“DEAR DR EVE,
I have been diagnosed with Depression and I’m confused about this. Actually, I feel
angry as I don’t believe that I am depressed. I went to my healthcare provider as I
was struggling with a recent breakup and just wanted some medication to feel better
again. I complained about feeling so sad and tearful all the time. He asked me about
other things and when I told him of my bad mood, sleeping a lot, isolating and also
no interest in sex. That’s when he said I am depressed. But I’m used to these
feelings as since I was a young child I have felt this way and no one told me I’m
Do you think I need therapy?
DR EVE REPLIES
Anonymous, let me begin by explaining Depression to you.
We look to science for definitions as Depression is the most common mental
illness or mood disorder, and it is so common that it is a major public health
It is also often misdiagnosed and mistreated as at the core of depression is
Inflammation – and inflammation is a result of childhood trauma. This means
that childhood trauma needs to be addressed and managed for the resultant
depression to be well managed.
And reading your e-mail alerts me to the fact that you experienced childhood trauma
with resultant depression. Depression that was not treated, depression that
negatively impacts every part of your life: intimate relationships are deeply
challenging, cognitive ability to think clearly and make good decisions is impaired,
social interactions can be awkward and lonely. To avoid feeling “depressed”, people
revert to behaviours that may be high risk or even harmful to themselves such as
repeatedly choosing toxic partners, overeating/undereating, over-exercising,
overworking, overthinking, risky sexual behaviours, alcohol, recreational drugs, abuse
of prescription medication.
There are a number of different types of Depression. These include Major
depressive disorder, Persistent Depressive Disorder, Postpartum Depression,
Situational depression, Treatment-resistant Depression, Seasonal Affective Disorder,
Bipolar Disorder. And Anhedonia, which is a reduced ability to experience pleasure
The symptoms of anhedonia can include:
– social withdrawal.
– diminished pleasure derived from daily activities.
– a lack of relationships or withdrawal from previous relationships.
– less of an interest in previous hobbies.
– a loss of libido or a lack of interest in physical intimacy.
Professionally a person is diagnosed with depression when fulfilling these criteria
which are from the DSM5.
A person must experience 5x symptoms during the same two-week period that are a
change from previous functioning; depressed mood and /or loss of interest /pleasure
must be present;
Important to exclude symptoms clearly attributable to another medical condition.
– Depressed mood (feel sad, empty, hopeless, tearful) most of the day
– Loss of interest/pleasure
– Weight loss/gain
– Psychomotor agitation or retardation
– Feeling worthless or excessive /inappropriate guilt
– Decreased concentration
– Thoughts of death/suicide
– Cause significant distress or impairment in social, and occupational, settings
– Not due to substance or medical condition
– Not due to other psychiatric disorders
– No history of a manic or hypomanic episode
You may be wondering how depression is linked to events that happened long ago in
childhood. Childhood trauma, or as it is known, Developmental Trauma Disorder, is
operationalized as emotional (or psychological) abuse, physical abuse, sexual
abuse, and neglect (emotional or physical) before the age of 18 years.
The literature tells us that Childhood trauma (CT) is one of the most robust and
significant risk factors for depressive and anxiety disorders.
Childhood trauma (CT) has adverse consequences on mental health across the
lifespan. As a child, your depression was triggered by a rough childhood, perhaps
even a traumatic childhood as described above. And is continues throughout your
life, influencing every step that you take.
CT impacts the functioning of the brain, mind, and body, which together may
contribute to a higher vulnerability for affective disorders
In studies, CT was associated with a higher risk of anxiety and depressive
disorders. CT predicted the onset of these disorders. This is directly due to the
ongoing releasing of stress hormones, primarily cortisol, which causes inflammation.
And remember, depression is an inflammation disorder.
– Higher neuroticism and negativity
– Heightened levels of cortisol and inflammation
– Advanced biological ageing
– Poorer lifestyle ( higher smoking rate and body mass index )
– Somatic illnesses (metabolic syndrome )
– Brain alterations /inflammations due to cortisol
More facts: About one-third of all adult-onset psychiatric disorders are related to
CT with lifelong effects on morbidity and mortality). Moreover, CT increases the risk
of negative life events, suicidality, sleep problems, and cognitive problems CT not
only affects mental health but also increases the risk of obesity, diabetes, lung
disease, and cardiovascular disorders, For instance, exposure to CT has not only
been associated with a three to four-times increased risk for depression and anxiety
but also with a two to three-times increased risk of adult cancer, respiratory and
cardiovascular disease. CT is, therefore, a major public health problem, and arguably
the most potent predictor of poor mental health across the lifespan.
Anonymous, seek out therapy to manage your childhood trauma and work with a
health care practitioner to manage your symptoms of depression. In this way, you will
also avoid physical illnesses and live a life of more joy and pleasure!