What is depression?

Many of us say “I’m feeling depressed” when we feel sad or miserable. But usually, these feelings pass after a while. But clinical depression is when these feelings are disabling and interfer with your life. Clinical depression can stop people from leading a normal life, it makes everything harder to do and everything may seem less worthwhile. At its most severe depression can be life-threatening, because it can make people suicidal or simply give up the will to live.

How do I know if I am depressed?

You may be ‘clinically’ depressed if you have most of the following symptoms:

  • depressed mood most of the day, nearly every day, that may be noticed by others.
  • Loss of interest or pleasure in all, or almost all, activities most of the day, nearly every day
  • significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
  • insomnia or hypersomnia nearly every day
  • psychomotor agitation or retardation nearly every day
  • loss of energy nearly every day
  • feelings of worthlessness or excessive or inappropriate guilt nearly every day
  • diminished ability to think or concentrate, or indecisiveness, nearly every day
  • recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

What types of depression are there?

  • General Depression People who suffer from general depression still have most of the major signs and symptoms of depression as discussed above. Depression can very from mild to moderate to sever (which is sometimes called major depression).
  • Seasonal affective disorder This happens when someone becomes depressed only during the autumn and winter, and it is caused by not getting enough daylight.
  • Postnatal depression Also known as “the baby blues”. This is a depression that occurs after the birth of their baby and can appear any time between two weeks and two years after the birth.
  • Manic depression Also known as Bipolar Disorder. Some people have mood swings, with periods of depression that then change into periods of mania. Mania is a state of high excitement, and peope who are manic may plan or believe lofty schemes and ideas.

What causes depression?

There’s no one cause of depression; it varies from person to person and can happen for a combination of factors. Although depression there has been not enough evidence to believe that is is something inherited in the genes, some of us are more prone to depression than others. Some factors that could cause depression include:

  • the way we’re made
  • our experiences
  • family background.
  • traumatic life events
  • poor coping strategies
  • after a loss of some sort (loved one, job, house etc)
  • life changes
  • inability to adapt
  • physical illness
  • poor diet and lifestyle
  • chemical imbalances

What can you do to help yourself?

Remember that depression can feed on itself. In other words, you get depressed and then you get more depressed about being depressed. An important thing to remember is that there are no instant solutions to problems in life. Solving problems involves time, energy and work. Here are some things you can do to try and break the hold of low moods:

  • Make an effort to be more aware of how you talk and think to yourself. Listen to yourself in your head.
  • Every time something negative crops up, quickly scrap that thought and think of something kinder, more encouraging things to say to yourself. For instance, when you have to do something, if you always say to yourself, ‘You’re sure to fail. You always make a mess of everything you do’ try to ‘delete’ those thoughts and replace it with something like: ‘You’re going to do the best you possibly can.
  • Look for things to do that occupy your mind.
  • Although you may not feel like it, it’s very therapeutic to take part in physical activities, for 20 minutes a day. This can stimulate chemicals in the brain called endorphins, which can help you to feel better.
  • Try doing things that will improve the way you feel about yourself. Allow yourself treats. Pay attention to your personal appearance. Set yourself daily or weekly goals that you can achieve. Look after yourself by eating healthily.
  • Try some alternative therapies such as acupuncture, massage, homeopathy and herbal medicine. St John’s Wort is one of the herbal remedies that have become very popular, and may help to lift your mood. But if you are already taking other medication, it may not be safe to combine them. Consult your pharmacist or GP for more information.
  • It can be a great relief to meet and share experiences with other people who are going through the same thing you are. It can break down isolation and can show you how other people have coped and that is how SpeakOut and support groups can help.
  • Remember to try and value and accept yourself. If you’ve spent most of your life believing that you’re unacceptable and of little value, it’s hard to change yourself for the better, because all your ideas and ways of behaving are based on that assumption.
  • Question the assumptions on which you base your ideas. Is it really true that everybody in the whole world hates you, or that everything you’ve ever done has turned out badly? Is it really true that you have nothing worthwhile in your life?
  • Try to remember how you came to think and feel this way.
  • Writing these things down puts what you’re thinking and feeling outside of yourself, and you can see it more clearly. Books can be helpful. Try reading, not just self-help books, but well-written novels, poetry and biography.
  • Talk about these things to other people and find out how they see things. Talk to friends, call at a local drop-in centre, join a self-help group. Talking to a therapist or counsellor can be very helpful.

What can you do if you think you need more help?

If you find your depression is effecting your daily functioning and has been present for a length of time now, it may be worth seeking the advice of your local doctor. Also if you have been going through a lengthy period of consecutive suicidal thoughts then it may be a good idea to seek out some reassuring aid from your local doctor if you haven’t already. 4 out of 10 appointments at G.P. surgery’s are on the concerns of a persons mental and emotional well-being, so there’s no need to feel like your the only one. Here are some of the things the doctor can offer:

  • Antidepressants – These are drugs which work on chemical messengers in the brain to lift your mood. It often takes between 2-4 weeks before the drugs take effect. The usual recommendation is that you stay on them for six months.
  • Psychological treatments – This is things like therapy and counselling. Many people find it helpful to talk about their difficulties to someone who is trained in listening skills. The therapist or counsellor can also help you to put your problems in perspective and to develop new coping and problem solving strategies.
  • Befriending schemes – Your doctor may put you in touch with a local befriending scheme this will lead to trained volunteers visiting you regularly to give you practical advice, support and a sympathetic ear.
  • Support groups – This is when you meet up and talk with other people who are feeling the same way as you and share your experiences. This can be helpful to discover what works for other people and how other people cope.
  • What if the depression gets worse?

    If you are severely depressed then you may need more intensive aid. Your doctor may refer you to a psychologist, psychiatrist or mental health nurse. The sort of services that you may be on offer for you include:

    • Community Mental Health Teams (CMHTs) – These are often the most easily accessible service for people with mental health problems. They can provide support for people living in their own homes. The CMHTs include a psychiatrist, community psychiatric nurses (CPNs), social workers and support workers etc. These professionals will visit you at your own home or refer you to Day Hospitals or Day centres where you spend the day but return home afterwards.
    • Crisis resolution services – These are teams of doctors and nurses who provide support during crisis situations, and will help you to stay at home if you’re in crisis, rather than go into hospital.
    • Electroconvulsive therapy (ECT) – This is a controversial treatment, that is only offered when people who are severely depressed and have not responded to any other treatment. It involves passing an electric current through the brain, while you are under general anaesthetic. I’ve witnessed this being done several times and in my opinion it sounds worse than it really is.
    • Hospital admission – If you are severely depressed and are a significant risk to yourself or others you may need the shelter and security of a ward hospital. It also gives a chance for the health professionals to monitor the effects of different treatments. Hospital can provide a safe, supportive environment if you are in a state of distress. Generally however doctors want to avoid placing people in hospital, but some patients are compulsorily detained if they are a dangerous risk to others or themselves.

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