Depression and how to help

Depression is very common – one in six of us can expect to experience depression at some point in our life.

There are different degrees of depression, ranging in intensity from mild to severe. When you are suffering from mild depression, you may feel low, sad or fed up for a while, however, these feelings normally lift. If you are suffering from severe depression you are likely to feel very down and unable to cope with normal activities like going to work or seeing friends. Severe depression is longer lasting. Sometimes you may feel so hopeless that you think of suicide. If you are severely depressed it’s important to seek help.

Depression doesn’t have to be forever, although when you’re in it, it's hard to see a way forward. You are not broken, you’re just stuck. Depression counselling can help you clear the fog, despair and feeling of hopelessness and find clarity and hope.

Am I depressed and what are the signs?

What is the difference between feeling a bit low and depression? If you’re familiar with the feelings of depression you may already know how you experience it, if you are not here are some of the signs and symptoms people experience when they are depressed. Depression can be a mix of physical, emotional and cognitive (thinking) experiences, which may vary for different people…

Do you have or feel any of the following?

• difficulty concentrating, remembering details, and making decisions
• fatigue and decreased energy
• feelings of guilt, worthlessness, and/or helplessness
• feelings of hopelessness and/or pessimism
• insomnia, early-morning wakefulness, or excessive sleeping
• irritability, restlessness
• loss of interest in activities or hobbies once pleasurable, including sex
• overeating or appetite loss
• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• persistent sad, anxious, or "empty" feelings
• thoughts of suicide, suicide attempts

If you are suffering from a combination of any or several of the above, please give me a call to discuss how we can find a way to help you uncover what the causes are and find a more satisfying way to live.

What causes depression? 

While we don’t know exactly what causes depression, a number of things are often linked to its development. Depression usually results from a combination of recent events and other longer-term or personal factors, rather than one immediate issue or event.

While we may experience sadness, outside factors can impact our normal life balance and tip us into a deeper sadness and depression. Factors such as grief, loss of someone significant, long-term unemployment, financial worry, living in an abusive or uncaring relationship, long-term isolation or loneliness and prolonged work stress are all possible contributing factors. 

It may also be due to how we have been taught to deal with conflict and stress from our family and upbringing. Depression can run in families and therefore some people may be more susceptible to depression. 

We may also have formed ourselves to be more at risk of depression (although this may also be due to our family patterns and behaviour). If you worry a lot, have low self-esteem, are a perfectionist, sensitive to personal criticism, or are self-critical and negative about life you may be more likely to experience depression as you struggle to manage the complex feelings, thoughts and physical effects. 

Serious illness in us or others can lead to depression, particularly if you are coping with long-term pain management and/or chronic pain. 

Finally, if we have a negative relationship with drink, drugs, eating, sexual relationships or any other addictive behaviours, this will work in a negative cycle of low mood and low self-esteem and it can be harder to move out of this negative cycle of thinking and behaviour, which could lead to depression.

Types of depression

We may experience depression in different ways, or it may be connected to specific circumstances. 

You may have:

• SAD – seasonal affective disorder/January blues/winter blues
• clinical depression
• bipolar depression/manic depression
• postnatal depression/baby blues
• bereavement and loss

What is ‘clinical depression’?

Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression. Clinical depression is the more severe form of depression, also known as major depression or major depressive disorder. It isn't the same as depression caused by a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder.

To diagnose clinical depression, many doctors use the symptom criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Signs and symptoms of clinical depression may include:

• feelings of sadness, tearfulness, emptiness or hopelessness
• angry outbursts, irritability or frustration, even over small matters
• loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• sleep disturbances, including insomnia or sleeping too much
• tiredness and lack of energy, so even small tasks take extra effort
• reduced appetite and weight loss or increased cravings for food and weight gain
• anxiety, agitation or restlessness
• slowed thinking, speaking or body movements
• feelings of worthlessness or guilt, fixating on past failures or self-blame
• trouble thinking, concentrating, making decisions and remembering things
• frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• unexplained physical problems, such as back pain or headaches

Symptoms are usually severe enough to cause noticeable problems in relationships with others or in day-to-day activities, such as work, school or social activities.

Clinical depression can affect people of any age, including children. However, clinical depression symptoms, even if severe, usually improve with psychological counselling, antidepressant medications or a combination of the two.

What is SAD?

SAD is sometimes known as "winter depression" because the symptoms are usually more apparent and more severe during the winter. A few people with SAD may have symptoms during the summer and feel better during the winter.

Symptoms of SAD can include:

• a persistent low mood 
• a loss of pleasure or interest in everyday activities 
• irritability 
• feelings of despair, guilt and worthlessness 
• feeling lethargic (lacking in energy) and sleepy during the day 
• sleeping for longer than normal and finding it hard to get up in the morning 
• craving carbohydrates and gaining weight 

For some people, these symptoms can be severe and have a significant impact on their day-to-day activities.

What is meant by the term ‘manic depression’ (now known as bipolar)?

Bipolar disorder, formerly known as manic depression, is a condition that affects your moods, which can swing from one extreme to another.

People with bipolar disorder have periods or episodes of:

• depression – feeling very low and lethargic 
• mania – feeling very high and overactive (less severe mania is known as hypomania) 

Symptoms of bipolar disorder depend on which mood you're experiencing. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer), and some people may not experience a "normal" mood very often.

Depression and relationships

Depression can make it difficult to maintain supportive and fulfilling relationships.

If your partner is suffering from depression, they may be so overwhelmed by their symptoms that finding the energy to communicate feels impossible.

As a partner or family member, it can be easy to find this draining and upsetting. You might become exhausted with the effort of feeling you need to support your partner and also keep up with running the house or looking after the rest of the family. You may also feel angry, lonely, fed up and hopeless yourself if you’re partner experiences depression on an ongoing basis. 

And in turn, the person with depression may begin to feel like a burden – as though they’re simply getting in the way and making the lives of those around them worse. They may be aware of the effects their depression is having on their relationships but feel powerless to do anything about it. This can make them feel guilty and lower their self-esteem even more.

How I will work with you and your depression

As your therapist, I will work with you on your depression and help you get to the bottom of the underlying causes by examining the thoughts, feelings and behaviours that are contributing to your low mood.

Together we will develop coping strategies to enable you to manage low moods, and you will learn techniques and tools that will be effective for you in the long run.

Can I have counselling and take antidepressants?

You may find that antidepressants may have helped with your low mood or mood swings, or you are thinking about trying them. You will be speaking to your GP about this decision or may decide you’d like to come off them slowly. Therapy can support you in what you feel is working and will also allow you some space and time to work on the underlying problems. 

Counselling and antidepressants can go together. What is not appropriate is to see more than one therapist at a time. So, if you are currently in talking therapy or CBT, it is required that you finish seeing that therapist before accessing counselling again.

Is there anything I can do to lessen my depression? 

Stay in touch with people

Don't withdraw from life. Socialising can improve your mood. Keeping in touch with friends and family means you have someone to talk to when you feel low. If this is not possible, then walking to the shops, getting out for a while, or speaking to someone online could help. 

Be more active

Take up some form of exercise. There's evidence that exercise can help lift your mood. If you haven't exercised for a while, start gently by walking for 20 minutes every day.

Face your fears

Don't avoid the things you find difficult. When people feel low or anxious, they sometimes avoid talking to other people. Some people can lose their confidence in going out, driving or travelling. 

If this starts to happen, facing up to these situations will help them become easier. 

Don't drink too much alcohol or take drugs

For some people, alcohol or drugs can become a problem. You may drink or take drugs as a way of coping with or hiding your emotions, or just to fill time. But alcohol or drugs won't help you solve your problems and could also make you feel more depressed. 

Eat a healthy diet

Some people don't feel like eating when they're depressed and are at risk of becoming underweight. Others find comfort in food and can put on excess weight. 

Antidepressants can also affect your appetite. If you're concerned about weight loss, weight gain or how antidepressants are affecting your appetite, talk to your GP.

Have a routine

When people feel down, they can get into poor sleep patterns, staying up late and sleeping during the day. Try to get up at your normal time and stick to your routine as much as possible. 

Not having a routine can affect your eating. Try to carry on cooking and eating regular meals.

Get in touch if you’d like a chat about how therapy could help.

Useful resources:

• Ted Talk: What is depression?
• I had a black dog