Depression is a common mental disorder affecting about 15% of people at some point in their lives. Depression often results feelings of extreme sadness that can last for a long time. These feelings are severe enough to interfere with your daily life, and can last for weeks or months, rather than days. Other symptoms of depression are a loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
Women are twice as likely to suffer from depression as men, although men are far more likely to commit suicide,. This may be because men are more reluctant to seek help for depression. Studies have also shown that 2% of teenagers in the UK are affected by depression.
People with a family history of depression are more likely to experience depression themselves. Depression affects people in many different ways and can cause a wide variety of physical, psychological (mental) and social symptoms.
A few people still think that depression is not a real illness and that it is a form of weakness or admission of failure. This is simply not true. Depression is a real illness with real effects, and it is certainly not a sign of failure. In fact, famous leaders, such as Winston Churchill, Abraham Lincoln and Mahatma Gandhi, all had periods of depression.
If you are depressed, it can really help to talk about how you really feel, as talking puts you back in control and can help identify what choices you have. However many people who are depressed don’t feel they can express their feelings due to embarrassment, or because they do not want to burden family or friends.
Others who are suffering from depression may have tried to express their despair only to be told to pull themselves together, to put things in perspective or to count their blessings. None of these help if you are feeling depressed, and it is important not to hide your true feelings as this will only save the problem for later. Whether you are able to talk to a friend, your doctor or the Samaritans - talking really can help. If you don’t feel you can talk to anyone, you can also email or write to the Samaritans; their website address is shown above.
The following are the sort of feelings that people who are depressed often feel. If you can identify with some or all of the following feelings, please seek help and talk to someone:
- Finding it hard to cope with everyday things
- Finding it hard to make simple decisions
- Having difficulty concentrating
- Finding it hard to get the motivation to get up in the mornings
- Feeling tearful at something which would not normally affect you that way
- Lacking energy and feeling very tired
- Not wanting to talk to or be with people, and conversation can be a struggle
- Eating, drinking or sleeping more or less than usual
- Using alcohol or drugs to cope with feelings
- Feeling restless and agitated
- Not taking care of yourself or feeling you don’t matter
- Having recurring thoughts of death and/or suicidal impulses, where suicide seems like a welcome relief
Treatment for depression usually involves a combination of drugs, talking therapies and self help, and it will depend on the severity of the depression.
Mild depression - if you are diagnosed with mild depression but your GP feels you will improve, you may be asked to return in two weeks' time so that your progress can be monitored - also known as 'watchful waiting'. Antidepressants are not usually recommended as a first treatment, but exercise seems to help some people, and talking through your feelings may also be helpful, so the GP may suggest a local self-help group.
Chronic mild depression (present for two years or more) is called dysthymia. This is more likely in people over 55 years and can be difficult to treat, and so the GP may suggest a course of antidepressants.
Moderate depression - if you have mild depression that is not improving, or you have moderate depression, your GP may recommend a 'talking treatment' (see below) or prescribe an antidepressant.
Severe depression - your GP may recommend that you take an antidepressant, together with talking therapy. A combination of an antidepressant and cognitive behavioural therapy (CBT) usually works better than having just one of these treatments. You may be referred to a mental health team. These teams are usually made up of psychologists, psychiatrists, specialist nurses and occupational therapists. They often provide intensive specialist talking treatments, such as psychotherapy.
Talking treatments for depression:
- Cognitive behavioural therapy (CBT) - CBT is based on the principle that the way we feel is partly dependent on the way we think about things. It teaches you to behave in ways that challenge negative thoughts - for example, being active to challenge feelings of hopelessness.
- Interpersonal therapy (IPT) - IPT focuses on your relationships with other people and on problems, such as difficulties with communication or coping with bereavement. There is some evidence that IPT can be as effective as medication or CBT, but more research is needed.
- Counselling - Counselling is a form of therapy that helps you to think about the problems you are experiencing in your life, in order to find new ways of dealing with them. Counsellors support you in finding solutions to problems, but do not tell you what to do.
Antidepressants take 2-4 weeks to take effect. You should continue taking the antidepressants for at least four weeks (six weeks if you are elderly) to see how well they are working. If your antidepressants are working, treatment should be continued at the same dose for at least four to six months after your symptoms have eased. If you have a history of depression, you may continue to receive antidepressants for up to five years, or longer. Antidepressants are not addictive but withdrawal symptoms are quite common if you stop taking them suddenly, or you miss a dose.