Depression, according to Beck and Alford (2009), is a psychological disorder characterized by deviations in feelings, cognition, and individual behavior.
Depression is a prevalent mental condition characterized by sad mood, lack of interest or pleasure, less energy, feelings of guilt or low self-worth, interrupted sleep or food, and impaired attention (Kumar et al., 2012). It also represents the fluctuating moods or range of moods that can interfere with a person's existence. Depression affects the feeling of being overwhelmed and unable to cope. Depression is a prevalent mental disease in the modern world.
According to Alford and Beck's (2009) book Depression Cause and Treatment, depression is characterized by four symptoms, including emotional, cognitive, motivational, vegetative and physical. The following will be delivered for these categories:
1. Emotional Manifestations
These emotional Manifestations describe the changes in habitual activity or behaviour and mood caused by the emotional state. An increase in emotionality accompanies the shifting of perspective. It alters the depressed mood, a wrong view of oneself, constant feelings of satisfaction, crying, and happiness response (Lubis, 2009). A decrease in mood occurs when a depressive individual feels more unhappiness, unease, dissatisfaction, or dysphoria. Emotional symptoms are split into six categories, including depressed mood, negative sentiments about oneself, a
reduction in gratification, a loss of emotional attachment, sobbing spells, and a loss of the ability to laugh (Beck & Alford, 2009).
a. Dejected Mood
People who are depressed show that they feel restless. It is evident when individuals describe their emotions using sad, unhappy, lonely, or bored terms. One example is "I'm so miserable that I can't endure another minute" (Beck & Alford, 2009).
b. Negative Feelings Toward Self
Due to their dissatisfaction with their lives, many sad people have negative thoughts about themselves. Self-dislike and self-hatred may lead to the occurrence of negative emotions (Beck and Alford, 2009)
c. Reduction in Gratification
According to Alford and Beck (2009), the loss of satisfaction is considered the central sickness among depressed individuals. This example may represent a sensation of boredom, dissatisfaction, or lack of interest in any activity, but actually, it is delightful (Margiana, Kuncara, & Lubis, 2020).
d. Loss of Emotional Attachment
familial affection, which is responsible for the decline in interest in interaction (Beck and Alford, 2009)
e. Crying Spells
Someone who is depressed will always begin by crying excessively. An increase in crying frequency often accompanies depression. In this instance, women were more frequently affected than men (Beck and Alford, 2009).
f. Loos of Mirth Response
Depressed individuals lose their sense of humor, as indicated by the loss of mirth reaction. Even though they are smiling or laughing, it does not necessarily indicate that they are pleased. Depressed people tend to take everything seriously, so their smiles and laughter are phony (Beck and Alford, 2009).
2. Cognitive Manifestation
Cognitive is all about selflessnesses, such as low self-evaluation, negative thoughts, self-blame and criticism, inability to make decisions, and body image distortion (Lubis, 2009). These types of negative altruism would be the source of someone's anger. All opinions agree that social, physical, and economic conditions are inadequate. In addition, cognitive symptoms characterize the lowest awareness of attractiveness, health, popularity, self-assurance, money, salary, and the appeal of personality branding. Alford and Beck (2009) classify cognitive manifestations
into five groups: low self-evaluations, negative expectations, self-blame and self- criticism, indecisiveness, and body image distortion.
a. Low Self-Evaluations
Low self-evaluation suggests that sad individuals tend to lack confidence in their talents. Low self-esteem is a defining symptom of depression (Beck & Alford, 2009). They have a low opinion of IQ, education, health, strength, popularity, finances, and other aspects of life. Occasionally, individuals lack confidence in their social status. People with low self-evaluations use phrases like "I am inferior" or "I am insufficient”.
b. Negative Expectations
Negative expectancy implies that depressed individuals are always pessimistic.
It represents the viewpoint of depressed individuals, which is a pessimistic appearance. They believe that nothing improves and that there is no future. One example is when sad people are supposed to take antidepressant pills but do not, and the pills are discarded because they believe they are ineffective (Beck & Alford, 2009).
c. Self-Blame and Self-Criticism
Self-blame and self-criticism are symptoms of a depressive state. It occurs when depressed people can't keep up with the overall achievement around them; for
example, if they can't graduate in the fourth year, everyone else can graduate in the fourth year, leading to blaming and criticism (Beck & Alford, 2009).
d. Indecisiveness
Most depressed individuals feel hesitant to venture outside. This situation is an indication of depression. They are constantly worried about what she or they will do wrong. Beck and Alford (2009) state that depressed features include difficulties making or constantly changing decisions.
e. Distortion of Body Image
When depressed individuals gaze in the mirror, they frequently experience feelings of physical self-blame. In this scenario, women are more susceptible to body image distortion than males (Beck & Alford, 2009).
3. Motivational Manifestations.
Motivational manifestation refers to a person who has lost their motivation. It is also known as willpower paralysis. Motivational manifestations are the primary obstacles to engaging in fundamental behaviors, such as eating, drinking, and defecating (Lubis, 2009). The core issue is the individual's lack of responsiveness to their tasks, despite their awareness that they are delaying them. Therefore, depressed individuals will have more time to daydream than to perform necessary
tasks. According to Alford and Beck's book Depression Cause and Treatment, motivational manifestations are categorized into four categories: willpower paralysis, avoidance, escapist, Withdrawal Wishes, suicidal thoughts, and increased dependence (Beck & Alford, 2009). It will describe the subsequent;
a. Paralysis of the Will
Paralysis of the will indicates that nothing, not even basic tasks such as eating, drinking, or taking medication to alleviate their disease, brings them any pleasure. It is pretty unlikely that they will complete it. This they will lose all motivation to do anything (Margiana, Kuncara, & Lubis, 2020). Depression is distinguished by the loss of positive motivation (Beck & Alford, 2009).
b. Avoidance, Escapist, and Withdrawal Wishes
People with depression are more likely to be alone than to socialize.
Activities. Some depressed individuals prefer to live exclusively in their rooms and shun people who wish to interact with them (Margiana, Kuncara, & Lubis, 2020).
People who have experienced trauma will no longer attempt to persuade others that the event was terrible (Satriawan & Rahayu. 2020). According to Beck and Alford, depressed individuals desire a break from their everyday activities. One example is a manager who desires to leave an excellent job in years because he or she views the position as monotonous and oppressive, so he or she wishes to flee the position (Beck & Alford, 2009).
c. Suicidal Wishes
The most important desire of depressed individuals is to die by other means, such as by knife or hanging. Historically, it has been linked to a depressed state.
Suicidal desires include both active and passive forms, such as "I want to die" and
"I wish I were dead" (Beck & Alford, 2009).
d. Increased Dependency
Dependence is prevalent among depressed individuals because of their designation of assistance when they can perform tasks independently.
Consequently, depressed individuals rely more on assistance, direction, or advice than on their initiative (Beck & Alford, 2009).
4. Vegetative and Physical Manifestations.
According to Beck and Alford (2009), physical manifestations include four symptoms: hunger loss, sleep problems, loss of libido, and fatigue. The following will discuss these four symptoms:
a. The loss of appetite
Appetite loss is the first sign of depression in the case of physical symptoms.
Beck supports this in her book titled Depression: Causes and Treatment, which states that 72% of patients are profoundly depressed while 21% are not (Beck &
Alford, 2009). Therefore, anorexia is the initial symptom of depression in humans.
b. Sleep disturbance
excessive activity. Insomnia is one of the most prominent symptoms of depression among young, middle-aged, and elderly adults.
c. Loss of Libido
Depression causes libido loss, adverse effects on lust and orgasm, emotional withdrawal from a romantic partner, and consequent sexual performance anxiety (Manohar et al., 2017). This condition is also referred to as sexual dysfunction.
Sexual dysfunction is also likely a result of antidepressant medication. Then, loss of interest in desiring sex would decrease significantly for both men and women and would be awoken only by intense stimulation (Beck & Alford, 2009).
d. Fatigability
Fatigue is commonly used to describe the state of being weary quickly. Fatigue is a somatic symptom of depression, the most common manifestation of depression in primary care (Demyttenaere, 2015). People who are depressed will be weary of any action, even the smallest amount of movement.