Online sessions now available.Kristian S. Nibe - clinical psychologist and ISTDP practitioner.
Symptoms of depression.
The most common symptoms of depression are:
* Low energy and exhaustion.
* Lack of interest in activities that previously provided meaning and happiness.
* Passivity and lack of initiative.
* Emptiness rather than access to feelings.
* Thoughts about hopelessness, worthlessness, and indifference.
* Sleep disturbances – either oversleeping or not sleeping enough.
* Thoughts about death and dying.
* Somatic symptoms – back pain, neck pain, stomach problems etc.
* Excessive worrying, worst-case scenario thinking, and pessimism.
* Passive-aggressive behavior – alternating between withdrawal and acting out.
* Difficulty concentrating.
* Avoiding making decisions.
* Low self-esteem.
* Self-critical and doubting own discernment.
* Negative thought patterns – about self, others, and the world.
* Continuous guilt.
Depression is very limiting for the afflicted person and leads to a significant reduction in the quality of life. The extent and intensity of the symptoms varies greatly from person to person. Someone with a major depression is often so reduced in their functioning that they find it hard to even get out of bed, while someone with a light depression can seemingly be fully functioning at work.
During the course of depression the symptoms may also change and vary in intensity. If several of the symptoms have continued for more than two weeks you should consider help from a professional therapist in order to get back to a healthy state.
Even though several symptoms of depression can manifest, the most common ones are; low energy level, excessive worrying, pessimism, negative thinking, and lack of initiative and personal responsibility.
The depressed is pessimistic and self-critical and expects failure and disappointments in nearly every situation. Often will they use their previous failures as reminders and confirmations of these assumptions.
Their self-esteem is usually so low that seldom does the depressed person say what he wants or stand his ground. Passivity is often the main strategy when confronted with challenging situations. They doubt their decisions and ability to complete even simple tasks. Even when they experience success they will not attribute that to their own effort, but believe that it was all based on luck or coincidence.
An objective discernment of ones thoughts, assumptions, skills, of challenging situations, and of other people, is a protective mechanism against depression.
Worries and negative thinking makes it difficult to participate socially. That is why social isolation is common in depression. Many depressed often avoid socializing because they don’t expect that anything good will come of it. This leads to a negative spiral since increased social isolation leads to increased depression.
Depressed people have a tendency to rely on passive coping strategies or that they avoid dealing with their problems in their entirety. A behavioral pattern termed “learned helplessness” arises when previous attempts at problem solving only have ended in failure. A pattern of not giving any effort in order to overcome a challenge then becomes a habit.
Depression as a clinical diagnosis.
According to the diagnostic manual for psychiatric disorders DSM-IV, five of the nine following symptoms have to be present for at least two weeks in order to fulfill the diagnostic criteria for depression:
- A depressive emotional state.
- Reduced interest in all or most activities.
- Weight loss or weight gain, or changes in appetite.
- Insomnia (sleeplessness) or hypersomnia (oversleeping).
- Psychomotoric agitation or retardation.
- Tiredness or loss of energy.
- Feelings or worthlessness and/or exaggerated guilt.
- Reduced ability to think, concentrate, or make decisions.
- Repetitive thoughts about death, suicide, suicidal plans or suicidal thoughts.
Depression is characterized by at least one depressive episode, without having had any manic episodes also. Manic conditions are characterized by periods of intense energy, distorted thinking, and acting out.
In order to qualify for a depression diagnosis, the depressive symptoms need to be present most of the day, every day, for at least two weeks. The symptoms also need to be of such intensity as to disturb the ability to function socially or/and occupationally.
If able to meet daily commitments at work, in the family, and other social settings, then the person is having a mild form of depression. If the person is having problems getting out of bed in the morning, and is unable to meet his commitments to work and family, the depression is said to be moderate. If the person is thinking about death and dying frequently, hasn’t been out of bed in a long time, is not eating or able to care for basic hygiene, and/or has behavior of a borderline psychotic character, then depression is of a major character.
If the person has fulfilled the diagnostic criteria for two years or more, DSM-IV diagnoses a person with chronic depression. Only a single depressive episode is relatively rare, and if depression has occurred before the probability for subsequent depressive episodes increases significantly.
Persons with other psychological symptoms will experience depressive symptoms more often than other people. Those suffering from generalized anxiety disorder more often have depressive symptoms and mood swings. Depressive symptoms also correlate high with avoidant, borderline, and obsessive-compulsive personality disorders.
Sadness and grief are not psychological disorders.
Sometimes depressive symptoms might be present without diagnosing it as clinical depression. Depressive disorders are not the same as sadness or grief triggered by the loss of a close person, a relationship, illness, or physical handicap.
If loss or grief after a specific event is the cause of the depressive symptoms, and that they are briefer than two months, the condition would not be called depression. This condition is often referred to as an adjustment disruption in psychological terms.
Everyone feels sad from time to time, and that’s part of human nature that shouldn’t be pathologized. Depressive symptoms first become a concern when they last longer than two weeks and they interfere with the ability to implement daily tasks at work or at home.
Online consultations available.
Use the contact form below for any inquiries. Please state briefly the nature of your problem, when and how you are available, and how you prefer to conduct payment (Credit Card or PayPal).
Consultations are available for either 45 minutes or 90 minutes, and are conducted by video either through Skype or appear.in. Alternatively I also offer sessions through chat/e-mail.
The price per 45 minute consultation is 160 Euro. The price for a 90 minute consultation is 300 Euro.