Depression, also known as Major Depressive Disorder, is a disorder that affects your mood, how you feel, think, and behave. Someone suffering from depression is often feeling sad, blue, or  “down in the dumps.” Further, depression can lead to emotional and/or physical problems that can affect an individual’s normal day-to-day activities. Those suffering from clinical depression, feel low most days.


Individuals suffering from depression may experience one or more following symptoms:

  • Feelings of sadness or unhappiness

  • Agitation, restlessness, and irritability

  • Dramatic change in appetite, often with weight gain or loss

  • Fatigue and lack of energy

  • Feelings of hopelessness and helplessness

  • Inactivity and loss of interest or pleasure in normal activities

  • Thoughts of death or suicide

  • Feelings of worthlessness or guilt

  • Impaired concentration, indecisiveness

  • Insomnia or hypersomnia (excessive sleeping)

  • Significant weight loss or gain

  • Reduced sex drive

  • Slowed thinking, speaking, or body movements

  • Indecisiveness, distractibility and decreased concentration

  • Trouble thinking, making decisions and remembering things

  • Crying spells for no apparent reason

  • Unexplained physical problems (ex. back pain or headaches)

Who Gets Depression?

About 6.7% of the population over 18 suffers from depression. 20-25% of the population has had a depressive episode once in their life. Major depression can occur in childhood, adolescence, adulthood, or old age. Women are twice more likely to be at risk.

According to the World Health Organization (WHO), depression was the leading cause of disability world wide and the 4th leading contributor to the global burden of disease in 2000.

The exact cause of depression is unknown but the following are some risk factors:

  • Chemical Imbalance

  • Genetics

  • Hormones

  • Life stressors/changes

  • Work or School

  • Loss of a Family Member

  • Trauma

How Does Thinking Affect Depression?

Certain thoughts, especially maladaptive thoughts can cause an individual to be depressed. The following are some examples of maladaptive thoughts:

Dysfunctional automatic thoughts – Spontaneous thoughts that are plausible, thought not rational, which lead to negative feelings.

  • Mind-reading – “He thinks I am dumb.”

  • Labeling – “I’m such an idiot.”

  • Fortune-telling – “I won’t pass my exam.”

  • Catastrophizing – “My life is over if I don’t get that promotion.”

  • Black and white (aka, all-or-nothing) thinking “Nobody cares about me.”

  • Discounting Positives – “Maybe I did that well, but anyone can do that.”

Maladaptive Assumptions of Beliefs.

  • “If I fail at something, then I’m a failure.”

  • “If someone doesn’t like me, then I’m not lovable.”

  • “I will not be happy if I don’t succeed.”

How Does Behavior Affect Depression?

Changes in Behavior can also cause or worsen depression. Behaviors that may cause changes include:

  • Loss of Rewards – Losing friends, a job, family member, etc.

  • Decrease of Rewarding Behavior – Spending less time in engaging activities such as socializing, exercising, or working.

  • Lack of Self-Rewards – lack of praise for positive behavior. Never “taking credit” or rewarding yourself for your achievements.

  • Skill deficits – social skills, work skills, assertiveness, etc.

  • New Demands – Change in residence, starting a family, a new job, etc.

  • Situations that result in the feeling of helplessness – having no control over circumstances, rewards, or punishments.

  • Punishment – Engaging with individuals who are negative or critical.

How Does CBT Help?

CBT is known to be 85% effective in treating depression, especially when paired with medication. Studies have shown that within 20 sessions, 75% of patients experience a significant decrease in their symptoms.

CBT treatment of depression starts by identifying and addressing behaviors and thought patterns that cause the unpleasant or sad feelings. There is a focus on the present thoughts and behaviors and how your actions (or lack thereof) affect your moods. Further, your unrealistic and negative thoughts will be explored. CBT treatment will help you think more realistically and feel better.

Treatment usually begins by identifying symptoms and the severity of the symptoms. You may be asked to fill out some forms, such as the Beck Depression Inventory to help assess your symptoms. During your appointment, you will set goals you wish to attain with the therapist and your progress will then be monitored throughout treatment. You will be expected to come to therapy about once a week (sometimes twice a week).

Participation during treatment is important in helping to reduce your symptoms and decrease your depression.
To learn more about treatment or to set up an appointment, contact Dr. Fazzari today.