a downward spiral which drags them deeper and deeper into despair. Later we'll consider ways of breaking the cycle but for now It's enough simply to recognize some of the more common thought patterns and the effect they have on depressive behavior.

1. THINGS WILL NEVER GET ANY BETTER

   If we believe this then we also believe that there's no point in trying to improve things. This one thought stops depressed people from joining in with their treatment plans. These people become lethargic and apathetic. Not the most helpful start to recovery.

2. PEOPLE WOULD BE BETTER OFF WITHOUT ME

   It's not difficult to see where this thought pattern is leading. Many depressed people are so convinced of their own worthlessness that they come to see themselves as nothing more than a burden to others. This idea can lead to withdrawal, social isolation, shame and even self harm or suicide. Once again this is not a helpful way to think about oneself.

3. I CAN't HELP BEING DEPRESSED AFTER WHAT I'VE BEEN THROUGH

   This is a remarkably common depressive thought. It also seems quite reasonable at first glance. People who've been through difficult times are almost expected to become depressed. The problem is that such a belief system takes away the individual's choices. If you believe depression is inevitable you won't really struggle against it and so you won't change it until you believe you've suffered enough.

   Some people 'wear' their depression like a badge. It's as though they think they've earned it and no one's going to take it away from them. Of course It's true that they have a perfect right to feel as depressed as they like for as long as they like. The question is – why would they want to?

4. DEPRESSION RUNS IN MY FAMILY – It's GENETIC

   This attitude is called determinism. That's the idea that people are helpless victims of fate. They believe that because their parents suffered from depression they also must. Of course It's true that depressive illness does often run in families but that's not always because of genetics. Sometimes It's simply because of the coping skills we learn from our parents. Skills which can be unlearned or altered – often with surprisingly little effort. Even those cases where the problem does appear to be genetic can be helped considerably once they let go of their deterministic attitudes. Any thought which implies helplessness is deterministic and extremely damaging.

There are many more depressive thoughts – too many to cover in this handout. However people who recognize themselves and their own style of thinking in the paragraphs above may well benefit from the wide range of 'talking cures' available.