Understanding Depression

Dr. Olayinka ATILOLA

Department of Behavioral Medicine
Lagos State University College of
Medicine
 What is not Depression
Everyday Unhappiness
We all have our ups and downs
Having a bad day
Waking up on the wrong side of bed
Feeling under the weather
Feeling a bit stressed
 Depression vs. Grief
Grief Depression
Identifiable loss Identifiable loss may or
Fluctuating mood may not be apparent
Comforted by being Mood is pervasively
with loved ones low
Intensity reduces Withdraws from loved
progressively over time ones, may be irritated
by their presence
Feelings are same or
getting worse over time
 Depression vs. Grief
Grief Depression
May express guilt over Has general feelings of
certain aspects of event guilt
No significant Significant impairment
impairment of function of function
Thought of death related Thought of death related
to joining the deceased to being tired of life
Fleeting hallucinatory Well formed
experiences hallucinatory
experiences
What are the symptoms of depression?
 Symptoms
Common Symptoms
Persistently low mood for at least 2 weeks
Loss of energy (feeling weak from within)
Loss of interest in previously pleasurable
activities
Early morning awakening
Change in appetite
 Common Symptoms

Change in weight
Social withdrawal
Feeling inferior or hopeless
Guilt feelings
Irritability
Inability to concentrate
Crawling sensations and other somatic
symptoms
Who is at Risk?
 Risk factors
Everybody!

Commoner among three age groups:

Elderly, Mid-age (30-40), and
Adolescents
Commoner among females
Persons with disabilities or debility
 Children and Adolescents
Aside the common symptoms other
manifestations include
School refusal/truancy
Declining academic performance
Emergence of gross misconduct
Resurgence of enuresis
Substance abuse
 The elderly
Aside from common symptoms, other
manifestations include
Masking of symptoms
Severe guilt feelings
Memory impairments
Suicide and Depression
 Suicide and Depression
Untreated depression is one of the
leading cause of suicide
Most people who will die by suicide
would have told someone about
depressive symptoms
Suicide is a process not an event!
 Suicide pathway

Suicidal
Tired of
Wish to die ideation
Life
without plan
 Suicide pathway (continued)

Suicidal
Suicidal Completed
ideation
attempt Suicide
with plan
Management of Depression
 Self-help strategies
Talk to someone who will understand!
Regular sleep-wake cycle
Behavioral activation
Pleasure seeking
Music
Exercise and evening walk
 Psychological interventions
This approach addresses inevitable wrong
way of thinking which accompanies
depression
These kind of thinking keeps the
depression running
It also addresses problem-solving
 Wrong ways of thinking
All or none thinking Looking at things in black and white, not
accommodating middle grounds
Over-generalization Based on a single negative experience,
believing that same hold forever
The mental filter Focusing only on the negative aspects,
ignoring the huge positives
Catastrophising Always expecting the worse case scenario
from a situation
Personalization Ascribing responsibility for things
completely out of ones control
 Cognitive (thinking) Therapy
Listening empathically to the person
Asking questions on meaning of their
concerns
Identify wrong patterns of thinking
Secular counseling geared towards
correcting wrong ways of thinking
 Problem (solving) Therapy
Encouraging the individual to write out
ALL their current problems
To state why each is a problem
(Identify wrong pattern of thinking)
Encourage the individual to come up with
solutions starting from the easiest to the
most difficult
 Applying the principles to spiritual
counseling
Listening empathically is important
Be realistic and open with the person (going
beyond it is well)
Identifying biblical figures who had survived what
the individual is going through
Identifying bible passages which speak to wrong
ways of thinking
Identifying the problems you want us to pray
about
 Bible passages in spiritual counseling
Deuteronomy 31:8 The LORD himself goes before you and will be with you; he will
never leave you nor forsake you. Do not be afraid; do not be
discouraged
Philippians 4:8 ..Whatever is pure, whatever is lovely, whatever is
admirableif anything is excellent or praiseworthythink
about such things
Psalm 42:11 Why, my soul, are you downcast? Why so disturbed within me?
Put your hope in God, for I will yet praise him, my Savior and
my God

John 16:33 I have told you these things, so that in me you may have peace.
In this world you will have trouble. But take heart! I have
overcome the world

Isaiah 41:10 So do not fear, for I am with you; do not be dismayed, for I am
your God. I will strengthen you and help you; I will uphold you
with my righteous right hand
 Danger Signs
Severe loss of appetite
Worsening general symptoms
Suicidal ideations
 What else can the church do
More of seminars like this
Seminars for resident pastors on how to
recognize depression and other common
psychological depression
Funding research into incorporated secular-
spiritual counseling
 Thank you

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