Depression, like anxiety is present everywhere and is a reality of our daily life. It can be a normal reaction to a wide variety of events and must be evaluated as such. When the depression is appropriate to a life event and is not of major magnitude, specific treatment is not necessary. In many cases a person comes to a health expert, a psychiatrist or physician to find out if the depression is abnormal, and in a significant number of cases all that is needed is to reassure the person that the depression is not significantly abnormal. Not every depression requires treatment, and the overuse of antidepressant medications is a direct result of doctors to appreciate this.
The whole issue of depression is further confused by the fact that the word is used as an expression of mood, a symptom, a syndrome or a disease. The classifications of depression are totally different and do not necessarily relate to each other. A so-called neurotic versus psychotic classifications are not well differentiated, and treatment is not predicated on the distinction.
There are four basic models of derpression: Agression-turned-inward, loss, interpersonal relationship and biogenic amine.
Agression-turned-inward construct is apparent in many clinical cases of depression but has no substantial proof, although the emergence or expression of anger does at times alleviate the depression.
Loss model postulates that depression is a reaction to loss of a person, thing, status, self-esteem, or even a habit pattern. This model is often quite evident in everyday life situations, and the connection between the loss and the depressed response is often quite clear.
Interpersonal relationship approach utilizes the behavioral concepts. The person who is depressed may use depression as a means of controlling other people. It can be an extension and outgrowth of such simple behavior as pouting, silence, or ignoring something or someone. These ways of coping can grow malignantly as the person expands the reactions to feeling sorry for himself, unloved and alone. This may temporarily elicit some reassurance or attention from another person, but gradually, like most neurotic patterns, it fails to serve the need and the problems worsen.
Biogenic amine hypothesis stresses biochemical derangements characterized by a depletion of biogenic amines. The action of reserpine in its physiologic activity and occasional production of depression has been a major support of the hypothesis which requires further investigation.
In any of the four models of depression, it is important to talk and express the feelings out than holding it in.