What is Depression?

21 April 2016

Dr Lopa Winters, Consultant Child and Adolescent Psychiatrist, discusses how we address depression in young people and why it is important for them to seek help.

What is depression? How can we know how it differs from ‘ordinary angst’? Can it be understood? Do the benefits of modern science and medicine mean we know more about it now? Does it matter?

Depression is common.

Increasingly so during childhood and adolescence. Rates of depression in young people in the UK have risen by 70% in the past 25 years, and one in four young people report experiencing suicidal thoughts. (source youngminds.co.uk)

Depression is not new.

It has seemingly been a part of the human condition throughout the ages. The word we now use may have changed; yet one need only explore the origins of the word melancholia - ‘Black bile’ Greek - to evoke a sense of how it feels, has always felt and will likely always feel to those who suffer from it. This Hippocratic idea is that there is an imbalance in one of the four ‘humours’ or bodily liquids within the body, an imbalance in temperament. Something which results in physical and mental symptoms.

Anonymous adolescents (ado-486)

Melancholia is often associated with ideas of mourning, loss, wistfulness.

As long ago as 1917, Freud was struck by the commonality and differences in the experiences of those who felt a sense of loss, be that from death and mourning or the melancholic loss of an ideal, or something where ‘one cannot see clearly what it is that has been lost’. What is shared and prevails then and now is the feeling of deep sadness.

At The Tavistock the quest continues to understand these experiences. Be that from engaging in national and international research and academia; or from directly working with young people and their families to explore how things feel at an individual or systemic family level. Our aim is to engage with and find out from young people and the local community how best to provide support.

Overcoming stigma to provide help

Depression has always been shrouded in stigma and we work hard to promote awareness. Awareness in young people is important as we know from our adult patients and our research that most adults with severe depression have felt this way to some extent for most of their lives. By offering services based within schools, social care and community settings we deliver services more easily to young people in need and who may struggle to get themselves here to be helped. Crucially young people have been actively involved in shaping the services offered; including naming some of the Camden services!

Modern life, age old feelings

Our inquisitive approach means many of the staff at the Tavistock are also engaged in research and teaching. One of our areas of interest is seeking to understand the complexities of negotiating adolescence in a digital age and the Tavistock is involved in research and education in this rapidly developing area.

We are committed to finding out what works and for whom; offering a wide variety of treatments ranging from intensive or brief psychotherapeutic, individual, family or group approaches and medication. There are specialist services to help young people who may suffer with depression in the context of other difficulties such as being a looked after child, refugee or autism spectrum conditions. Young people and families are actively involved in using tools and their sessions to let us know how things are and how they feel along the way; only then can we truly know what works or doesn’t  at a research and individual level.

We may or may not know more about depression in the present day. The word for it may have changed, the socio-cultural environment and political climate have undoubtedly changed; but what remains a constant is our wish to try to be with the young person in their time of pain and distress. To try and understand the unfathomable, tolerate the intolerable, retain hope in the face of despair and attempt to bear what feels unbearable.

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