Mood disorders are known to have the ability to take many different forms. Among these, depression is one of the most common, and sometimes the difficulties in distinguishing it from normal sadness can make many people who need professional help not go to therapy.

On this occasion we talked about the subject of depression with the psychologist Begoña Fernández Seco , a professional in psychotherapy residing in Madrid and with more than 15 years of experience in this field.

Interview with Begoña Fernández: the complexity of depression

Begoña Fernández Seco is a General Health Psychologist and Director of the Begoña Fernández Psychology Centre, located in Madrid. In these lines she talks about her experience as a professional who has spent many years helping people with depression.

How often does depression arise without its cause being a clear event, such as a separation, dismissal or death of a family member?

Yeah, it’s pretty common. In fact, it’s not uncommon for depression symptoms to appear long after a precipitating event, and therefore the patient may not see the connection between his or her current symptoms and what’s happening in his or her life at the time, especially if the circumstances are favorable.

In these cases, it will be necessary to find out if in the recent past, he has gone through some difficult situation or perhaps he has been accumulating several stressful episodes that have kept him in a fighting attitude.

It is often assumed that people with depression are very sad. Are there cases where the person with depression does not feel sad, but experiences other symptoms?

Sadness is one of the most common symptoms of depression, but not the only one, and not always the main one either. Sometimes, it is put ahead of sadness, irritability, reluctance or lack of energy and motivation to do everyday things, guilt, feelings of failure, blockage, difficulty in making simple decisions. Sometimes a person moves from one emotion to another in a relatively short period of time, and this can lead to even more confusion.

What is often done in psychotherapy to help a person with major depression?

Major depression is a disorder in which a person has a negative view of himself or herself, the world around him or her, and a pessimistic view of the future. This negative view leads to automatic negative thoughts about yourself and your circumstances and to distortions of reality and interpretation of what happens to you.

Psychotherapy teaches the person tools to realize and change the dysfunctional, exaggerated and negative way they interpret what is happening to them, looking for alternatives to their way of thinking about what is happening to them. It also works with the behavioral part, to act in a way that brings them closer to achieving their goals.

On the emotional side, psychotherapy helps us not to fight negative emotions, and to learn to see the relationship between what we feel and what we think.

Is the process of improvement slow? How is it developing?

Depression is not a disorder we can get rid of overnight. The degree of hopelessness an individual has will be key to its duration. That is why it is important to work with the feeling of hopelessness, because if we think that circumstances will improve in the future, this vision will help us to get out of depression earlier.

Another beneficial circumstance is to have a good social and family network, above all to avoid falling into the self-absorption and self-attention to the symptoms that is usually so common in this mental disorder. Rewarding activities, even if done with little desire, also help the person not to fall into recurrent and looping negative thoughts.

In your experience as a psychologist, do you think that friends and family members of patients with depression tend to hold these people responsible for their own suffering?

It is less and less frequent to hear from family or friends phrases such as: “This is not a big deal”, “You have to do your part”, “You have a lot of story” or “You are just too weak”. But until recently, when there was less information, it was a disease that people did not understand much in general.

What ideas about this psychological disorder do you think need to be spread more widely, so that people with depression feel more understood and have it easier to get better?

To begin with, the phrases written in the previous section, since in most cases, it is the patients themselves who say all these statements, and not so much those around them.

Improvement does not depend on willingness, on “trying” to be better or on “doing our part”, but on learning to think and act in a way that is useful and adaptive. Let it be realistic. And that the patient, who normally sees no way out, manages to contemplate varied and different ways of thinking and acting in order to get out of the loop they get into.