Depression is extremely common, and extremely treatable. More than 1 in 5 adults will experience a diagnosable mood disorder at some time during their lives, with major depressive disorder being the most common (this is what some counselors call “clinical depression.”) If you’re suffering from depression, you already know how many different kinds of problems it can cause… problems with work, relationships, health. And it steals your ability to feel joy, enthusiasm, or even simple pleasure.

Now, here’s where things get tricky: depression isn’t really a single thing

There’s no medical test that can definitively diagnose depression — and anyone who tells you that depression is caused by a “chemical imbalance” is either misinformed, or has some medication to sell you. Even the psychological tests for depression are really just lists of symptoms that you check off, or questions that other people who are depressed have been found to answer in a similar way.

The truth is, there are many different causes of depression, many different ways that depression might affect you, and therefore many different types of treatment that might be effective for your particular case. Some examples:

• Major Depression – already mentioned, this is the diagnosis for people feeling sad, guilty, tearful, and withdrawn
• Atypical Depression – tends to be reactive to external events, and is characterized by overeating, oversleeping, and an inflamed sense of rejection
• Dysthymia – a form of low-grade, chronic depression (they used to call this depressive personality disorder)
• Adjustment Disorder – this situational depression occurs when external events overcome your ability to manage the emotional stress of what you’re going through
• Postpartum Depression – depression after giving birth, or occasionally during pregnancy
• Premenstrual Dysphoric Disorder – depression which follows a woman’s monthly cycle
• Seasonal Affective Disorder – “winter sadness”
• Bipolar Disorder – where depressive episodes alternate with periods of hyperactivity called mania (this pattern used to be called manic depression)

Depression treatment is very effective. But…

One-size-fits-all treatments are only going to be effective for people that they are actually a good fit for. The treatment should not only be a good fit for your symptoms, but also for you as a person. Your personality dynamics determine what types of psychological problems you might have, how they’ll present themselves, and how you can find your way back to feeling better.

That’s why I like to take a holistic (Adlerian/Ericksonian) approach, creating a customized treatment for each patient. This may incorporate any of the following:

• Behavioral prescriptions – Targeted action plans can help gradually break the inertia of depression, so you start regaining a sense of yourself as a person who can accomplish things. In the scientific literature, this is referred to as “behavioral activation,” and it is actually one of the most effective techniques — especially for severe depression.
• Lifestyle modification – I help my clients examine their style of living to identify simple, powerful changes they can make to help support a positive mood — things like exercise, sleep, relaxation, stress management, nutrition, and time in nature. This ties in with behavioral activation, but goes beyond mere activity for it’s own sake, into choosing activities that will have specific physiological and psychological effects.
• Cognitive restructuring – This central aspect of cognitive behavioral therapy involves learning to recognize and change the automatic thoughts and mental images that support the depressive symptoms, as well as the core beliefs which make a person susceptible to depression in the first place.
• Psychodynamic therapy – Many people who are “cured” of depression remain susceptible to experiencing the same thing all over again later on. Through the use of insight-oriented or psychoanalytic techniques, you can discover the source of this susceptibility and develop strategies to help ensure that the rest of your life keeps getting better and better. Research shows that patients who receive this type of therapy continue to improve for years after the treatment is done.