People often used the word ‘depressed’. They may say, ‘I’m so depressed about this’. Or ‘This is so depressing’. They are describing what appears to be a ‘down’ moment. What will determine, however, whether you actually suffer from depression or not is whether you recover quite quickly from these down moments, or stay in them for long periods of time, or constantly.
When suffering from what was known as ‘clinical depression’, you have a very low mood and perhaps other symptoms every day for at least a fortnight. Often the symptoms can escalate and interfere with the running of your everyday life and activities.
What is Depression?
The word ‘depression’ is used to describe and assimilate everyday feelings of very low moods which can affect you from time to time. This is different from just feeling sad or down, disappointed or stressed, upset or angry. Depression as an illness means you experience intense and chronic feelings of ongoing sadness, hopelessness and helplessness and these feelings are often combined with physical side effects such as loss of energy, lack of sleep and physical ailments.
If you’ve felt the same way for a long period of time, you may not realise that you are depressed. You may put it down to bad luck, or other people, or circumstances. Some people find that they reach a state where their life is no longer functioning. It is then that they may see their doctor and they may receive a diagnosis of depression.
How do I know that I’m depressed? What are the symptoms?
Some people think that they may have a physical illness alone and are unaware that they are also depressed. The following is a list of symptoms that you may experience when you are depressed. You may have one or two or several.
- Loss of enjoyment and interest in life and activities that you used to enjoy
- Low mood nearly every day and life in general appears ‘dark’ or ‘black’
- Persistent feelings of sadness and lack of joy, accompanied by crying
- Tiredness, loss of energy and inertia
- Physical aches and pains with no medical cause
- Suicidal thoughts, occupation with death
- Feelings of helplessness, hopelessness, guilt and worthlessness
- Poor motivation where simple tasks seem very difficult
- Self-harm (cutting, burning, overdosing)
- Sleep problems
- Loss of appetite or increase in appetite
- Loss of sex drive or other sexual problems
- Poor concentration, such as difficulty reading, working, driving, etc.
- Agitation, restlessness and irritability
If you find that you have most of the symptoms on this list, this can indicate how severe your depression is at this time. The severity can fluctuate from mild to severe.
What is the cause of Depression?
There has been no single exact cause known for depression. In most cases, there are usually a series of reasons and experiences that contributed, but in some cases, no obvious reason can be found. This is where the research about chemical imbalances, hereditary and genealogical causes find merit.
An episode of depression may sometimes be triggered by an event in life such as bereavement, loss of job, illness or relationship problems.
It has been found that women are more prone to depression than men. Menopause and postnatal depression after childbirth are common times for women to become depressed, as well as fluctuating hormones with menstruation and family responsibilities. An alteration in the chemicals in the brain is thought to be a reason why some antidepressants can work in treating depression. More on this later.
What are the myths associated with Depression?
Unfortunately, we are finding that there is still stigma associated with mental health problems, especially depression. People tend to think that if you are depressed then you are of a weak nature. But in fact, many very intelligent, high profile, hard-working people have suffered from depression. The most noted is Winston Churchill.
It can also be frustrating when healthcare professionals themselves are not specially trained in depression and are unaware of what is helpful language to use in treatment. Telling someone to ‘pull their socks up’ or to ‘snap out of it’ is not only ignorant but can prove to be harmful and add to existing feelings of unworthiness and worthlessness.
It is helpful to understand that the symptoms you suffer are due to depression. It is a very common illness and one of the most presented at GP surgeries. If a GP is appearing to not understand your symptoms, you can ask to be referred to a specialist practitioner who can examine your symptoms in depth and take a full case history.
Commonly Used Terms
Manic Depression (now most commonly known as bipolar). People suffering from bipolar disorder experience severe mood swings with extreme ‘highs’ of excitement, elation and energy, to extreme ‘lows’ of lethargy and sadness. Symptoms of bipolar disorder tend to show up very early on in childhood, but as late as late teens.
Post-natal depression. Mothers can experience mood swings, crying spells, or extreme lows during the first few days after giving birth. This can continue up to a year or so if untreated and if conjoined with sleep difficulties and anxiety.
Seasonal Affective Disorder (SAD). As the seasons change and winter looms, this type of depression can begin to affect your sleep and eating habits. This is due to the lack of daylight hours and sunlight. Special ‘light boxes’ have been invented to help increase exposure to light.
Reactive depression. When traumatic events occur in life, people can begin to feel low, irritable, anxious or angry. These emotions can be directly related to the traumatic event and cause this reaction. This type of depression can go once the event has passed or the condition is treated. However, it can also continue if the stress is prolonged.
Endogenous depression. Similar to Reactive depression, this type of depression can be triggered by a stressful event or time in life. Physical symptoms are most common in this depression and tiredness, sleep disturbance, low mood and poor concentration can also affect everyday life.
What May Help?
Treatments for depression vary and can be a combination of medication, talking therapies, holistic therapies, and self-help peer support groups. Let’s look at these in this order:
- SSRI’s (Selective Serotonin Re-uptake Inhibitors have been around since the 80’s and tend to cause the least side effects. They are also less sedative than other types of medications. Serotonin is our natural feel-good drug that the body produces naturally. This is a synthetic one but helps to emulate the effect of serotonin in your brain.
- RIMA’s Reversible Inhibitors of Monoamine Oxidase are similar to MAOI’s and are usually prescribed in higher doses as they are given to those for whom other treatments have proven non-responsive.
There are other medications available and this can be discussed with your GP. Sometimes these medications may be combined with anti-anxiety medication.
Medication doesn’t address underlying issues such as childhood trauma or other psychological problems that may have contributed to being depressed.
Whilst there is a plethora of psychological therapies available, there are a few that are specifically designed to help treat some of the more severe symptoms of depression.
Psychodynamic Therapy This type of therapy be helpful when exploring long-term problems that recur and lost memory and childhood trauma. It is known to be thought provoking and anxiety inducing. It is based on the premise that whatever is brought into the therapy room is explored and relative to ongoing issues. This therapy can go on for years and most people attend 2-3 sessions per week.
Cognitive Behavioural Therapy. Known most commonly as CBT, this therapy has been backed by the NHS and is time-limited and goal focused. For this reason it is easier to produce evidence and outcomes, in other words, progress. Your thoughts, behaviours and feelings are explored. Tasks are given to complete between sessions. The average number of sessions is 12 on the NHS, but can be longer privately, depending on your symptoms and progress.
Counselling. This can involve several different schools of thought and as a general rule, counselling is the opportunity for people to explore what happens to them when they are depressed and focusing on the here and now, rather than going back to childhood and more deep-rooted problems.
Dialectical Behavioural Therapy. Better known as DBT, this therapy helps those who have self-harm as a symptom and uses Mindfulness as a means to help the person focus on the here and now and being mindful of every thought and action and what it produces. The typical treatment time is 1 year and a ‘step-down’ program offered as telephone support if needed. DBT specialises in helping those with personality disorder and self-harm. It is offered on the NHS, but some DBT therapists work privately.
Mentalization Based Therapy, known as MBT is a therapy that helps you to ‘mentalize’ which means to understand your own mental state, perhaps asking yourself ‘why did I do that?’ You begin to stop and understand or examine why you behave the way you behave and what your mental state was at that time. This is known to be helpful for personality disorders and self-harm. It is offered on the NHS, but you can also find specially trained MBT therapists who work privately.
There are a number of holistic or alternative therapies that can help you to ease the symptoms of anxiety. These include Hypnotherapy, Stress Management, and Acupuncture, Relaxation and Visualisation therapy and meditation. Also many of the homeopathic remedies such as Bach and Australian Bush remedies may help. Massage therapy, reiki and sound therapy have also yielded results for some people from the symptoms of depression.
As a Holistic Therapist, I must add that before manufactured medications existed these remedies successfully treated ‘mania’. I believe that these remedies can be used in combination with conventional ones.
Self-Help Recovery and Support Groups
The online community is very active in offering information and support for depression.
There are also peer support groups throughout the UK who offer meetings where people with similar symptoms can meet and discuss coping strategies. If depression has caused you to be isolated, attending a support group can be a way to get you out of the house and amongst other people. It often lifts your mood.
Helpful hints and tasks:
- Keep a mood diary. Note the days and how long you feel down. Also note physical symptoms and feelings.
- Identify your feelings. Get a list online of feelings. Go through it and see if any particular ones stand out. Note if you feel some more than others.
- Stay clear of substances that exacerbate depression such as alcohol, drugs and tobacco.
- Find a hobby that can occupy your time for at least a few hours per day.
- Pay attention to your person hygiene. Be sure to shower, wash and put on clean clothes. This can increase your mood immediately. It can also induce a feeling of relaxation.
- Try to continue to work if you can manage it. Although if you need to take time off, speak with whom you need to do so, your GP and other’s to determine the best course of action.
- Take care of areas which may be cause for concern, like debt, relationship difficulties, disputes, falling grades at school, or other responsibilities like pets and the household. Seek help if you need it.
- Try to speak to at least one person per day if you are isolated. This can be in person or telephone or even online.
- Try to get to bed at the same time each night.
- Try to get up at the same time each morning.
- Make it a point to prepare for bedtime. Take a soothing bath. Make sure your bed covers are clean.
- Try to meditate or sit quietly for a while. Listen to nature sounds or a favourite piece of music.
- When you retire at night, make a list of what you did that day that made you feel better, even if only for a few minutes.
Here are a few online communities:
Depression Alliance www.depressionalliance.org
Depression Recovery Groups www.depressionrecoverygroups.org
Turn 2 Me www.turn2me.org
Depression Understood www.depression-understood.org
For more information about depression visit:
Mind UK www.mind.org.uk