A look into mood issues

Mertha Mo Nyamande

DEPRESSION is one of the most common of all mental disorders, alongside anxiety.

It is present in other disorders as it appears when one feels hopeless and helpless.

So, one could have anxiety or schizophrenia. Those affected may not necessarily know what it is they may be struggling with. However, with whatever they are going through not going away, or seemingly getting worse and not getting under control, depression sets in.

This is also witnessed in chronic physical health presentations, especially where pain is a feature. We have to pay attention to those who have chronic pain or any other long-term issues and those who may have to look after chronically ill family members.

In medicine, psychiatrists often speak of depression in two forms:

Reactive depression. It arises after the occurrence of something terrible, for example, loss of a job or the death of a loved one — a parent or a child.

Endogenous depression. This is more complex for most people. They may have everything that money can buy — a great job, a mansion and a fleet of cars — but still feel low and unable to shake it regardless of how hard they try.

Naturally, these two forms of depression are treated differently.

Reactive depression

It subsides with time and through support. This is referred to as watchful waiting. Good and strong social support networks can help this type of depression go away, often without any formal treatment.

This is the type that bereaved people go through, the type that Elizabeth Kubler-Ross describes in her “Grief Cycle”.

When something tragic happens in life, normally, we feel low and may struggle to understand why, but with time and support, we learn to come to terms with the change. We then adjust and move on.

In circumstances where our attachments to whatever we have lost were extremely strong, we may also need some counselling to allow us to vent our thoughts and feelings to someone who does not judge us, and to allow us to let out our frustrations about the loss.

Endogenous depression

This is usually linked to deep-rooted and unresolved psychological issues that may have happened much earlier in our lives.

Examples are things we may feel guilty or ashamed of, and keep as secrets. They are issues we would rather take to the grave, but without realising how these things hold us back and prevent us from living our lives to the full and achieving our full potential.

These things also affect those we love and care about, as they can sense that something is wrong and may also feel hopeless and helpless.

Endogenous is a medical term that essentially suggests depression has no known cause.

However, in psychology, particularly psychodynamics, we establish that there is nothing without a cause. We, therefore, excavate until we find the root cause of the problem.

While many people may have struggled to recover from depression for many years with the use of different forms and doses of antidepressant medications, they may find that talking therapy becomes more effective in helping them to find the patterns in their thinking that maintain their depression.

These patterns are what can help them to establish the root cause of their depression.

Naturally, when you know the problem, the solution becomes much easier to establish.

So, psychotherapy helps to explore emotional blocks, and once we have established the root cause, most people can find their own solutions. However, others may require further support to experiment with new behaviours to arrive at the emotion they desire.

At times, they may not even remember what being happy feels like. This is particularly so when they have not been truly happy for a long time. Thus, they may actually struggle to accept this new good feeling, and know what to do with all the time they may have spent worrying and depressed.

Core skills like behavioural activation, getting out and about to do things that bring joy and use up pent-up energy, and thought challenging — retraining thought processes to utilise new pathways — may require numerous sessions to reinforce these new habits.

All emotions are essentially energy one needs to know how to utilise, and how to respond to whatever challenges.

Therefore, problem solving or solution-focused concepts become very helpful in such circumstances. Reach out, we can help.

Mertha Mo Nyamande is a psychotherapist. He can be contacted on: [email protected] or @ www.i-wellbeing.weebly.com