Experts say that depression is sickness of 21.century. Today is depression used in every kind of situations and because of that people are not sure what definition of depression really is. How to fight or deal with it? We spoke about it with a master psychologist and psychotherapist Dragan Žuljević.
Mr. Žuljević has experience of many years working in psychological counseling with various clinical and subclinical psychical problems. He said that be unsecure is normal for youth because they are in specific period of their life. He has opinion that no one should be afraid of their emotions and he suggests using psychological counseling to everyone who needs this kind of support.
Consultation from psychologist can’t be wrong. Human strength to fight with problems has its limits. Someone prefers to try to solve problems alone and if it is not going well to ask for another solution. Someone can solve the problems and knows how to do that but he needs a support; and someone just looks a way to speak about his feelings in safe environment, said Žuljević.
He explained misapprehension about psychology and gave us difference between sadness and depression. Also, Dragan Žuljević told us which activities can or can’t help us to defeat sad mood and also what psychologist can really do about our problems and why it should not be shame going to counseling.
Term depression is used today in almost every context; when somebody is sad he thinks he is depressive. What depression really is?
Depression is term which is used in the really wrong ways. Despite the sad mood, depression is clinical statement which reflects on various human aspects. The first is emotionally – intensive sad mood, crying, unhappiness and dissatisfaction; then, thoughts are empty, those persons are emotionally exhausted and they are not feeling anything – even sadness.
The other aspect is about thoughts, as we say cognitive – thoughts are “black”, negative, catastrophic; future seems horrible or they don’t see it at all; people are thinking about them like as bad persons who deserve punishment and rejection, persons who are annoying and guilty for many things. Those people think that world is uninteresting and boring problem which is difficult to fight with and survive. Because of that many people thinks about suicide and self-destruction.
Third aspect is about will; nothing can cheer you up, nothing interests you, you don’t have will for anything, even for going out from bed or doing personal hygiene. People are often anti-social; they are spending their time alone, most of the time in the bed thinking about past and mistakes.
Forth aspect is biological – insomnia and lost of appetite. Person is sleeping too much or has intensive insomnia. They lose their appetite or they are eating too much, so, they feels exhausted and tired all of the time. Everyone in some period of life feel some of these aspects, especially after a loss. Diagnostic classification of World health organization (WHO) consider that everyone has at least two of those aspects which seriously reflect on everyday life, and those problems last more than 6 months. In that case, this state can be described like depressive episode.
Can you tell us the difference between depression and sad mood?
When you experience some lost, disappointment or if you watch sad movie, listen to sad music is normal and natural to feel sadness. That sadness can be bigger or smaller, depending how stressful was event which made us sad. Researches shows that most of the people in case of losing someone they love over this loss after 6 months. Longer sadness and also impossibility of feeling sadness in situation of lost are signs that it will be better to consult with someone professional. In these situations we are at risk to develop some disorder like long term of sadness or depressive episode. That is really depression unlike changing mood how people today popularly identifies depression.
Many young people feel unsecure and worried about their life, especially after finishing studies. Is that normal and expected reaction or they should be worried about their mental health?
Of course is normal and expected reaction. Every life change is stressful and creates the need of adaption. During the process of adaptation is usual to make effort and feel unpleasant emotions because we are passing from zone of comfort to zone of something new and unknown. If we are all the time experiencing failures or emotional consequences we should ask for help. It is optimistic that most of the people in that period find his way without consulting a psychologist.
How to know when is necessary to ask for help from professional?
When we realize that we need counseling. Rule doesn’t exist. Suffering is subjective statement which can be short term and temporally but also can be long-term and frequently. In every of these spots person can realize that she need advice from psychologist. In the most of the times, people asks for help when they are unmotivated and helpless because they done all of their methods to fight with problems. When those methods are not enough good, psychology is there to assist.
Do you suggest speaking with friends or family about the problems or rather with psychologists?
I suggest both of them. One of the most important things of coping with stress and emotional problems is social support. Friends and family can give us support which reminds us they are here for us. Support from psychologist is different because psychologist knows how to cope with persons who has similar problems. These two types of support aren’t and shouldn’t be separated. The best effects will give support from psychologist and in the same time support and love from family and friends.
Many people still believe it’s a shame going to the counseling. How can psychologist help us?
Fortunately, prejudges that you are mental patient if you consults psychologist are not so big as before. We are expecting that in the near future people will ask for help if they experience some problem, like they are going to the dentist if they have pain. According to Penn, Schoen, & Berland Associates (2004) research say that 91% of American society would consult psychologist if they have a problem, 27% asked for help in the last 2 years, 49% knew someone who asked for psychological help, and around 30% of people would be worried if someone find out that they were on counseling. As you can see, numbers are telling it is normal to ask for help from psychologist. Unfortunately, research for territory Southeast Europe don’t exist but considering the situation in which society is in transition, there is a chance that this percent is even more. Many factors decide if person will consult psychologist.
First, it is question of availability of psychological services, it is important if those services finances client or social protection; or is that service available in psychiatric clinic, local ambulance or free consulting.
Second factor which decide if person will consult the psychologist is emancipation of client, society which consider a person who needs help as a week or mental patient. If society is developing, there is a bigger chance to people get support.
Considering the fact that psychologists are not all-powerful and that they are here to have an effect on people but not to solve the problems; how psychologist really can help us, and how can we help to us?
Psychologist or psychotherapist is there to work with you and teach you how to deal with problems of everyday life, sometimes really cruel life. Psychotherapist gives you support in specific way; he speaks with you sincerely. In so-called medicine way, client has opportunity to feel intensive emotions, unpleasant past experiences, learn new ways of thinking and behavior which can help to be more satisfied with life. A person will have a chance to try all of that in real life and make various experiences and results which he hadn’t had chance to have before. Psychologist in this way looks a little bit like English queen – from position professional authority he gives advices, suggestions; he thinks, supports, praises, favorites, motivates, he has his personal attitude and he wants to help his client. In the same way, psychotherapist doesn’t have and he should not have power to react on client attitude. Client decides what he will do.
Is it true that currently treated depressive people have more chance to be again depressive or, especially because they were healed once before they have smaller chance to be depressive again?
Depression you can’t just pick up somewhere or fall into it like into a hole. In the most cases, depression is result of learned and implemented patterns of behavior or thinking which lasts many years. People can develop depressive statement when in real life some event activities make us depressive. Researchers tell us that people who solve their problems of depression only with medicaments in big percent again in their life has again depressive episode – according to Moncrief and Kirsch (2005, 2010) it is 85% of people. Those who the same problem solves with psychotherapy have extremely smaller chances for another depression – according to Steinert, Hofmann, Kruse, & Leichsenring (2014), number is under 43%. When the problem is smaller, chances for longer success are better.
Can mediation, yoga, music, motivating books etc. can help us really or those are just fake phrases which are used all the time like universally solutions for depression?
There are no quick or universal solutions because there are no universal problems. People are individual. When psychologist has his first interview with a client he often want to know information about client’s history or present habits and also about the problem which made him to come there. Result of this complicated collecting information is giving suggestions considering science researches. However, people doing many things to feel better and, luckily, psychology is not the only way of helping us. Even today people are going to fortune-teller and asking for a help. Believing or not, they feel better because they are sure that fortune-teller can help them. If someone believes that hatha yoga or Christian religion makes sense and make you feel good, then you should do those things. But if you are Orthodox and someone force you to meditate with mantra or you are agnostic physicist who is forced to pray – that methods hardly can help.
The best medicine against depression is work, activity. Is that true?
No. Physical activity is important, required and usable; but every fake attempt to solve emotional problems I consider as insult for psychology and people who objectively suffers.
How can help us doing some sports? Which is really connection with physically and mentally training?
Sport and every kind of physical activity have effects on psychical mood. For example, physical activity causes synthesis and hormone secretion in nervous system, in the first place endorphin and dopamine. They are natural painkillers, responsible for feeling of well-being and satisfaction. When we are physically tired, good feeling which drifting through muscles and whole body is a result of concentration of these substances. They increase psychological well-being. When somebody is physically active he enriches his life with something new. If you are doing some sport it is a bigger chance to something good happen to you, to find something new, meet someone, talk or to look forward, which can’t happen if you stay in house watching TV.
There are some discussions which tell us that antidepressants heal consequence but not cause of the problems. Do you think antidepressants are the best solution for people who can’t fight with their problems?
No. First important thing is effectiveness of antidepressants. There are medicine researches mentioned in the book of Irving Kirsch Emperrors New Drug (2010) which show that antidepressants are effectiveness, but the most of the effectiveness are in fact that person is aware that takes medicine. On the second place is active substance of medicine which can also cause many unpleasant effects.
There are researches like, for example NIMH collaborative study of depression Irene Elkin (1994) which tells us that psychotherapy has most of the time the same effects like medicines and it is more effective in long term. Medicines work symptomatically – they remove current sadness but psychotherapy offers a chance to learn new skills how to prevent new depressive episodes. Therefore, like in the situation when you have pain in your tooth you have choice. You can take medicine and the pain will disappear for some period of time. But also, you can go to the dentist who will fix your tooth, or, even better, who will teach you how to wash better your teeth and how to prevent new pain.
There is one article with a title: Screw motivation, what you need is discipline. They are talking that if you are doing something only when you are in the mood to do that, you will never reach a goal. What is your opinion about that?
It is ignored psychical functioning of 7 milliard people on the planet; 7 milliard individuals with different life histories. They offer a solution in one sentence which says: work, work, discipline and ignore your own wishes? I think it is quite risky and not intelligent putting our psychical life in one isolating world like they do.
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