Depression

What disease has about 350 million sufferers, affects every country in the world, and is the leading cause of disability for both men and women?

If you guessed that the answer is one of the mental health illnesses, you are correct; it is depression. The “impairment” of depression leads to greater difficulties in carrying out work and personal commitments when it is mild. At the deep end, depression sees nearly one million people per year lose their lives through suicide, which means nearly 3000 people every day. For every death by suicide, there are at least 20 attempts (Marcus, Yasamy, van Ommeren, Chisholm, & Saxena, 2012).

Depression is the third highest burden of all diseases; this is true both in Australia and globally. An estimated 65 percent of depressed people do not access any treatment for their depression and it is the number one cause of non-fatal disability in Australia (at 24 percent) (Black Dog Institute, 2012).

Some summary facts from quoted resources:

1. Prevalence

• Australian Bureau of Statistics (ABS) data identifies that one in seven Australians (around 13-15%) experiencing depression at some point in their lives.
• The 2020-2021 National Health Survey revealed that 5.3% of Australians aged 16 and over reported having depression, equating to about 1.2 million people.
• Depression is more common in women than men, with women having almost double the prevalence of depression compared to men.

2. Age Group Considerations

• Depression rates are higher among younger Australians, particularly in the 16-24 age group, where around 1 in 6 report symptoms of depression.
• Older Australians (aged 65+) tend to report lower rates of depression, but this demographic still experiences significant mental health challenges, often related to isolation and chronic health issues.

3. COVID-19 Pandemic Impacts

• The COVID-19 pandemic exacerbated mental health issues, including depression, across Australia. During the pandemic, national surveys indicated that rates of anxiety and depression significantly increased due to factors like lockdowns, social isolation, economic uncertainty, and health concerns.
• A 2022 survey from Beyond Blue illustrated that 45% of Australians reported experiencing worsening mental health due to the pandemic.

4. Treatments

• Stigma and lack of access to mental health services remain barriers.
• Psychological treatments (for example cognitive-behavioural therapy, or CBT) and medication (such as antidepressants) are commonly used.
• A broader array of holistic treatments is now more widely used (rather than a default to medication). Examples include Mindfulness training, Yoga, Somatic therapies and broader lifestyle considerations such as nutrition and exercise regmins.

5. Risk Factors

• Common risk factors in Australia include genetic predisposition, chronic illness, stressful life events, financial insecurity, and social isolation.
• The LGBTIQ+ community and Aboriginal and Torres Strait Islander peoples are known to experience higher rates of depression, partly due to social stigma, discrimination, and historical trauma.

6. Youth Mental Health

• Mental health issues, including depression, are particularly prevalent in Australian youth. Headspace, a national youth mental health foundation, has reported that depression is one of the most common reasons young people seek support.
• Suicide is a major concern, particularly among young Australians. The Australian Institute for Health and Welfare (AIHW) notes that suicide is a leading cause of death for people aged 15-44.

7. Symptoms (referencing in part DSM-5)

• Depressed mood most of the day, nearly every day, as indicated by either self-report (e.g. feeling sad or empty) or observation made by others (e.g., appears tearful); in children and adolescents this can be irritable mood.
• Markedly diminished interest of pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
• Significant weight loss when not dieting or weight gain (e.g., a change of more than five percent of body weight in a month), or decrease or increase in appetite nearly every day (in children, this may manifest as failure to make expected weight gains).
• Insomnia or hypersomnia nearly every day.
• Physical agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
• Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing·

Impact

Many of my clients who seek treatment for Depression will report impacts including self-isolation, active avoidance of social interactions, loss of motivation and deteriorating relationships. Those close to the affected report withdrawal, loss of communication, reduced intimacy and reduced levels of physical exercise.

Depression affects everyone close to the affected, including in many cases, a failure to identify the condition or an application of mis-diagnosis. In today’s world of mass information, many partners or friends of those affected by Depression will default to “label settings” often derived from dubious online resources. For example, “ADD”; “ADHD”; “Bipolar”; etc.

How I can help

Counsellors and Psychologists in general will apply Cognitive Behaviour Therapy and/or Acceptance and Commitment Therapy when treating clients with Depression. Most in the profession use a “blend” of both with other technical overlays.

I use the above as part of a broader holistic assessment. This includes active consideration of possible referrals to Medical Health Professionals. Some clients will definitely benefit from anti-depressant medication. Taking the time to assess and consider all factors is part of my practice.

Individual assessments usually take 4-6 sessions of one hour each to determine a course of treatment. Assessment factors include relationships, work, lifestyle, diet, family history, environment and consideration of the development years.

I then deploy a “toolkit” of resources to support the initial assessment depending on the capability of the individual. There is simply no “one size fits all” when treating those affected with Depression.

My practice approach depends on the outcomes of individual assessment: for some clients adopting a directional approach may be prudent. For others, a self-directed style may emerge as wholly suitable. Regular check ins and assessments are important to me. Individual empowerment is my objective for all.

Why Choose Me?

1. I spend the time assessing before treating. I will refer you to another professional if I do not think I can help you.
2. I work collaboratively: following the assessment period, we will discuss the approach including advantages and disadvantages.
3. Feedback loops are part of practice.
4. I aim for empowerment rather than reliance
5. I have a personal, lived experience of Depression. It took me years to find the right help. I understand the struggle and challenge.
6. Male practitioners can bring a different lens to treatment. Empathy and Compassion are part of my method. Sharing lived insights and technical skills works alongside this.