Mental Health Information

This section contains information produced by Mind on areas of mental health. If you are interested in a specific topic enter it into the search engine or see the resources below.

• What is mental illness?
• Anxiety Disorder
• Panic Disorder
• Anger and Rage
• Violent Video Games - Psychologists Help Protect Children from Harmful Effects
• Depression
• Turning Lemons into Lemonade: Hardiness Helps People Turn Stressful Circumstances into Opportunities

What is Mental Illness?

Occasional anxiety, grief, stress or depression are common to us all, but we usually 'get back to normal' relatively quickly. For some people though, these feelings may be unusually intense or prolonged and can seriously affect our abilities to cope with the demands of every day life. We may also experience extreme mood swings, feelings of persecution or hear voices that no one else hears. Like physical illness, mental illness can be mild and easily treated, or more serious and need lengthy treatment. There are many different types of mental illness and people react to their illness in different ways, but most people become well again with the right treatment and support.

Mental illness can affect anyone at any time. It is very common, and it's possible that you or someone in your family will be affected at some time in your lives. Mental illness can be very worrying and upsetting for the person with the illness and also for their family, friends and carers. They may all need some support and someone to talk to.

Where to get help from?

It's often difficult to admit to a mental illness, even more difficult to ask for help. Many people talk first to their GP or someone in the medical field. GPs can refer people to a counsellor or voluntary organisation such as CPT who can help solve problems by talking things through. People with serious or life-threatening illness would be referred to their local community mental health team for in-patient psychiatric care

Anxiety Disorders: The Role of Psychotherapy in Effective Treatment

Everyone feels anxious and under stress from time to time. Situations such as meeting tight deadlines, important social obligations or driving in heavy traffic, often bring about anxious feelings. Such mild anxiety may help make you alert and focused on facing threatening or challenging circumstances. On the other hand, anxiety disorders cause severe distress over a period of time and disrupt the lives of individuals suffering from them. The frequency and intensity of anxiety involved in these disorders is often debilitating. But fortunately, with proper and effective treatment, people suffering from anxiety disorders can lead normal lives.

What are the major kinds of anxiety disorders?

There are several major types of anxiety disorders, each with its own characteristics.

• People with generalized anxiety disorder have recurring fears or worries, such as about health or finances, and they often have a persistent sense that something bad is just about to happen. The reason for the intense feelings of anxiety may be difficult to identify. But the fears and worries are very real and often keep individuals from concentrating on daily tasks.
• Panic disorder involves sudden, intense and unprovoked feelings of terror and dread. People who suffer from this disorder generally develop strong fears about when and where their next panic attack will occur, and they often restrict their activities as a result.
• A related disorder involves phobias, or intense fears, about certain objects or situations. Specific phobias may involve things such as encountering certain animals or flying in airplanes, whereas social phobias involve fear of social settings or public places.
• Obsessive-compulsive disorder is characterized by persistent, uncontrollable and unwanted feelings or thoughts (obsessions) and routines or rituals in which individuals engage to try to prevent or rid themselves of these thoughts (compulsions). Examples of common compulsions include washing hands or cleaning house excessively for fear of germs, or checking over something repeatedly for errors.
• Someone who suffers severe physical or emotional trauma such as from a natural disaster or serious accident or crime may experience post-traumatic stress disorder. Thoughts, feelings and behavior patterns become seriously affected by reminders of the event, sometimes months or even years after the traumatic experience.

Symptoms such as shortness of breath, racing heartbeat, trembling and dizziness often accompany certain anxiety disorders such as panic and generalized anxiety disorders. Although they may begin at any time, anxiety disorders often surface in adolescence or early adulthood. There is some evidence of a genetic or family predisposition to certain anxiety disorders.

Why is it important to seek treatment for these disorders?

If left untreated, anxiety disorders can have severe consequences. For example, some people who suffer from recurring panic attacks avoid at all costs putting themselves in a situation that they fear may trigger an attack. Such avoidance behavior may create problems by conflicting with job requirements, family obligations or other basic activities of daily living. Many people who suffer from an untreated anxiety disorder are prone to other psychological disorders, such as depression, and they have a greater tendency to abuse alcohol and other drugs. Their relationships with family members, friends and coworkers may become very strained. And their job performance may falter.

Are there effective treatments available for anxiety disorders?

Absolutely. Most cases of anxiety disorder can be treated successfully by trained counsellor.

According to the National Institute of Mental Health, research has demonstrated that both "behavioral therapy" and "cognitive therapy" can be highly effective in treating anxiety disorders. Behavioral therapy involves using techniques to reduce or stop the undesired behavior associated with these disorders. For example, one approach involves training patients in relaxation and deep breathing techniques to counteract the agitation and hyperventilation (rapid, shallow breathing) that accompany certain anxiety disorders.

Through cognitive therapy, patients learn to understand how their thoughts contribute to the symptoms of anxiety disorders, and how to change those thought patterns to reduce the likelihood of occurrence and the intensity of reaction. The patient's increased cognitive awareness is often combined with behavioral techniques to help the individual gradually confront and tolerate fearful situations in a controlled, safe environment.

Proper and effective medications may have a role in treatment along with psychotherapy. In cases where medications are used, the patient's care may be managed collaboratively by a therapist and physician. It is important for patients to realize that there are side effects to any drugs, which must be monitored closely by the prescribing physician.

How long does psychological treatment take?

It is very important to understand that treatments for anxiety disorders do not work instantly. The patient should be comfortable from the outset with the general treatment being proposed and with the therapist with whom he or she is working. The patient's cooperation is crucial, and there must be a strong sense that the patient and therapist are collaborating as a team to remedy the anxiety disorder.

No one plan works well for all patients. Treatment needs to be tailored to the needs of the patient and to the type of disorder, or disorders, from which the individual suffers. A therapist and patient should work together to assess whether a treatment plan seems to be on track. Adjustments to the plan sometimes are necessary, since patients respond differently to treatment. Many patients will begin to improve noticeably within eight to ten sessions, especially those who carefully follow the outlined treatment plan.

There is no question that the various kinds of anxiety disorders can severely impair a person's functioning in work, family and social environments. But the prospects for long-term recovery for most individuals who seek appropriate professional help are very good. Those who suffer from anxiety disorders can work with a qualified and experienced therapist such as a licensed psychologist to help them regain control of their feelings and thoughts -- and their lives.

Panic Disorder

Panic Disorder is a serious condition that around one out of every 75 people might experience. It usually appears during the teens or early adulthood, and while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful: graduating from college, getting married, having a first child, and so on. There is also some evidence for a genetic predisposition; if a family member has suffered from panic disorder, you have an increased risk of suffering from it yourself, especially during a time in your life that is particularly stressful.

Panic Attacks: The Hallmark of Panic Disorder

A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being 'stressed out' that most people experience. Symptoms of a panic attack include:

• racing heartbeat
• difficulty breathing, feeling as though you 'can't get enough air'
• terror that is almost paralyzing
• dizziness, lightheadedness or nausea
• trembling, sweating, shaking
• choking, chest pains
• hot flashes, or sudden chills
• tingling in fingers or toes ('pins and needles')
• fear that you're going to go crazy or are about to die

You probably recognize this as the classic 'flight or fight' response that human beings experience when we are in a situation of danger. But during a panic attack, these symptoms seem to rise from out of nowhere. They occur in seemingly harmless situations--they can even happen while you are asleep.

In addition to the above symptoms, a panic attack is marked by the following conditions:

• it occurs suddenly, without any warning and without any way to stop it.
• the level of fear is way out of proportion to the actual situation; often, in fact, it's completely unrelated.
• it passes in a few minutes; the body cannot sustain the 'fight or flight' response for longer than that. However, repeated attacks can continue to recur for hours.

A panic attack is not dangerous, but it can be terrifying, largely because it feels 'crazy' and 'out of control.' Panic disorder is frightening because of the panic attacks associated with it, and also because it often leads to other complications such as phobias, depression, substance abuse, medical complications, even suicide. Its effects can range from mild word or social impairment to a total inability to face the outside world.

In fact, the phobias that people with panic disorder develop do not come from fears of actual objects or events, but rather from fear of having another attack. In these cases, people will avoid certain objects or situations because they fear that these things will trigger another attack

How to Identify Panic Disorder

Please remember that only a professional medical practitioner can diagnose a panic disorder. There are certain signs you may already be aware of, though.

Many people experience occasional panic attacks, and if you have had one or two such attacks, there probably isn't any reason to worry. The key symptom of panic disorder is the persistent fear of having future panic attacks. If you suffer from repeated (four or more) panic attacks, and especially if you have had a panic attack and are in continued fear of having another, these are signs that you should consider finding a mental health professional who specializes in panic or anxiety disorders.

What Causes Panic Disorder: Mind, Body, or Both?

Body: There may be a genetic predisposition to anxiety disorders; some sufferers report that a family member has or had a panic disorder or some other emotional disorder such as depression. Studies with twins have confirmed the possibility of 'genetic inheritance' of the disorder.

Panic Disorder could also be due to a biological malfunction, although a specific biological marker has yet to be identified.

All ethnic groups are vulnerable to panic disorder. For unknown reasons, women are twice as likely to get the disorder as men.

Mind: Stressful life events can trigger panic disorders. One association that has been noted is that of a recent loss or separation. Some researchers liken the 'life stressor' to a thermostat; that is, when stresses lower your resistance, the underlying physical predisposition kicks in and triggers an attack.

Both: Physical and psychological causes of panic disorder work together. Although initially attacks may come out of the blue, eventually the sufferer may actually help bring them on by responding to physical symptoms of an attack.

For example, if a person with panic disorder experiences a racing heartbeat caused by drinking coffee, exercising, or taking a certain medication, they might interpret this as a symptom of an attack and , because of their anxiety, actually bring on the attack. On the other hand, coffee, exercise, and certain medications sometimes do, in fact, cause panic attacks. One of the most frustrating things for the panic sufferer is never knowing how to isolate the different triggers of an attack. That's why the right therapy for panic disorder focuses on all aspects -- physical, psychological, and physiological -- of the disorder.

Can People with Panic Disorder lead normal lives?

The answer to this is a resounding YES -- if they receive treatment.

Panic disorder is highly treatable, with a variety of available therapies. These treatments are extremely effective, and most people who have successfully completed treatment can continue to experience situational avoidance or anxiety, and further treatment might be necessary in those cases. Once treated, panic disorder doesn't lead to any permanent complications.

Side Effects of Panic Disorder

Without treatment, panic disorder can have very serious consequences.

The immediate danger with panic disorder is that it can often lead to a phobia. That's because once you've suffered a panic attack, you may start to avoid situations like the one you were in when the attack occurred.

Many people with panic disorder show 'situational avoidance' associated with their panic attacks. For example, you might have an attack while driving, and start to avoid driving until you develop an actual phobia towards it. In worst case scenarios, people with panic disorder develop agoraphobia -- fear of going outdoors -- because they believe that by staying inside, they can avoid all situations that might provoke an attack, or where they might not be able to get help. The fear of an attack is so debilitating, they prefer to spend their lives locked inside their homes.

Even if you don't develop these extreme phobias, your quality of life can be severely damaged by untreated panic disorder. A recent study showed that people who suffer from panic disorder:

• are more prone to alcohol and other drug abuse
• have greater risk of attempting suicide
• spend more time in hospital emergency rooms
• spend less time on hobbies, sports and other satisfying activities
• tend to be financially dependent on others
• report feeling emotionally and physically less healthy than non-sufferers.
• are afraid of driving more than a few miles away from home

Panic disorder can be treated successfully, and sufferers can go on to lead full and satisfying lives.

How Can Panic Disorder Be Treated?

Most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for panic disorder. Medication might also be appropriate in some cases.

The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is, and how many others suffer from it. Many people who suffer from panic disorder are worried that their panic attacks mean they're 'going crazy' or that the panic might induce a heart attack. 'Cognitive restructuring' (changing one's way of thinking) helps people replace those thoughts with more realistic, positive ways of viewing the attacks.

Cognitive therapy can help the patient identify possible triggers for the attacks. The trigger in an individual case could be something like a thought, a situation, or something as subtle as a slight change in heartbeat. Once the patient understands that the panic attack is separate and independent of the trigger, that trigger begins to lose some of its power to induce an attack.

The behavioral components of the therapy can consist of what one group of clinicians has termed 'interoceptive exposure.' This is similar to the systematic desensitization used to cure phobias, but what it focuses on is exposure to he actual physical sensations that someone experiences during a panic attack.

People with panic disorder are more afraid of the actual attack than they are of specific objects or events; for instance, their 'fear of flying' is not that the planes will crash but that they will have a panic attack in a place, like a plane, where they can't get to help. Others won't drink coffee or go to an overheated room because they're afraid that these might trigger the physical symptoms of a panic attack. Interceptive exposure can help them go through the symptoms of an attack (elevated heart rate, hot flashes, sweating, and so on) in a controlled setting, and teach them that these symptoms need not develop into a full-blown attack. Behavioral therapy is also used to deal with the situational avoidance associated with panic attacks. One very effective treatment for phobias is in vivo exposure, which is in its simplest terms means breaking a fearful situation down into small manageable steps and doing them one at a time until the most difficult level is mastered.

Relaxation techniques can further help someone 'flow through' an attack. These techniques include breathing retraining and positive visualization. Some experts have found that people with panic disorder tend to have slightly higher than average breathing rates, learning to slow this can help someone deal with a panic attack and can also prevent future attacks.

In some cases, medications may also be needed. Anti-anxiety medications may be prescribed, as well as antidepressants, and sometimes even heart medications (such as beta blockers) that are used to control irregular heartbeats.

Finally, a support group with others who suffer from panic disorder can be very helpful to some people. It can't take the place of therapy, but it can be a useful adjunct.

If you suffer from panic disorder, these therapies can help you. But you can't do them on your own; all of these treatments must be outlined and prescribed by a psychologist or psychiatrist.

How Long Does Treatment Take?

Much of the success of treatment depends on your willingness to carefully follow the outlined treatment plan. This is often multifaceted, and it won't work overnight, but if you stick with it, you should start to have noticeable improvement within about 10 to 20 weekly sessions. If you continue to follow the program, within one year you will notice a tremendous improvement.

Panic disorder does not need to disrupt your life in any way!

Anger

Anger is a feeling that we all encounter form time to time and often we experience it as a response to frustration, hurt, disappointment and threats (real or imagined). When we feel angry, we have some confidence in responding to the danger or threat. Fear leads to flight; anger sustains fight. Anger is a completely normal, usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems-problems at work, in your personal relationships, and in the overall quality of your life. And it can make you feel as though you're at the mercy of an unpredictable and powerful emotion.

Whilst rational anger can be constructive in feeling competent to confront a threatening situation, we may reactor the threat with more anger that is warranted. A hammer may work very effectively to make a square peg fit into a round hole. Unfortunately the damaged peg may no longer be functional. Excess anger has the potential to numb us both emotionally as well as mentally.

Expressing Anger

The instinctive, natural way to express anger is to respond aggressively. Anger is a natural, adaptive response to threats; it inspires powerful, often aggressive, feelings and behaviours, which allow us to fight and to defend ourselves when we are attacked. A certain amount of anger, therefore, is necessary to our survival.

On the other hand, we can't physically lash out at every person or object that irritates or annoys us; laws, social norms, and common sense place limits on how far our anger can take us. People use a variety of both conscious and unconscious processes to deal with their angry feelings. The three main approaches are expressing, suppressing, and calming. Expressing your angry feelings in an assertive�not aggressive�manner is the healthiest way to express anger. To do this, you have to learn how to make clear what your needs are, and how to get them met, without hurting others. Being assertive doesn't mean being pushy or demanding; it means being respectful of yourself and others.

.Unexpressed anger can create other problems. It can lead to pathological expressions of anger, such as passive-aggressive behaviour (getting back at people indirectly, without telling them why, rather than confronting them head-on) or a personality that seems perpetually cynical and hostile. People who are constantly putting others down, criticizing everything, and making cynical comments haven't learned how to constructively express their anger. Not surprisingly, they aren't likely to have many successful relationships�this can be defined as Rage.

What is Rage?

There is research available that suggest that suppressed anger is an underlying ingredient both of anxiety and of depression. Anger that is not expressed can erupt in a manner that disrupts relationships and can lead to a variety of medical and relationship problems.

Rage is a shamed based expression of anger. Rage is the accumulations of unexpressed anger and perceived disrespectful transactions that after multiple 'stuffing' finally flowing to the surface. When we become enraged, usually there is the belief that someone is deliberately attempting to incite us to become angry. Within this state we are convinced that trying to be reasonable will prove to be ineffective and therefore we will need to 'even the score' or methodically disarm the offending party

How is Rage expressed?

While expressing anger is all about the controlled sense that one feels threatened in some way, rage has little to do with control. Rage denotes a loss of control and is characterized by shouting, manipulating through emotional backmail or punishing through social withdrawal. Raging offers a false sense of empowerment to an individual who feels inadequate and in turn uses the rage to shut down the other individual. From time to time anyone can have a very bad day�however a persistant pattern of rage as a style of communication is damaging.

Anger Management

The goal of anger management is to reduce both your emotional feelings and the physiological arousal that anger causes. You can't get rid of, or avoid, the things or the people that enrage you, nor can you change them, but you can learn to control your reactions.

Are You Too Angry?

There are psychological tests that measure the intensity of angry feelings, how prone to anger you are, and how well you handle it. But chances are good that if you do have a problem with anger, you already know it. If you find yourself acting in ways that seem out of control and frightening, you might need help finding better ways to deal with this emotion.

Is It Good To "Let it All Hang Out?"

Psychologists now say that this is a dangerous myth. Some people use this theory as a license to hurt others. Research has found that "letting it rip" with anger actually escalates anger and aggression and does nothing to help you (or the person you're angry with) resolve the situation.

It's best to find out what it is that triggers your anger, and then to develop strategies to keep those triggers from tipping you over the edge.

Do You Need Counselling?

If you feel that your anger is really out of control, if it is having an impact on your relationships and on important parts of your life, you might consider counseling to learn how to handle it better. A psychologist or other licensed mental health professional can work with you in developing a range of techniques for changing your thinking and your behavior.

When you talk to a prospective therapist, tell her or him that you have problems with anger that you want to work on, and ask about his or her approach to anger management. Make sure this isn't only a course of action designed to "put you in touch with your feelings and express them"�that may be precisely what your problem is. With counseling, psychologists say, a highly angry person can move closer to a middle range of anger in about 8 to 10 weeks, depending on the circumstances and the techniques used.

What About Assertiveness Training?

It's true that angry people need to learn to become assertive (rather than aggressive), but most books and courses on developing assertiveness are aimed at people who don't feel enough anger. These people are more passive and acquiescent than the average person; they tend to let others walk all over them. That isn't something that most angry people do. Still, these books can contain some useful tactics to use in frustrating situations.

Remember, you can't eliminate anger�and it wouldn't be a good idea if you could. In spite of all your efforts, things will happen that will cause you anger; and sometimes it will be justifiable anger. Life will be filled with frustration, pain, loss, and the unpredictable actions of others. You can't change that; but you can change the way you let such events affect you. Controlling your angry responses can keep them from making you even more unhappy in the long run.

Do You Need Counselling?

If you feel that your anger is really out of control, if it is having an impact on your relationships and on important parts of your life, you might consider counselling to learn how to handle it better. A psychologist or other licensed mental health professional can work with you in developing a range of techniques for changing your thinking and your behaviour.

When you talk to a prospective therapist, tell her or him that you have problems with anger that you want to work on, and ask about his or her approach to anger management. Make sure this isn't only a course of action designed to "put you in touch with your feelings and express them"�that may be precisely what your problem is. With counselling, psychologists say, a highly angry person can move closer to a middle range of anger in about 8 to 10 weeks, depending on the circumstances and the techniques used.

Remember, you can't eliminate anger�and it wouldn't be a good idea if you could. In spite of all your efforts, things will happen that will cause you anger; and sometimes it will be justifiable anger. Life will be filled with frustration, pain, loss, and the unpredictable actions of others. You can't change that; but you can change the way you let such events affect you. Controlling your angry responses can keep them from making you even more unhappy in the long run.

Violent Video Games

Psychologists Help Protect Children from Harmful Effects

Psychological research confirms that violent video games can increase children's aggression, but that parents moderate the negative effects.

Findings

Fifty years' of research on violent television and movies has shown that there are several negative effects of watching such fare (see http://www.psychologymatters.org/mediaviolence.html). Because video games are a newer medium, there is less research on them than there is on TV and movies. However, studies by psychologists such as Douglas Gentile, PhD, and Craig Anderson, PhD, indicate it is likely that violent video games may have even stronger effects on children's aggression because (1) the games are highly engaging and interactive, (2) the games reward violent behavior, and because (3) children repeat these behaviors over and over as they play (Gentile & Anderson, 2003). Psychologists know that each of these help learning - active involvement improves learning, rewards increase learning, and repeating something over and over increases learning.

Drs. Anderson and Gentile's research shows that children are spending increasing amounts of time playing video games - 13 hours per week for boys, on average, and 5 hours per week for girls (Anderson, Gentile, & Buckley, under review; Gentile, Lynch, Linder, & Walsh, 2004). A 2001 content analyses by the research organization Children Now shows that a majority of video games include violence, about half of which would result in serious injuries or death in the 'real' world. Children often say their favorite video games are violent. What is the result of all this video game mayhem?

Dr. Anderson and colleagues have shown that playing a lot of violent video games is related to having more aggressive thoughts, feelings, and behaviors (Anderson & Bushman, 2001). Furthermore, playing violent games is also related to children being less willing to be caring and helpful towards their peers. Importantly, research has shown that these effects happen just as much for non-aggressive children as they do for children who already have aggressive tendencies (Anderson et al., under review; Gentile et al., 2004).

Parents have an important role to play. Psychologists have found that when parents limit the amount of time as well as the types of games their children play, children are less likely to show aggressive behaviors (Anderson et al., under review; Gentile et al., 2004). Other research suggests that active parental involvement in children's media usage-including discussing the inappropriateness of violent solutions to real life conflicts, reducing time spent on violent media, and generating alternative nonviolent solutions to problems-all can reduce the impact of media violence on children and youth (Anderson et al., 2003).

Significance

Children spend a great deal of time with violent video games at exactly the ages that they should be learning healthy ways to relate to other people and to resolve conflicts peacefully. Because video games are such good teachers, it is critical to help parents, educators, and policy-makers understand how to maximize their benefits while minimizing potential harms.

Practical Application

In 1993, the video game industry began putting ratings on video games (E for 'everyone,' T for 'teen,' and M for 'mature'). Psychologists such as David Walsh, PhD, have conducted research on how useful the ratings are and how easily children can purchase mature-rated video games This research has caused the video game industry to improve its ratings systems and to improve its policies regarding marketing mature video games to children.

Research has shown both the deleterious effects of violent video games on children and the ease with which children can purchase mature-rated games (e.g., FTC, 2003). These combined types of studies have influenced several major retail stores (e.g., Sears, Target, Walmart) to create policies preventing children under 17 from buying mature-rated video games. Researchers are continuing to study how effectively stores enforce such policies.

Some researchers have created school curricula to help teach children to reduce their total amount of screen time and/or the types of programs and games watched/played. Although the research is still limited, these curricula show many positive effects, such as a reduction of aggressive behaviours on school playgrounds (Robinson et al., 2001).

Some cities, states, and countries have considered legislation preventing the sale of mature-rated video games to children (similar to laws preventing the sale of tobacco to children). Also, Dr. Anderson is among the psychologists helping policy-makers to understand the problems that violent video games can pose for children's healthy outcomes. In addition, numerous child advocacy and parent support groups have incorporated video game research findings into their web sites and educational materials. Examples include National Institute on Media and the Family, Lion and Lamb project, Young Media Australia, Children Now, Center for Successful Parenting, Action Coalition for Media Education, and Victorian Parenting Centre.

Depression

How Does Depression Differ From Occasional Sadness?

Everyone feels sad or "blue" on occasion. It is also perfectly normal to grieve over upsetting life experiences, such as a major illness, a death in the family, a loss of a job, or a divorce. But, for most people, these feelings of grief and sadness tend to lessen with the passing of time.

However, if a person's feelings of sadness last for 2 weeks or longer, and if they interfere with daily life activities, something more serious than "feeling blue" may be going on.

Depressed individuals tend to feel helpless and hopeless and to blame themselves for having these feelings. People who are depressed may become overwhelmed and exhausted and may stop participating in their routine activities. They may withdraw from family and friends. Some may even have thoughts of death or suicide.

What Causes Depression?

There is no single answer to this question. Some depression is caused by changes in the body's chemistry that influence mood and thought processes. Biological factors can also cause depression. In other cases, depression is a sign that certain mental and emotional aspects of a person's life are out of balance. For example, significant life transitions and life stresses, such as the death of a loved one, can bring about a depressive episode.

Can Depression Be Successfully Treated?

Yes, it can. A person's depression is highly treatable when he or she receives competent care. It is critical for people who suspect that they or a family member may be suffering from depression seek care from a counsellor or seek guidance from a medical professional who has training and experience in helping people recover from depression. Simply put, people with depression who do not seek help suffer needlessly. Unexpressed feelings and concerns accompanied by a sense of isolation can worsen a depression; therefore, the importance of getting appropriate help cannot be overemphasized.

How Does Psychotherapy Help People Recover From Depression?

Several approaches to psychotherapy, including cognitive-behavioral, interpersonal, and psychodynamic, help depressed people 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 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 them 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 the past.

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 increases 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.

In What Other Ways Do Therapists Help Depressed Individuals and Their Loved Ones?

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 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 identify constructive ways 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 some people, particularly in cases of moderate to severe depression. Often a combination of psychotherapy and medications is the best course of treatment. However, given the potential side effects, any use of medication requires close monitoring by the physician who prescribes the drugs.

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

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

How Psychotherapy Helps People Recover From Depression

According to the National Institute of Mental Health, an estimated 18.8 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 a 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 life experiences such as a major illness, loss of a job, a death in the family, or a 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 thoughts 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 illnesses such as heart disease or cancer may be accompanied by depression. For many individuals, however, depression signals first and foremost that certain mental and emotional aspects of 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 successfully?

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 spontaneously.

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, psycho-dynamic 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 the past.

* 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 increases 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.
In what other ways do therapists help depressed individuals and their loved ones?

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 for 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.

Are medications useful for treating 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 the drugs.

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 depression.

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

Turning Lemons into Lemonade

(Hardiness Helps People Turn Stressful Circumstances into Opportunities)

Research shows hardiness is the key to the resiliency for not only surviving, but also thriving, under stress. Hardiness enhances performance, leadership, conduct, stamina, mood and both physical and mental health.

Findings

Why do some people suffer physical and mental breakdowns when faced with overwhelming stress while others seem to thrive? A landmark 12-year longitudinal study by psychologist Salvatore R. Maddi, Ph.D., and colleagues at the University of Chicago involving one of the biggest deregulation and divestiture cases in American history provides some answers.

In 1981 Illinois Bell Telephone (IBT) downsized from 26,000 employees to just over half that many in one year. The remaining employees faced changing job descriptions, company goals and supervisors. One manager reported having 10 different supervisors in one year. Dr. Maddi and his research team were already studying more than 400 supervisors, managers and executives at IBT before the downsizing occurred and they were able to continue following the original study group on a yearly basis until 1987. Results shows that about two-thirds of the employees in the study suffered significant performance, leadership and health declines as the result of the extreme stress from the deregulation and divestiture, including heart attacks, strokes, obesity, depression, substance abuse and poor performance reviews. However, the other one-third actually thrived during the upheaval despite experiencing the same amount of disruption and stressful events as their co-workers. These employees maintained their health, happiness and performance and felt renewed enthusiasm.

What made the two groups so different? Dr. Maddi found that those who thrived maintained three key beliefs that helped them turn adversity into an advantage: commitment, control and challenge attitudes. The Commitment attitude led them to strive to be involved in ongoing events, rather than feeling isolated. The Control attitude led them to struggle and try to influence outcomes, rather than lapse into passivity and powerlessness. The Challenge attitude led them to view stress changes, whether positive or negative, as opportunities for new learning.

There is no more extreme example of workplace stress than the battlefield. Research by psychologist Paul T. Bartone, Ph.D., of the U.S. Military Academy at West Point found that hardiness protected Army reserve personnel mobilized for the Persian Gulf War in the early 1990's. In this study, the higher the hardiness level, the greater the ability of soldiers to experience life- and combat-related stress without apparent negative health consequences, such as post traumatic stress disorder or depression. So, hardiness at least partially explains why some soldiers remain healthy under war related stress.

Hardiness and resiliency research is also being used by the American Psychological Association (APA) to help children, teenagers and adults to adapt well to adversity, trauma, tragedy, threats and other significant sources of stress.



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