- Thoughts: Ruminating over events of the past, expecting low positivity in the future, difficulty concentrating or making decisions. People who are depressed often have difficulty controlling their sad, regretful, or otherwise painful thoughts.
- Behaviors: withdrawing, isolating, deactivating. Depression makes people do less and live a less enriching life.
- Emotional feelings: sadness, misery, guilt, worthlessness, regret, pessimism, low positive emotions
- Physical feelings: tired, slow, heavy, drained, burned out, appetite/weight changes (increases, decreases), sleep changes (too much, too little)
Anhedonia is a special (but treatable) type of depression
Anhedonia is decreased interest, pleasure, and positivity in daily activities. It involves difficulty feeling positive, not expecting good things to happen, and not being motivated or putting in effort.
Depression is common
~30% of people will have depression at some point in their lives (Kessler, et al., 2012). ~60-80% of people with depression will also have an anxiety disorder (or vice versa) (Lamers, et al., 2011).
Depression is very treatable!
The gold standard treatment for anxiety is cognitive-behavioral therapy. However, a new evidence-based treatment called positive affect treatment might be even better for depression and anhedonia. I am one of the very few psychologists who offers this therapy. It was developed in the lab where I am Associate Director at UCLA.
Major Depressive Disorder
~30% of people will have major depressive disorder at some point in their lives (Kessler, et al., 2012).
Major depressive disorder involves at least one major depressive episode (defined below). Major depressive disorder can sometimes be continuous (one long episode), recurring (multiple episodes with times of “feeling good” in between), or singular (just one episode). A major depressive episode involves at least five of the following:
- Depressed mood.
- Loss of interest or pleasure in most activities (anhedonia).
- Change in weight or appetite.
- Increased or decreased sleep.
- Feeling restless or moving slowly.
- Fatigue, low energy, or decreased efficiency with routine tasks.
- Feeling worthlessness or guilt.
- Difficulty thinking, concentrating, or making decisions.
- Recurrent thoughts of death, dying, thoughts of suicide, or suicide attempts.
Persistent Depressive Disorder (Dysthymia)
~2–3% of people experience persistent depressive disorder (PDD) at some point in their lives (Kessler, et al., 2005)
- Persistent depressive disorder involves a chronic, low-grade depressed mood that lasts for two years or more (one year for children and adolescents). While symptoms may be less severe than major depression, they are long-lasting and can significantly affect daily functioning, relationships, and quality of life.
- Some examples of persistent depressive disorder include ongoing feelings of:
- Sadness, emptiness, or low mood most days.
- Low energy, fatigue, or feeling “worn down.”
- Low self-esteem, guilt, or feelings of inadequacy.
- Hopelessness or pessimism about the future.
- Difficulty concentrating or making decisions.
- People with PDD often describe feeling this way for so long that it seems like “just who I am,” rather than something that could change.
- Persistent depressive disorder commonly includes avoidance, such as withdrawing from social activities, avoiding new opportunities, procrastinating, or disengaging from goals or hobbies due to low motivation or fear of failure.
- Some people with PDD also experience periods of more severe depression on top of their chronic low mood, sometimes referred to as “double depression.”
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