Depression - how do you recognise it? How is it caused and how to get help?
The symptoms of depression may vary from tolerable unhappiness to unbearable misery. It affects different people in different ways, but if you think that you or someone you know is depressed, ask the following questions:
- Have you felt continually low or sad for several weeks?
- Does your future look bleak?
- Do you feel a loser or a failure?
- Have you lost your enjoyment of life?
- Do you feel you are a bad or unworthy person?
- Are you disappointed in yourself?
- Do you think it would be better if you were dead?
- Have you lost your interest in other people?
- Has it become difficult to make decisions?
- Do you feel you unattractive?
- Is it hard to make yourself to do things?
- Do you appear to be losing your stamina?
- Have you lost interest in food, or do you eat more than you used to?
If the answer to most of these questions is "yes", you may be suffering from depression. There are other indicators because it disturbs different people in different ways and its severity is estimated by how great an effect it has on your life.
What causes depression?
Different professionals explain it with different ideas.
The medical model says that depression happens when some chemicals in your brain get out of balance. Rebalancing these using medication cures the symptoms of depression.
Talking therapists think early life experiences made you believe bad things about yourself, which you usually keep repressed, but they burst out when harmful things happen, disturbing your life, like bullying, bereavement, chronic illness, losing your job or your relationship; these (and others) can trigger depression.
Some people are more vulnerable to depression than others: women more than men; some personality types; and depression sometimes runs in families, but once you’ve had depression, you are twice as likely to have it again as someone who has never had it.
What should I do if I am depressed?
Depression affects us all differently. Some may be able to cope with it without help. If you do nothing, it often lifts naturally within four to six months, but if it is too distressing or debilitating, or you don’t heal naturally, you might need help.
You can help yourself by:
Talking to a friend or a family member you trust about how you feel and about anything that is causing you to feel low - the old saying “a trouble shared is a trouble halved” is still true. On the other hand, you may have good reason for not doing so - they may be part of the problem, or they may be unable to keep your secrets.
Trying to discover if there was an event that triggered your depression and if you can identify one, if you can't change it, what you can do to change how you perceive it… A threat to your way of life? or an opportunity for change?
Taking exercise every day, anything, even walking round the block will get you out in the open air and your blood circulating; it will release hormones which make you feel healthy, help to maintain and improve your fitness, and probably help you to sleep better afterwards.
Attending to your diet, eat regularly and eat healthy food (without binging), even if you don’t feel like it. This will help maintain your energy and vitamin levels.
Keeping alcohol to a minimum. Alcohol itself has the effect of making you feel depressed, and excessive use of alcohol prevents your mind from processing the problem that is causing your depression and restoring your peace of mind.
If self-help isn’t working, or depression is affecting your work or isolating you from your support network or from your family and friends, you may prefer to talk to a professional person who doesn’t know you, who is impartial, who is trained to help and is bound by obligation to keep your confidences.
If it becomes so bad you feel it would be better if you were dead you should seek professional help, straight away.
What kinds of help can I access?
Your doctor may offer you medication, talking therapy, or self-help programmes provided by the NHS.
Individual therapy is one-to-one, client and therapist working together, and includes CBT, counselling, psychodynamic therapy, interpersonal therapy, EMDR and bereavement counselling.
To get better you must be willing to dedicate energy to the process. If your problem is having a bad effect on your life, if it is important for you to feel better, and if you are able to make recovering your health a priority, then you are probably ready to commit to attending your appointments regularly and to being open and honest with your therapist. You usually agree to meet weekly and your progress towards recovery is assessed regularly.
Talking therapy on the NHS is limited. The demand outstrips the supply and, if accepted on the waiting list, you could wait six to 12 months for an appointment to see a therapist. Despite IAPT being the acronym for Increased Access to Psychological Therapy, the service is underfunded and in some areas waiting lists are closed and patients are signposted to the voluntary sector where you are more likely to see a trainee counsellor than a qualified professional.
Many skilled and experienced therapists practising in the private sector offer their services to those who either are covered by private health insurance or can afford to fund their treatment themselves.