MICHELLE BARRATT PSYCHOLOGY

35 Wondall Road

WYNNUM WEST

Qld 4178

Tel: 0401 924 331 

Fax:  (07) 3009 0553

MICHELLE BARRATT PSYCHOLOGY

Suite 37, Level 1 Benson House,

No. 2 Benson Street, TOOWONG,

Qld 4066.

Tel: 0411 731 516

Fax: (07) 3009 0075

 

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Accreditations

Michelle Barratt is a Fellow of the Clinical College at the Australian Psychological Society. 

Michelle Barratt Psychology - Brisbane Clinical Psychologists

DEPRESSION

Depression

 

Clinical Psychologists can support children, adolescents, and adults with depression. 

 

Research has found that men, women, children and adolescents have all been found to struggle with depression.  Depression is not an illness that suddenly occurs overnight; it is in fact an insidious illness as it can seemingly grow within a person rather stealthily over time where one day a person will wake up to feeling they are feeling overwhelmingly depressed.  Sometimes people say they cannot remember how it all really happened, and when they felt depressed for the first time, they just know they don’t feel right – that something deep inside them is different.  

Although there are similar factors that show in depression for men, women, children and adolescents; for example (and not all of them need to exist at the same time), the gradual onset for low self-esteem, low self-worth, feeling unmotivated to do anything, feeling a sense of hopelessness, unworthiness and generally wanting to withdraw from the world – it needs to be understood that depressin can present itself differently too for all of us and that depression in children, depression in adolescents, depression in men and depression in women, can all also be caused from many different causes too.

Overall, there are predominantly three different types of depression and namely these are:

1.  Melancholic depression

2.  Non-melancholic depression

3.  Psychotic depression 

4.  Atypical depression.

Assessement of Depression:

To be able to treat depression effectively, an in depth clinical assessment needs to be done to determine the type of depression the person is suffering from, whether it be for men, women, children or adolescents – without this information it will be difficult for any practitioner to provide an effective treatment plan to effectively treat the depression. 

 

To determine the type, severity and treatment for depression, it is highly recommended anyone you know suffering from depression, or if you feel you are struggling with depression, you would benefit at least to speak with your GP, and then if you would like further support, he would most likely refer you to a psychologist for the ongoing treatment of depression and possibly a psychiatrist who can effectively prescribe the right medication to treat the depression.  Practitioners need to work in a multi-disciplinary team to effectively treat your depression, so the right advice to support your journey through your recovery of depression is absolutely vital.

 

Once the correct information is collated, the practitioner will need to decipher as best they can what possible causes and what other factors in your life are perhaps ‘maintaining’ your depression; whether it be psychological, biological or environmental.  Without specific and accurate information, intervention planning and expected outcomes will be difficult to gauge and plan for your treatment.

 

For the different types of depression:

 

1.  Melancholic Depression: 

   Melancholic depression is probably the most classic form of biological depression, and the depression most people could detect in someone if      they were to see it.

  Defining Features:

  • It’s a more severe type of depression than non-melancholic depression as these symptoms are indicated by someone who struggles to find pleasure in doing anything and has great difficulty finding a way to cheer themselves up in most of the things they try to do.

  • Additionally, there are ‘psychomotor’ disturbances – low energy, poor concentration and memory, slowed or agitated movements.

      Prevalence:  It affects less than 10% of people presenting with a depression diagnosis, and both men and women suffer this type of                   depression equally

2. Non-Melancholic Depression: 

    Non-melancholic depression simply means it is not melancholic; meaning that its main cause is likely to be biologically related, and     so if           causes (often alongside anti-depressant medication) are sourced and addressed, the depression will most likely subside.

    Prevalence:  Non-melancholic depression is the most common of the three sub-types of depression and accounts for up to 90% of cases of         depression seen in clinical practice.

    Depression is classed as an illness when:

  • The mood state is severe and is

  • Consistently low for two weeks or more and

  • Interferes with our ability to function at home or at work

    Some Defining Features of Non-melancholic depression

    These don’t all have to present at one time: 

    So always seek the clinical assessment of a practitioner for a proper evaluation of depression.

 

  • Lowered self-esteem

  • No self-worth

  • Change in sleeping patterns – ‘struggling to fall asleep’ ‘waking up’ at night and not being able to fall back to sleep and struggling to wake up in the morning when you wake

  • Change in appetite

  • Loss of weight or weight gain by 5% of your standard general weight in the last couple of weeks

  • Less ability to control emotions: e.g., increased levels of pessimism, anger, guilt, irritability and anxiety

  • Appetite is usually reduced, and may individuals feel that they have to force themselves to eat.

  • Lower levels of tolerance than usual

  • Emotions experienced during the day are incredibly variable: for example, feeling better in the morning but increasingly unhappy as the day progresses

  • Reduced capacity to find pleasure in doing things or in what one ‘used to’ find pleasure in and,

  • Not looking forward to doing things anymore – even when exciting things are planned and hobbies tend to drop off too

  • Reduced pain tolerance: you are less able to tolerate aches and pains and may have a host of new ailments

  • Changed sex drive: absent or reduced

  • Poor concentration and memory: some people are so impaired that they think they are becoming demented

  • Reduced motivation: it doesn’t seem worth the effort like it did before to do anything – a real sense of ‘meaninglessness’

  • Lowered levels of energuy

  • Social impairment – difficulty dealing with work or relationships

  • There may be frequent reference to death, suicide ideation, or suicide attempts.  These thoughts can range from a believf that others would be better off if the person ‘with depression’ was dead, to othr recurrent thoughts of committing suicide to actual plans on how to do it.

  • Please note: that in regards to any thoughts of suicide – that immediate support is recommended, please dial 000 or review the Crisis Support in the Trauma Counselling section of this website.

 

3. Psychotic Depression: 

    Psychotic depression when compared to the others is less common.

    Some of the defining features of psychotic depression are:

  • An extremely severe depressed mood than melancholic or non-melancholic depression – with the inability to pull themselves out of it.

  • There will be the presence of eithe delusions or hallucinations (typically auditory). Most commonly, the conent of the delusions or hallucinations is consistent with the depressive themes – for example; such as delusions of guilt (e.g., of being punished because of a moral transgression or some personal inadequeacy).

  • Severe psychomotor disturbance than is the case with melancholic depression; for example the person has an inability to sit still,  insists on pacing, hand wringing, pulling or rubbing of the skin, clinging onto clothing or other objects, folding and unfolding of arms, tapping of feet, consistent eye darting, etc

  • Psychotic depression has a very low spontaneous remission rate. It responds only to physical treatments.

 

4. Atypical Depression: 

    This type of depression is diagnosed when it contrasts with the usual characteristics of depression.

    For example, rather than experiencing appetite loss the person instead experiences appetite increase; and sleepiness rather than     insomnia.       Someone with atypical depression is also likely to have a personality style of interpersonal hypersensitivity (expecting       others not to like or     approve of them).

 

   Some of the defining features of Atypical depression are:

  • They can at times be cheered up by pleasant events

  • Significant weight gain or increase in appetite (especially to comfort foods)

  • Excessive sleeping (hypersomnia)

  • Heaviness in the arms and legs

  • An ever present sensitivity to interpersonal rejection —the individual is quick to feel that others are rejecting of them.

Author: Michelle Barratt
          Clinical Psychologist
 

 

 

 

Depression