Depression Disorders Treated with Cognitive Behavior Therapy CBT at New York Behavioral Health
Definition of Depression
Depression is a condition that affects feelings, thoughts, and behaviors. Symptoms vary but can include depressed mood, fatigue, inability to concentrate, heavy arms and legs, feelings of worthlessness, guilt, anxiety, insomnia, trouble getting out of bed, hopelessness, anhedonia (nothing is fun or pleasurable), changes in appetite, sex drive, or weight.
The American Psychiatric Association classifies Major Depressive Disorder as a Mood Disorder in the DSM-IV-TR. Other mood disorders include Dysthymic Disorder, Cyclothymic Disorder, and Bipolar Disorder (manic-depression). To receive the diagnosis of Major Depressive Disorder, depressed mood or the loss of interest in pleasurable activities would need to be present, plus at least four of the following symptoms:
1) weight loss (not due to intentional dieting), weight gain, or a significant increase or decrease in appetite
2) difficulty sleeping (insomnia), daytime sleepiness, or prolonged nighttime sleep periods (exceeding 10 hours, or significantly more than typical sleep patterns)
3) psychomotor agitation or retardation, a.k.a., people’s level of motor activity has increased, or slowed down (e.g., restlessness, or moving very slowly, as if sick)
4) general fatigue or decreased energy levels, feeling tired
5) inability to concentrate or make decisions
6) ruminating about death or suicide
These symptoms need to be present for at least two weeks and a number of other potential diagnoses need to be ruled out, therefore, a diagnosis should only be made by a qualified mental health professional (e.g., licensed psychologist or psychiatrist)
Evidence suggests that there are biological predispositions to Major Depression. It is more common in close relatives, even when controlling for potential learning patterns, i.e., a mother models depressive behaviors or communication patterns. Many biological causes have been posited, e.g., insufficient amounts of particular neurotransmitters like serotonin, norepinephrine, or dopamine in various brain regions or an overabundance of cortisol, cytokines, and other related stress-related hormones. Cognitive Behavioral (learned) theories have also been used to explain the origins of depression. Beck’s cognitive theory proposes three crucial variables in the development and maintenance of depression, the negative triad. These are cognitive distortions about the self, world, and the future. Ellis’ theory of emotional disturbance holds that global evaluations of worth, such as “I am a failure,” or “Life is miserable,” may be the root cause of depression. Seligman’s depressive explanation focuses on one’s sense of control or a history of learned helplessness. Stressful life events surrounding loss may also trigger a depressive episode. In particular themes of interpersonal loss, lack of control, or meaning may be related to depression.
Treatment should always be determined by a professional (licensed psychologist, psychiatrist, licensed social worker, or licensed mental health counselor). Depression has been successfully treated by cognitive behavioral therapies, psychopharmacological treatments, interpersonal psychotherapy, and exercise. Although it is imperative for an accurate diagnosis and treatment plan to be developed with a clinician, not through self-treatment. The majority of depressed people begin to “feel better” within a few meetings with a properly trained psychologist and may have symptom reduction in as little as eight to 12 weeks. There is evidence that relapse rates may be reduced by particular kinds of treatment.