According to the National Institute of Mental
Health, an estimated 17 million adult Americans suffer from
depression during any one year period. Many do not even recognize
that they have a condition that can be treated very effectively.
This question-and-answer fact sheet discusses depression with
focus on ways in which psychotherapy can help a depressed
How does depression differ
from occasional sadness?
Everyone feels sad or "blue" on occasion. Most
people grieve over upsetting life experiences such as a major
illness, loss of job, a death in the family, or divorce. These
feelings of grief tend to become less intense on their own
as time goes on.
Depression occurs when feelings of extreme sadness
or despair last for at least two weeks or longer and when
they interfere with activities of daily living-such as working
or even eating and sleeping. Depressed individuals tend to
feel helpless and hopeless and to blame themselves for having
these feelings. Some may have thought of death or suicide.
People who are depressed may become overwhelmed
and exhausted and stop participating in certain everyday activities
altogether. They may withdraw from family and friends.
What causes depression?
Changes in the body's chemistry influence mood
and thought processes, and biological factors contribute to
some cases of depression. In addition, chronic and serious
illness such as heart disease or cancer may be accompanied
by depression. With many individuals, however, depression
signals first and foremost that certain mental and emotional
aspects of a person's life are out of balance.
Significant transitions and major life stressors
such as the death of a loved one or the loss of a job can
help bring about depression. Other more subtle factors that
lead to a loss of identity or self-esteem may also contribute.
The causes of depression are not always immediately apparent,
so the disorder requires careful evaluation and diagnosis
by a trained mental health care professional.
Sometimes the circumstances involved in depression
are ones over which an individual has little or no control.
At other times, however, depression occurs when people are
unable to see that they actually have choices and can bring
about change in their lives.
Can depression be treated
Absolutely. Depression is highly treatable when
an individual receives competent care. Psychologists are among
the licensed and highly trained mental health providers with
years of experience studying depression and helping patients
recover from it.
There is still some stigma, or reluctance, associated
with seeking help for emotional and mental problems, including
depression. Unfortunately, feelings of depression often are
viewed as a sign of weakness rather than as a signal that
something is out of balance. The fact is that people with
depression can not simply "snap out of it" and feel better
Persons with depression who do not seek help
suffer needlessly. Unexpressed feelings and concerns accompanied
by a sense of isolation can worsen a depression. The importance
of obtaining quality professional health care can not be overemphasized.
How does psychotherapy
help people recover from depression?
There are several approaches to psychotherapy-including
cognitive-behavioral, interpersonal, psychodynamic, and other
kinds of "talk therapy"-that help depressed individuals recover.
Psychotherapy offers people the opportunity to identify the
factors that contribute to their depression and to deal effectively
with the psychological, behavioral, interpersonal, and situational
causes. Skilled therapists such as licensed psychologists
can work with depressed individuals to:
- pinpoint the life
problems that contribute to their depression and help
them understand which aspects of those problems they may
be able to solve or improve. A trained therapist can help
depressed patients identify options for the future and
set realistic goals that enable these individuals to enhance
their mental and emotional well-being. Therapists also
help individuals identify how they have successfully dealt
with similar feelings, if they have been depressed in
- identify negative or distorted
thinking patterns that contribute to feelings of hopelessness
and helplessness that accompany depression. For example,
depressed individuals may tend to overgeneralize, that
is, to think of circumstances in terms of "always" or
"never.". They may also take events personally. A trained
and competent therapist can help nurture a more positive
outlook on life.
- explore other learned thoughts
and behaviors that create problems and contribute to depression.
For example, therapists can help depressed individuals
understand and improve patterns of interacting with other
people that contribute to their depression.
- help people regain a sense of
control and pleasure in life. Psychotherapy helps people
see choices as well as gradually incorporate enjoyable,
fulfilling activities back into their lives.
- Having one episode of depression greatly increase
the risk of having another episode. There is some evidence
that ongoing psychotherapy may lessen the chance of future
episodes or reduce their intensity. Through therapy, people
can learn skills to avoid unnecessary suffering from later
bouts of depression.
The support and involvement of family and friends
can play a crucial role in helping someone who is depressed.
Individuals in the "support system" can help by encouraging
a depressed loved one to stick with treatment and to practice
the coping techniques and problem-solving skills he or she
is learning through psychotherapy.
Living with a depressed person can be very difficult
and stressful on family members and friends. The pain of watching
a loved one suffer from depression can bring about feelings
of helplessness and loss. Family or marital therapy may be
beneficial in bringing together all the individuals affected
by depression and helping them learn effective ways to cope
together. This type of psychotherapy can also provide a good
opportunity for individuals who have never experienced depression
themselves to learn more about it and to identify constructive
ways of supporting a loved one who is suffering from depression.
Medications can be very helpful for reducing
the symptoms of depression in some people, particularly for
cases of moderate to severe depression. Some health care providers
treating depression may favor using a combination of psychotherapy
and medications. Given the side effects, any use of medication
requires close monitoring by the physician who prescribes
Some depressed individuals may prefer psychotherapy
to the use of medications, especially if their depression
is not severe. By conducting a thorough assessment, a licensed
and trained mental health professional can help make recommendations
about an effective course of treatment for an individual's