Phone: 314-567-3040



Depression is the most common element of emotional problems. Depression may take the form of a symptom, that is, part of some other underlying emotional difficulty. Or, depression may be the primary emotional disorder itself. The forms that depression may take differ from individual to individual. Some forms may be quite mild and even normal and self-limiting: for example, becoming depressed and down-in-the dumps at the loss of a job, or mourning over the loss of a loved one. Indeed, mourning over the loss of a loved one is a necessary form of normal, adaptive behavior that often prevents a later depression. Other forms of depression, however, are quite severe and often of long standing duration. In these forms, a person's job, marriage, and, perhaps, life may be at risk. Depression may render a person unable to function in these areas and suicidal thoughts and behaviors may subsequently emerge.

Although a depressed mood, that is., feeling tearful, sad, blue, is a predominant sign of depression, it is not always present. Sometimes the depressed person may not realize that he or she is depressed, although other people in that person's immediate environment may have a sense that somehow something is ""wrong". For these reasons, it is important to be aware of some of the other signs of depression. Some of these signs are:

  • Poor appetite or weight loss, or increased appetite or weight gain
  • Persistent irritability
  • Difficulty in sleeping, or sleeping too much
  • Loss of energy, tiredness that is more than normal for the individual
  • Loss of interest or pleasure in one's usual activities, such as work, recreation, friends, or sex
  • Feelings of self-reproach or excessive guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicide, or any self-destructive or suicidal behavior.

Research has not yet pinpointed one single factor that is the primary cause of depression. Rather, there is evidence that suggests that all forms of, depression are due to the effects of interaction among a person's personality structure, brain chemistry, physical health, childhood experiences and present life circumstances. It is also clear that in some individuals the mix of these effects is such that they are more vulnerable to having a depressive reaction to a given situation than another person might be in the same situation.

Fortunately, the depressed person can be helped by psychological and/or medical treatment. The type of treatment varies in type and length according to the nature of the depression itself. For example, a crisis situation might overwhelm a person and plunge him or her into a depressive state from which the person has difficulty in recovering alone. In such a case, short term psychotherapy is often quite helpful in enabling the person to sort out thoughts and feelings and resume his or her previous level of functioning. On the other hand, a person's character or personality structure or brain chemistry may be such that they are continually vulnerable to depressive reactions to life's normal ups and downs. or may even bring about situations that are guaranteed to produce a depression. Long term psychotherapy and medical treatment may be necessary in such cases to reduce the individual's vulnerability to depression.

Given its high cost to life and livelihood, the best course of action when depression is suspected in oneself or a family member is to seek psychological evaluation and counsel.

After reviewing the aforementioned information, you may be considering a thorough evaluation to determine if psychotherapy, personal growth counseling and/or marriage counseling can help. I recommend you first review the website link, "When to consider psychotherapy?" also review any other link you may think applies to your circumstances.

My name is Oliver (Mike) Siems, MSW, LCSW, ACSW.
My company, Personal Growth, LLC, has been providing counseling services since 1975.

Personal Growth, LLC is located at:
443 N. New Ballas Rd., Ste. 201
St. Louis, MO 63141
314 567-3040