It is not uncommon for people to describe themselves as anxious or depressed; the different emotions associated with each state are natural when difficult or threatening situations arise. Anxiety or depression for a limited time and for a specified reason is not a problem in itself. When either state becomes predominant and affects a person’s ability to function in everyday circumstances, anxiety or depression becomes a disorder rather than a feeling.
Here are some common symptoms:
sadness, hopelessness, particularly in the morning
tiredness, loss of energy, initiative and strength
feelings of fear or intimidation
feeling numb or “flat“ (no joy, fear or happiness)
thoughts of guilt, self-blame, worthlessness and lack of self-respect
social withdrawal, loss of interest in surroundings
loss of willingness to have fun and participate in activities
physical agitation or even inhibited behaviour
suicidal thoughts/ tendencies
emotional episodes / excessive crying
In 10 to 15% of cases of depression, there are psychotic features whereby the person has an altered perspective of reality. This manifests itself as a psychotic depression and the person usually experiences delusions (incorrect thoughts). Often the content of those delusions are in accordance with the depressed mood: the themes are dominated by personal shortcomings, failures, guilt, death, penalty or nihilism.
Depression is a pervasive mood disorder that is characterised by low mood, low self-esteem and loss of interest or pleasure in everyday activities. Depression is said to result from a perception of helplessness, that is, a person perceives themselves as having no control over their own circumstances and feels pessimistic about their future. There are many different types of depression, such as major depression, dysthymia, seasonal affective disorder and bipolar disorder. People who have depression tend to have overly adverse reactions to incidents that would usually elicit a more moderate reaction, and they often experience these problems as overwhelming or unsolvable.
Some of the common symptoms of depression include lethargy, fatigue, sadness, pessimism, low self-esteem, changes in appetite and difficulty sleeping. More than anything, depression is associated with overwhelming feelings of helplessness and loss of control over one’s life.
Anxiety is an adaptive response that allows people to react appropriately in situations where they may need to exercise caution or be on alert for danger; this is commonly referred to as the fight-or-flight response. When a threat is perceived, the body anticipates and prepares the person for a high level of muscular activity by initiating a series of physiological changes. There is a release of adrenalin, the heart rate increases, blood flow to inessential physiological processes (such as digestion) is immediately ceased so that as much blood and oxygen as possible is available for the muscles. A certain amount of anxiety is healthy, even essential, in order to interact safely with our environment. Anxiety becomes a disorder when the intensity or duration of anxiety is beyond what would reasonably be expected in a given situation. Anxiety disorders may manifest as generalised anxiety, panic attacks, phobias, stress disorders or obsessive-compulsive disorder.
Feelings of anxiety can trigger a range of other symptoms. Some of the most common of these include sleeping difficulties, restlessness, tension, high blood pressure, irritability and poor concentration. Anxiety disorders generally arise when a person is continuously worried about a future threat that may not even be realised. Because there is no way to resolve the source of the worry at that time, the anxious symptoms become the primary experience rather than the stressor itself. This is a case of the mind dictating the body’s response. Most significantly the condition can impact a person on every level, affecting their ability to function in the workplace, at home or in social settings.
Research has shown that depression is a disturbance in the balance of certain substances in the brain (such as serotonin, norepinephrine and growth factors such as BDNF). However, recent research also shows that this is more complex than just a reduced serotonin level. Also, recent research has shown that depression is associated with a specific pattern of disturbed brain activity as well as the extent to which certain areas of the brain communicate. Treatment with rTMS is specifically aimed at restoring communication between brain regions (e.g. dorsolateral prefrontal cortex, anterior cingulate).
Genetic components also play a role in depression. Children of parents with depression are three times as likely to also experience depression as compared to children of parents who have not had depression.
A specific form of depression is associated with shortened daylight, called Seasonal Affective Disorder (or SAD) which is mainly caused by light deficiency. Light therapy can be used to prevent this kind of depression.
Major life events such as divorce, death, resignation, promotion or the arrival of a child can play a significant role in the development of depression. These are events that can evoke a lot of tension and stress. Often depressive episodes can be alleviated through a healthy and active social life. Stable employment, stable relationships and frequent contact with friends, particularly those who are supportive, often give a person a form of a social safety net for better stability and life-structure.
Blocking painful feelings and thoughts through unprocessed traumatic (childhood) experiences can increase the onset of depression.
Certain medications and different types of drugs (some high blood pressure medications, sedatives, alcohol, amphetamine, cocaine) are known to be a possible cause of depression. There are also a number of physical disorders which increase the risk of depression, such as stroke.
The underlying causes of Depression are not necessarily the same in two people. Because of this, it is important that the therapy program is tailored to take into account a range of factors that may be contributing to the negative symptoms and feelings of the patient. Follow a comprehensive assessment of symptoms, we can also take a closer look at brain activity and other behaviours by means of a Quantitative EEG (QEEG) examination with a psychometric assessment. This allows our trained Psychology and Psychiatry staff to take into account biological, psychological and personal factors.
Poor sleep and wake behaviours may also explain or contribute to symptoms of Depression. For this reason, we conduct Actigraphy Sleep Assessments as part of a comprehensive assessment of symptoms.
Depressive disorders can be treated with Psychotherapy integrated with magnetic stimulation. Magnetic Stimulation is a well-researched and scientifically proven treatment method with minimal side-effects. At neuroCare TMS treatment is combined with Psychotherapy and delivered in a friendly and comfortable outpatient setting. Clinically significant improvement has been reported in 66% of patient cases with Major Depression treated with TMS combined with Psychotherapy (Donse et al. 2017).
Whilst there is extensive research on TMS in adults, there is not enough research on TMS on the developing brain, so this is a therapy not recommended for clients under the age of 18.
TMS is supervised by a Psychologist or Psychiatrist and is conducted in a comfortable treatment chair where a magnetic coil is placed over the head. The coil generates a pulsating magnetic field, stimulating the target areas within the brain. The magnetic field generates a noticeable ticking sound. while the stimulation is not painful, a tingly sensation on the scalp is often noticed.
– clients with a depssive disorder or dysthymia;
– clients with “treatment-resistant” depression;
– clients who wish to lower or cease medication and want a therapy to support that process.