Depression and Anxiety
People normally experience a fairly constant mood state with brief changes. Depression is characterised by a fixed lowering of mood, which profoundly affects behaviour and thinking.
What are the indicators?
A number of symptoms are associated with depression beginning with the subjective feeling of sadness, which can range from mild despondency to overwhelming despair. Symptoms include irritability, lack of interest or pleasure in usual activities; loss of interest in personal appearance and decreased sex drive.
Sleep disturbance, difficulty thinking and concentrating, painful self-critical and pessimistic thinking frequently occur as well as feelings of helplessness or hopelessness. This severe negative thinking may be accompanied by suicidal thoughts, in which case medication and perhaps hospitalisation may be needed.
Physical symptoms that accompany depressive mood include fatigue, tiredness, loss of appetite and related weight loss, constipation, menstrual changes, bodily aches and pains, headaches, difficulty breathing, dry mouth and unusual sensations in abdomen, chest or heart. These "physical" symptoms are caused by changes in bodily function associated with depression and mediated through the autonomous nervous system.
Depressive symptoms tend to develop over a number of weeks and may persist for up to 12 months or more. The symptoms and duration of the illness can be reduced with treatment.
What causes depression?
Certain events may precipitate depressive symptoms including physical illness or operations, loss or bereavement, pregnancy and childbirth and certain drugs. Loss of usual supports, transition stress with the related changes in lifestyle and/or expectations may precipitate depression in some people. Usually there is a combination of factors co-occurring.
How is it treated?
People may try to self-medicate their depression by using alcohol or other substances and this may prolong and complicate the course of the mood disorder.
Mild depression may remit with increased social support and increased self-care. Reaching out and speaking with a supportive person and/or professional can hasten recovery significantly. When the depression is resolved the person reports feeling like his or her usual self.
Psychological therapy is an effective treatment for mild to severe depression. With the latter, anti-depressant medication may be required especially if physical symptoms such as sleep disturbance and weight loss persist and cause distress. Psychological therapy is significant in preventing recurrence of depression particularly when ineffective coping, depressive and negative self critique and interpersonal difficulties are identified as contributing factors.
Coping with Anxiety
Anxiety is a normal response of the central nervous system to stress, and physical symptoms may include heart racing, breathlessness, sweating, nausea, diarrhoea, feelings of weakness, chest pain and blushing.
The common subjective emotional experience is a feeling of uneasiness, worry or apprehension. Situations that often trigger anxiety include meeting new people, public speaking, presenting papers, attending interviews, exam and assessment task anxiety.
Usually people manage these symptoms by pushing through and using time-tested strategies they have developed including support from friends and others. Counselling may also be helpful particularly in developing more effective anxiety management skills.
For some, the experience of anxiety can be very severe such that it causes the person distress and/or impairment in activities of daily living. For example, the person may experience a phobia about a specific object or of social situation, obsessive worry or compulsive behaviours, generalised severe worry, panic attacks, agoraphobia and post traumatic stress symptoms.
How anxiety is treated?
Anxiety may co-occur with depression and alcohol or substance abuse. When the experience of anxiety causes impairment in functioning and/or distress, it is recommended that the individual see a psychologist or a doctor to discuss treatment.
Psychological therapy is an effective treatment for a range of anxiety disorders from relatively mild anxiety through over-stress to severe anxiety disorder. It addresses the particular concerns of the individual and the severity of the anxiety and may range from counselling through cognitive behavioural therapy to use of anti-anxiety medication. Counselling or therapy may focus on using anxiety to enhance performance. This treatment might include techniques in relaxation and combating negative thinking. Any prolonged or disabling experience of anxiety should be discussed with a psychologist or doctor who can recommend an appropriate treatment.
Anne Silbereisen,
Psychologist,
Monash University Counselling Service
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