What exactly is depression? I have written a fair bit on depression on the blog so far but never really delved into what it actually is. As you may know from previous posts, I live with depression. I am reluctant to write suffer from depression. Yes, depression is hard, it is often soul-sucking, it feels like you are living underneath a black cloud. But it doesn't have to be suffered, to be endured. Depression can be lived with. Even if it doesn't feel like it at the time.
What is depression?
Depression is a mental illness where you feel sad and miserable most of the time and your mood is persistently very low. Being depressed is more than feeling down for a day or two – it usually continues for weeks or months at a time. Depression can range from being a mild illness to a severe one – where you can lose interest in life and the things you used to enjoy.
This definition was taken from the Ministry of Health's website. It sums up depression well, people often think that depression is just a feeling of sadness. But it is more than that. Depending on the severity, it can inhibit your very being. It can take the very essence of you and leave you a shell of yourself. It is a nasty, sometimes all-consuming illness.
There are different kinds of depression such as post-natal depression, major depression, bipolar disorder, anxious depression and psychotic depression. We will cover all that eventually, one at a time though. Baby steps.
What are the signs of depression?
Signs differ from person to person. Some people experience some of the below symptoms, while others live with depression in a whole other way. Everyone experiences depression differently. But the below are some of the most common signs.
- Irritable - more than usual (we are all a bit irritable if we are being honest with ourselves)
- Feeling tired all the time
- Getting too much sleep or not enough
- Feeling worthless and helpless
- Thinking about death a lot
- Having no energy and feelings of low self-esteem
- Loss of appetite or overeating
- Sadness or emotional ‘numbness’
- Loss of pleasure in everyday activities
- Poor concentration
- Reduced sex drive
- Having little interest in things that used to give you enjoyment
- Problems with concentration
- Feeling guilty, or crying for no apparent reason.
What causes depression?
Not all depression can be pinpointed to an event or something tangible. Sometimes depression can be triggered by a difficult situation or stressful changes in your life or can build up over years. Other times it seems to creep up out of nowhere.
Some common triggers are:
- Your past such as stressful or traumatic events in childhood
- Major life changes or stressful events such as a break-up of a relationship, death of a close family member or friend or financial trouble
- Ongoing challenges
- A family history of depression
- Physical illness, such as a stroke or heart attack
- Certain medications can cause depression in some people
- Social isolation, for example, having no friends or family near you
- Having had depression in the past
- Biological factors such as vitamin deficiencies or endocrine disorders
How to manage depression
Depression can be managed. Even though when you are at a low it feels impossible and like a whole loada work. It can be done. Managing depression is individual depending on the person, the stage and severity of the depression and other factors unique to the person. What works for one person may not work for the next.
There are three main treatment approaches for depression including self-help techniques, psychological therapies and medications.
Self-help techniques require the drive to get better as they rely on the individual to make sure that the techniques are being implemented. Some of the self-help techniques that will be recommended include:
- Regular exercise
- Maintaining a healthy, balanced diet
- Reducing alcohol, caffeine and tobacco intake
- Having good sleep habits
- Recognising when time out is needed, and taking it
- Making time to undertake an enjoyable activity each day
- Asking for and/or accepting support from friends and families to achieve self-help goals
- Understand what triggers depression for you
- Joining a support group
- Using mindfulness and relaxation techniques
- Complementary therapies such as massage, hypnotherapy, acupuncture etc
Psychological therapies are essentially talking therapy. This can be recommended for mild cases on its own or with medications as part of a treatment plan.
Talking therapies include:
- Cognitive behavioural therapy (CBT) involves helping a person to change negative ways of thinking and behaving that are associated with their depression
- Interpersonal psychotherapy (ITP) focusses on a person's dysfunctional personal relationships that cause depression or make the depression worse
- Problem-solving therapy(PST) is a form of therapy that aims to help you develop coping skills to manage upsetting life experiences.
Medications shouldn't be looked as a negative thing. Sometimes we just need a little help with life. I take antidepressants now, it took a long time to find the right one and I was determined to not rely on medications. But I realised after a couple of years of being medication free that actually, I do need a little help. That's ok. Sometimes we just need that extra help to get us through a patch.
The most common medication is antidepressants but other medications include antipsychotics, sedatives and mood stabilisers.
Electroconvulsive therapy (ECT)
This is generally a last resort (one I was threatened with). It is used sparingly and only in cases of severe depression when other treatment options haven't been successful.
Where to go to for help
Asking for help isn't a sign of weakness. It takes courage and strength to reach out to someone. Especially if you are the kind of person that likes to keep things to themselves. But remember, asking for help may open other peoples eyes as to what you are going through. Most people don't realise other people's struggles. If no one knows, no one can help you.
Talk to someone:
- a friend or a family member
- your GP, who can advise on the best treatment options for you
- a member of your local community mental health team
Get in touch with counselling services:
- a school guidance counsellor
- relationships services
- alcohol and drug services
- family support services.
- Mental Health Foundation has a range of brochures, helplines, services and websites available
- Depression.org is a really useful website with information on depression, where to get help, how to help someone you know with depression, real stories and lots of resources.
- The Ministry of Health has a great website filled with information, links and PDF's
Depression doesn't have to be isolating. Often depression makes us isolate ourselves and makes it hard to reach out. It requires a mammoth effort on a depressed persons part to actually reach out. If you are struggling there are many different treatment paths you can take. You are not alone. There is a light at the end of the tunnel, even if it does feel very far away. You got this.