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How Psychotherapy Helps People Recover From Depression

According to the National Institute of Mental Health, an estimated = 18.8=20 million adult Americans suffer from depression during any one-year = period. Many=20 do not even recognize that they have a condition that can be treated = very=20 effectively. This question-and-answer fact sheet discusses depression = with a=20 focus on how psychotherapy can help a depressed person recover.

How does depression differ from occasional = sadness?

Everyone feels sad or "blue" on occasion. Most people grieve over = upsetting=20 life experiences such as a major illness, loss of a job, a death in the = family,=20 or a divorce. These feelings of grief tend to become less intense on = their own=20 as time goes on.

Depression occurs when feelings of extreme sadness or despair last = for at=20 least two weeks or longer and when they interfere with activities of = daily=20 living such as working or even eating and sleeping. Depressed = individuals tend=20 to feel helpless and hopeless and to blame themselves for having these = feelings.=20 Some may have thoughts of death or suicide.

People who are depressed may become overwhelmed and exhausted and = stop=20 participating in certain everyday activities altogether. They may = withdraw from=20 family and friends.

What causes depression?

Changes in the body's chemistry influence mood and thought processes, = and=20 biological factors contribute to some cases of depression. In addition, = chronic=20 and serious illnesses such as heart disease or cancer may be accompanied = by=20 depression. For many individuals, however, depression signals first and = foremost=20 that certain mental and emotional aspects of life are out of=20 balance.
Significant transitions and major life stressors such as the = death=20 of a loved one or the loss of a job can help bring about depression. = Other more=20 subtle factors that lead to a loss of identity or self-esteem may also=20 contribute. The causes of depression are not always immediately = apparent, so the=20 disorder requires careful evaluation and diagnosis by a trained mental = health=20 care professional.

Sometimes the circumstances involved in depression are ones over = which an=20 individual has little or no control. At other times, however, depression = occurs=20 when people are unable to see that they actually have choices and can = bring=20 about change in their lives.

Can depression be treated successfully?

Absolutely. Depression is highly treatable when an individual = receives=20 competent care. Psychologists are among the licensed and highly trained = mental=20 health providers with years of experience studying depression and = helping=20 patients recover from it.

There is still some stigma, or reluctance, associated with seeking = help for=20 emotional and mental problems, including depression. Unfortunately, = feelings of=20 depression often are viewed as a sign of weakness rather than as a = signal that=20 something is out of balance. The fact is that people with depression can = not=20 simply "snap out of it" and feel better spontaneously.

Persons with depression who do not seek help suffer needlessly. = Unexpressed=20 feelings and concerns accompanied by a sense of isolation can worsen a=20 depression. The importance of obtaining quality professional health care = can not=20 be overemphasized.

How does psychotherapy help people recover from=20 depression?

There are several approaches to psychotherapy - including=20 cognitive-behavioral, interpersonal, psycho-dynamic and other kinds of = "talk=20 therapy" - that help depressed individuals recover. Psychotherapy offers = people=20 the opportunity to identify the factors that contribute to their = depression and=20 to deal effectively with the psychological, behavioral, interpersonal = and=20 situational causes.

Skilled therapists such as licensed psychologists can work with = depressed=20 individuals to
* Pinpoint the life problems that contribute to their=20 depression, and help them understand which aspects of those problems = they may be=20 able to solve or improve. A trained therapist can help depressed = patients=20 identify options for the future and set realistic goals that enable = these=20 individuals to enhance their mental and emotional well-being. Therapists = also=20 help individuals identify how they have successfully dealt with similar=20 feelings, if they have been depressed in the past.
* Identify = negative or=20 distorted thinking patterns that contribute to feelings of hopelessness = and=20 helplessness that accompany depression. For example, depressed = individuals may=20 tend to overgeneralize, that is, to think of circumstances in terms of = "always"=20 or "never." They may also take events personally. A trained and = competent=20 therapist can help nurture a more positive outlook on life.
* Explore = other=20 learned thoughts and behaviors that create problems and contribute to=20 depression. For example, therapists can help depressed individuals = understand=20 and improve patterns of interacting with other people that contribute to = their=20 depression.
* Help people regain a sense of control and pleasure in = life.=20 Psychotherapy helps people see choices as well as gradually incorporate=20 enjoyable, fulfilling activities back into their lives.
Having one = episode of=20 depression greatly increases the risk of having another episode. There = is some=20 evidence that ongoing psychotherapy may lessen the chance of future = episodes or=20 reduce their intensity. Through therapy, people can learn skills to = avoid=20 unnecessary suffering from later bouts of depression.
In what other = ways do=20 therapists help depressed individuals and their loved ones?

The support and involvement of family and friends can play a crucial = role in=20 helping someone who is depressed. Individuals in the "support system" = can help=20 by encouraging a depressed loved one to stick with treatment and to = practice the=20 coping techniques and problem-solving skills he or she is learning = through=20 psychotherapy.

Living with a depressed person can be very difficult and stressful = for family=20 members and friends. The pain of watching a loved one suffer from = depression can=20 bring about feelings of helplessness and loss. Family or marital therapy = may be=20 beneficial in bringing together all the individuals affected by = depression and=20 helping them learn effective ways to cope together. This type of = psychotherapy=20 can also provide a good opportunity for individuals who have never = experienced=20 depression themselves to learn more about it and to identify = constructive ways=20 of supporting a loved one who is suffering from depression.

Are medications useful for treating depression?

Medications can be very helpful for reducing the symptoms of = depression in=20 some people, particularly for cases of moderate to severe depression. = Some=20 health care providers treating depression may favor using a combination = of=20 psychotherapy and medications. Given the side effects, any use of = medication=20 requires close monitoring by the physician who prescribes the drugs.

Some depressed individuals may prefer psychotherapy to the use of=20 medications, especially if their depression is not severe. By conducting = a=20 thorough assessment, a licensed and trained mental health professional = can help=20 make recommendations about an effective course of treatment for an = individual's=20 depression.

Depression can seriously impair a person's ability to function in = everyday=20 situations. But the prospects for recovery for depressed individuals who = seek=20 appropriate professional care are very good. By working with qualified = and=20 experienced therapists, those suffering from depression can help regain = control=20 of their lives.

The American Psychological Association Practice Directorate = gratefully=20 acknowledges the assistance of Daniel J. Abrahamson, Ph.D., Lynne M. = Hornyak,=20 Ph.D., and Lynn P. Rehm, Ph.D., in developing this fact sheet on = depression.

Documents from apahelpcenter.org may be = reprinted in=20 their entirety with credit given to the American Psychological = Association. Any=20 exceptions to this, including requests to excerpt or paraphrase = documents from=20 apahelpcenter.org, must be = presented=20 in writing to helping@apa.org and = will be=20 considered on a case-by-case basis. Permission for exceptions will be = given on a=20 one-time-only basis and must be sought for each additional use of the=20 document.