Psychoanalysis and depression

Depression.

Depression is a mood disorder that causes a persistent feeling of sadness.

What is depression

Depression is a mood disorder characterized by a persistent feeling of sadness and a loss of interest in activities and passions that were once a source of pleasure. This state can adversely affect the ability to think clearly, memory, sleep, and nutrition.

Sadness in depression goes beyond the normal sense of melancholy. It is a deep and constant emotional pain that seems to have no specific cause and can overwhelm the sufferer. This sadness can lead to a sense of emptiness, worthlessness, and a loss of hope, making it difficult to find meaning or joy in even the simplest experiences.

It is important to distinguish depression from the normal sadness or moments of discouragement that we all face occasionally. The latter, in fact, tend to disappear with time. Depression, on the other hand, also known as major depressive disorder or clinical depression, is a more serious condition that can have a significant impact on how one feels, thinks, and copes with daily activities, such as sleeping, eating, or working. This disorder knows no barriers: it can affect anyone, regardless of age, income, education or culture. Its origin is often multifactorial, arising from a combination of genetic, biological, environmental, and psychological factors.

Depression should not be regarded as a personal weakness. It is not something that can be overcome through sheer willpower. It often requires long-term treatment, but it is essential to know that it is possible to recover from depression, once the underlying causes of the experiences are understood.

If left untreated, depression can worsen and persist over time. In severe cases, it can lead to self-harm or suicide.

Coping with depression is a challenge that patient and therapist face together, through appropriate treatment and the knowledge that one is not alone in dealing with the problem.

Who can be affected by depressive states

Depression can affect anyone, regardless of age or social status, including children, adolescents, and adults.

Certain risk factors increase the likelihood of developing depression. These include specific medical conditions that often accompany depressive symptoms. The most common include neurodegenerative diseases, stroke, multiple sclerosis, oncological diseases, etc.

These examples demonstrate how depression can often be associated with physical health problems, underscoring the importance of addressing both mental and physical aspects for effective management.
Medical therapy and a psychotherapeutic approach can help regain a sense of well-being.

Spread of depression

In Italy, depression affects about 6 percent of the adult population. This equates to more than 3 million people living with depressive symptoms.

Globally, the situation is not much different. According to the World Health Organization (WHO), depression affects about 4.4 percent of the world’s population, or more than 300 million people. In recent years, this figure has increased significantly, partly due to the COVID-19 pandemic, which has had a major impact on mental health. Before the pandemic, an estimated 193 million people worldwide suffered from major depressive disorder. After 2020, the numbers rose to 246 million, an increase of 28 percent.

These data underscore how widespread depression is and how critical it is to consider it a health priority. However, these estimates are believed to be lower than reality because many people do not seek medical care for symptoms of depression and do not receive a diagnosis.

Depression. Symptoms

Depression manifests itself with a variety of symptoms that can profoundly affect how a person feels, thinks, and acts. Among the most common signs are feelings of persistent sadness, weeping, feelings of emptiness, and hopelessness. Sufferers may feel hopeless, worried and unable to find a way out. In children and adolescents, these emotional states may result in irritability rather than overt sadness.

Outbursts of anger, irritability or frustration, even over trivial matters, are other typical manifestations of depression. This increased emotional sensitivity can make it difficult to maintain stable relationships and cope with everyday situations.

Another key sign is the loss of interest or pleasure in activities that were once a source of joy, such as hobbies, sports or sex life.

Sleep disorders are very common: some people suffer from insomnia, finding it difficult to fall asleep or maintain continuous sleep, while others experience hypersomnia, sleeping excessively.

Appetite may also be impaired, leading to significant weight loss due to lack of hunger or, conversely, weight gain caused by excessive cravings for food.

Depression can generate anxiety, agitation or constant restlessness, which is often accompanied by a slowdown in body movements, thinking and speech. This state can worsen to the point where it is difficult to concentrate, make decisions, or remember things.

Feelings of worthlessness, guilt and self-blame are often present, with a fixation on past failures feeding a cycle of negative thoughts. In some cases, these feelings may evolve into frequent or recurrent thoughts of death, self-harm or suicide.

Finally, it is not uncommon for depression to also manifest itself through physical symptoms such as headaches, back pain, stomach pain, or even sexual dysfunction, which have no apparent medical cause.

Recognizing these symptoms is essential to understanding the extent of depression and seeking help.

Causes of depression

Depression is a complex condition that can have several origins and depend on a combination of factors. There is no single cause, but multiple aspects that intertwine and contribute to generating this state of suffering.

From a brain chemistry perspective, neurotransmitters, such as serotonin and dopamine, are key substances that regulate mood, sleep, and energy levels. When these balances are altered, for biological or environmental reasons, they can result in effects on our mental well-being and promote the development of depression.

Genetics also plays a significant role, as it is possible to inherit a tendency to develop depression from one’s family members. However, this is not a fixed rule: many people without a family history may still suffer from depression.

Our daily lives and the events we face can be another determining factor. Difficult moments such as the loss of a loved one, a divorce, trauma, or a period of social isolation can leave a deep mark, especially if adequate emotional support is not available. These episodes can trigger or exacerbate psychological vulnerability, increasing the risk of depression.

Physical conditions can contribute to the onset of depressive symptoms because of the fatigue and frustration that certain conditions bring. For example, living with chronic illnesses such as diabetes or states of persistent pain can be emotionally and energetically taxing.

The use of some substances, such as drugs and alcohol, can have the side effect of worsening mood, and in addition, alcohol or drug abuse can adversely affect the brain, accentuating the symptoms of depression or contributing to its onset.

All these often interconnected causes show how depression is a multifactorial and personal condition. Understanding its origins is crucial not only for the sufferer but also for caregivers.

Diagnosis of depression

From a scientific point of view, there are numerous instruments recognized as valid for evidencing a state of depression. The diagnostic tests that we feel are worth mentioning are the Quick Inventory of Depressive Symptomatology (QIDS), the Hamilton Rating Scale for Depression (HRSD), and the Patient Health Questionnaire-2 (PHQ-2).

There are several validated tests for the detection of depression (e.g., the Beck Depression Inventory the Hamilton Rating Scale for Depression). These are screening methods that highlight the presence of symptoms such as sadness, loss of interest, poor concentration, negative attitude about oneself, thoughts of suicide, lack of energy, sleep disturbances, altered appetite and agitation.

Beyond these types of diagnostic tests, the health care provider-psychologist, psychiatrist, psychotherapist-uses knowledge of the symptoms combined with analysis of the patient’s medical and mental health history to identify the specific state of distress.
For symptoms to be considered relevant, they must be repeated almost daily, and for a significant period of time.

Psychoanalytic therapy in the treatment of depression

Depression is a treatable mental health condition through different types of treatment. Among them, psychoanalytic therapy focuses on the root causes of emotional suffering, helping people better understand themselves and improve their inner well-being.

This therapy is based on dialogue with a professional, who guides the patient in exploring his or her emotions, thoughts and memories, often related to past experiences. The goal is not only to relieve symptoms, but also to foster deep and lasting change. This process occurs gradually, through the discovery and processing of aspects of one’s personality that were unclear or unexplored.

During the course of therapy, the patient experiences a safe space in which he or she can express himself or herself freely. The therapist helps to recognize and cope with emotional difficulties, offering support to develop greater confidence and awareness.

Although antidepressants can be helpful in reducing the symptoms of depression, numerous studies show that the combination of medication and psychoanalytic psychotherapy is more effective than medication alone. In addition, those who follow a course of treatment are less likely to relapse into depression in the long term.

A characteristic aspect of psychoanalytic therapy is the focus on dreams, fantasies and childhood memories, which can offer valuable clues about the patient’s inner world. This approach makes it possible not only to overcome depression, but also to acquire tools to better cope with life’s difficulties with greater balance and serenity.

Concluding

Depression can be addressed.

Dr. Laura Pedrazin’s Psychology and Psychotherapy Practice specializes in the psychoanalytic treatment of depression, offering professional support to understand and overcome this condition.

The different facets of depression on which Dr. Pedrazin speaks include:

• Experiences of loss and grief,
• Identity uncertainty and meaninglessness,
• conditions of anxiety and stress with a depressive background,
• mood and sleep disorders.

If you are experiencing depressive symptoms, it is critical not to face them alone and seek help as soon as possible.

Lo Studio of Psychology, Psychotherapy Dr. Pedrazin is located in Milan, via Procaccini 11; the doctor receives in the office and online.