Understanding Depression

Depression Assessment and Treatment: Symptoms, Causes and How We Can Help

You don’t feel pleasure anymore, you’re tired, you feel sad and you cannot motivate yourself to do something.

For a lot of people, these symptoms are recognizable, you feel down. Depressive periods are normal, particularly when a person faces tough personal issues, unemployment or relationship problems. However, if the depression continues for several weeks it may be a sign of a more prolonged and serious illness.

In terms of depression assessment, several factors may contribute to depression. Studies show that both ‘biological’ and environmental factors play a role in depression. Science often talks about the importance of certain chemicals in the brain like serotonin, growth factors such as BDNF or an imbalance of brain activity between the right and left frontal cortex. On the other hand, it is also known that severe emotional or traumatic experiences, or emotional neglect over a person’s history, may increase the risk of depression. Below you will find more details on depression assessment, including its symptoms as well as possible causes.

Psychological 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

Behavioural Symptoms

social withdrawal, loss of interest in surroundings

loss of willingness to have fun and participate in activities

physical agitation or even inhibited behaviour

reduced productivity

suicidal thoughts/ tendencies

emotional episodes / excessive crying

Psychotic Symptoms

In 10 to 15% of cases of depression assessment, 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.

What is Depression?

Depression is one of the most widespread mental illnesses and is distinguished from “normal” sadness by the nature and duration of symptoms. For it to be called a ‘disorder’ at least 5 out of 9 total symptoms would be present for more than two weeks which would include at least sadness and/or loss of interest or pleasure. It is said that women are two times more likely to have depression than men. Although it is more prevalent in women, the duration and recurrence rate is equal in men and women. According to the World Health Organization, around 350 million people suffer depression worldwide. Around 1 in 7 people will experience depression in their lifetime.

Not all depressive episodes or negative feelings are a mental disorder. It is normal for our emotions to fluctuate and to experience short-term periods of sadness from time to time. Depression, on the other hand, can be more difficult to overcome. It also has nothing to do with personal weakness or defects. It is a serious mental illness which people of all ages suffer. More than half of people with depression experience difficulties functioning socially. This may be reflected by increased absenteeism from school or work, fewer social contacts, poorer relationships with partners or family. In many cases, depression leads to temporary or permanent inability to work.

For immediate support, we encourage you to contact Lifeline on 13 11 14

“Clinical Depression“

Clinical depression is a mood disorder that is characterized by a loss of life pleasure or a heavily depressed mood. When depression treatment is not undertaken in the right way, it may worsen and can be life-threatening. Clinical depression assessment must meet certain criteria as defined in the DSM-V, the diagnostic manual for psychological disorders.

“Unipolar“ Depression

A unipolar depression is characterized by someone feeling down for a long period of time.

“Bipolar“ Depression

Bipolar depression is characterized by alternating periods in which a person feels depressive periods and subsequent periods of energy and activity.

What causes Depression?

It is difficult to give one cause for depression as it is often a combination of several factors, as outlined below:

Biochemical Factors

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. Depression treatment with rTMS is specifically aimed at restoring communication between brain regions (e.g. dorsolateral prefrontal cortex, anterior cingulate).

Bio-genetic Factors

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 as a depression treatment to prevent Seasonal Affective Disorder.

Psychosocial factors

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.

Psychological factors

Blocking painful feelings and thoughts through unprocessed traumatic (childhood) experiences can increase the onset of depression.

Organic factors

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.

Are you looking for help in assessing or managing Depression for you or a loved one?

Our clinics offer comprehensive assessments and personalized medication-free programs

Understanding Depression

We take a personalised approach to depression treatment

The underlying causes of Depression are not necessarily the same in two people. Because of this, it is important that the depression treatment 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 depression assessment.

Find out more about our assessment approach

About Transcranial Magnetic Stimulation (TMS)

A safe and proven therapy for Depression with long-term effects

Depressive disorders can be treated with Psychotherapy integrated with magnetic stimulation. Magnetic Stimulation is a well-researched and scientifically proven depression treatment method with minimal side-effects. At neuroCare TMS depression 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).

TMS in practice

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.

Who is TMS suitable for?

– 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.

Find out more about TMS

Want to learn more about this program or our assessments?

Please write to us below, briefly telling us about your situation and how you think we may be able to help.

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