What is depression?

Many of us say “I feel 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 interfere with your life. Clinical depression can prevent people from leading normal lives, make everything harder to do, and make everything seem less worthwhile. In its most severe form, depression can be life-threatening, causing people to commit suicide or simply give up the will to live.

How do I know if I’m depressed?

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

  • depressed mood most of the day, nearly every day, which others may notice.
  • Loss of interest or pleasure in all or nearly all activities most of the day, nearly every day
  • Significant weight loss when not dieting or weight gain or decreased or increased appetite almost every day.
  • insomnia or hypersomnia nearly every day
  • restlessness or psychomotor retardation almost every day
  • loss of energy almost every day
  • feelings of worthlessness or excessive or inappropriate guilt nearly every day
  • decreased 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 to commit suicide

What types of depression are there?

  • generalized depression

    People who suffer from general depression still have most of the major signs and symptoms of depression, as mentioned above. Depression can range from mild to moderate to severe (sometimes called major depression).

  • seasonal affective disorder

    This happens when someone gets depressed only during the fall and winter, and it’s because they don’t get enough daylight.

  • postnatal depression

    Also known as “the baby blues.” This is a depression that occurs after the birth of your baby and can appear anywhere from two weeks to two years after birth.

  • manic depressive

    Also known as Bipolar Disorder. Some people have mood swings, with periods of depression turning into periods of mania. Mania is a state of great excitement, and manic people may plan or believe lofty plans and ideas.

What causes depression?

There is no cause for depression; It varies from person to person and can occur due to a combination of factors. Although there hasn’t been enough evidence to believe that depression is inherited in the genes, some of us are more prone to depression than others. Some factors that could cause depression include:

  • the way we are made
  • our experiences
  • family background.
  • traumatic life events
  • bad coping strategies
  • after a loss of some kind (loved one, job, home, 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 back. In other words, you get depressed and then you get more depressed for being depressed. One important thing to remember is that there are no instant solutions to life’s problems. Solving problems takes time, energy and work. Here are some things you can do to try to break the grip of low moods:

  • Make an effort to be more aware of how you speak and think to yourself. Hear yourself in your head.
  • Whenever something negative comes up, quickly dismiss that thought and think of something kinder and more encouraging to say to yourself. For example, when you have to do something, if you always say to yourself: ‘You will surely fail. You always make a mess of everything you do’, try to ‘delete’ those thoughts and replace them with something like: ‘You are going to do the best you can.
  • Find things to do to occupy your mind.
  • Even if you don’t feel like it, it is very therapeutic to participate in physical activities for 20 minutes a day. This can stimulate chemicals in the brain called endorphins, which can help you feel better.
  • Try to do things that will improve the way you feel about yourself. Allow yourself sweets. Pay attention to your personal appearance. Set yourself daily or weekly goals that you can achieve. Take care by eating healthy.
  • Try some alternative therapies like acupuncture, massage, homeopathy, and herbal medicine. St. John’s wort is one of the herbal remedies that has become very popular and can help improve mood. But if you are already taking other medications, 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 as you. It can break the isolation and show you how other people have coped and that’s how SpeakOut and support groups can help.
  • Remember to try to value and accept yourself. If you have spent most of your life believing that you are unacceptable and of little value, it is difficult 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 everyone hates you or that everything you’ve done has gone wrong? 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 puts what you are thinking and feeling outside of yourself, and you can see it more clearly. Books can be helpful. Try to read, not just self-help books, but also well-written novels, poetry, and biographies.
  • Talk about these things with other people and find out how they see things. Talk to friends, call a local shelter, join a self-help group. Talking to a therapist or counselor can be very helpful.

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

If you find that your depression is affecting your daily functioning and has been around for a long time, it may be worth seeking the advice of your local doctor. Also, if you’ve been going through a prolonged period of back-to-back suicidal thoughts, it may be a good idea to seek reassuring help from your local doctor if you haven’t already. 4 out of 10 GP office appointments are due to concerns about someone’s mental and emotional well-being, so there’s no need to feel like you’re the only one. These are some of the things that the doctor can offer:

  • Antidepressants – These are medicines that work with chemical messengers in the brain to improve your mood. It often takes 2-4 weeks before the medicines take effect. The usual recommendation is that you stay with them for six months.

  • psychological treatments – This is things like therapy and counselling. Many people find it helpful to talk about their difficulties with someone who is a good listener. The therapist or counselor can also help you put your problems in perspective and develop new coping and problem-solving strategies.

  • Friendship Schemes – Your doctor can put you in touch with a local friendship scheme, which will lead to trained volunteers visiting you regularly to provide practical advice, support and a sympathetic ear.

  • Support groups – This is when you meet and talk with other people who feel the same way as you and share your experiences. This can be helpful in finding out what works for other people and how other people manage.

    • What if the depression gets worse?

    If you are severely depressed, you may need more intensive help. Your doctor may refer you to a psychologist, psychiatrist, or mental health nurse. The type of services that may be offered to you include:

    • Community Mental Health Teams (CMHT) – These are often the most easily accessible services for people with mental health problems. They can provide support to people living in their own homes. CMHTs include a psychiatrist, community psychiatric nurses (CPNs), social workers, and support workers, etc. These professionals will visit you at home or refer you to Day Hospitals or Day Centers where you spend the day but return home later.
    • Crisis Resolution Services – These are teams of doctors and nurses who provide crisis support and will help you stay home if you have a crisis, instead of going to the hospital.
    • Electroconvulsive therapy (ECT) – This is a controversial treatment, only offered when people are severely depressed and have not responded to any other treatment. It involves passing an electrical current through the brain, while it is under general anesthesia. I have witnessed this a number of times and it sounds worse than it actually is in my opinion.
    • Hospitalization – If you are severely depressed and pose a significant risk to yourself or others, you may need the shelter and safety of an on-call hospital. It also gives health professionals the opportunity to monitor the effects of different treatments. The hospital can provide a safe and supportive environment if you are in a state of distress. However, in general, doctors want to avoid admitting people to hospital, but some patients are compulsorily detained if they pose a dangerous risk to others or to themselves.