What is depression?
Depression can be a very serious mental illness and may have drastic implications for the way a person lives their life. Many people dismiss depression as a bad mood or simply feeling a bit down, but if these feelings persist, they could actually be suffering from depression. Depression can really affect a person and can inhibit them in social situations, as well as changing the way they interact with the people that are closest to them. Depression is usually diagnosed when the low mood continues for a long period of time and the symptoms are so bad that they alter the person’s daily life.
Depression can be mild, moderate or severe; severe depression is sometimes also known as clinical depression. Mild depression doesn’t usually prevent you from living your normal life but it can make normal life seem a lot more challenging and emotionally demanding than usual. Severe depression has a considerable impact on daily life and even the smallest of things can seem like a huge challenge. There are also other forms of depression including postnatal depression, bipolar disorder (this is also known as manic depression) and seasonal affective disorder (SAD).
Depression: the facts
Depression is common in the UK, with 15 percent of people suffering with a period of severe depression at some point in their life. It is estimated that many more people suffer from depression but a large proportion of sufferers never seek help for their condition and are therefore never diagnosed; consequently they are not included in the total number of cases of depression so the actual incidence of the condition remains unknown.
Depression can affect anyone at any stage in their lives; however, statistics show that women are much more likely to suffer from depression than men, but men are more likely to resort to extreme measures to deal with their depression and suicide rates are significantly higher in men than women. The statistics do not cater for the fact that many men do not seek help for depression, so in reality, the number of cases of male depression could be much closer to the number of female cases.
Causes and risk factors
Although depression can affect anyone, there are certain risk factors that contribute to depression; these include:
- Excessive alcohol consumption (research has consistently shown that there is a positive correlation between alcohol dependency and depression)
- Family history (people with a family history are much more likely to suffer from depression)
- Genetics: scientists have discovered a link between depression and a particular variation of the 5-HTT gene; this affects the serotonin levels in the body. 20 percent of the population inherits the short version of the 5-HTT gene, which has been linked to a predisposition to depression.
- Medication: certain prescription medications can increase the chances of suffering from depression
- Drug abuse: recreational drug use can increase the chances of suffering from depression. People that regularly take cocaine and cannabis often have depression
There are also a number of other social, physiological and psychological factors that can contribute to depression:
- Unemployment (unemployment contributes to tension between couples and families as well as increasing financial pressures and leading to a lack of self-esteem)
- Financial pressures
- Relationship breakdown
- Poor general health
- Lack of ambition and aspiration
- Hormone imbalances
- Low self-esteem
- Tragic event (the loss of a loved one, for example, can cause depression)
Symptoms of depression
Depression may cause a range of different physiological and psychological symptoms and consequently it may be difficult to diagnose. Some of the most common symptoms are listed below:
Mild depression:
- Lack of concentration
- Tiredness
- Lack of energy
- Lack of ambition and motivation
- Low self-esteem and a lack of confidence
- Anxiety and stress
- Prolonged feelings of sadness
- Feeling emotional
- Lack of sexual libido
- Change in appetite (either eating less or comfort eating)
- Abnormal periods
- Strained relationships with other people
Severe (clinical) depression:
- Disturbed sleep patterns
- Aggression
- Violence
- Joint pain
- Suicidal thoughts
Treatment for depression
There are a number of treatments available and the treatment that is offered to you will depend on the cause of the individual case and the severity of the depression. Common treatments include:
Mild depression:
- GPs usually recommend a change in lifestyle, coupled with talking through problems to treat mild depression. Exercising regularly, taking up a new hobby, sorting out sources of anxiety such as unemployment and financial stress and changing your diet can make huge changes to your physical and mental health. Exercise releases tension in the muscles and acts as a distraction for the mind and taking up new hobbies can provide a new focus that will boost confidence and create ambition. Talking to other people about your problems can also be beneficial. If symptoms persist for longer than a few weeks, alternative treatments may be recommended.
Moderate depression:
- Moderate depression is usually treated with a combination of ‘talking treatment’ and antidepressant medication.
- Talking treatments include cognitive behavioural therapy, counselling and interpersonal therapy; these treatments are designed to determine the source of the depression and enable people to talk through their problems and concerns, build their confidence and find new ways to manage any stressful incidents in their life.
- Antidepressants: there are a number of different types of antidepressant available, these include:
- SSRI (selective serotonin reuptake inhibitor)- this type of medication increases the natural production of serotonin; this helps to make people’s mood more positive. These medications have fewer side effects than other types of antidepressant but they should not be given to children as it can increase the chance of them committing suicide.
- TCI (tricyclic antidepressants)- these medications increase both serotonin and noradrenaline, which help to lift a person’s mood. This medication should not be taken by people that regularly use cannabis.
- MAOI (monoamine oxidase inhibitors)- this type of medication is used to treat people that spend an abnormal amount of time sleeping and eat more than usual.
- SSNI (serotonin-norepinephrine inhibitors)- these medications function in a slightly different manner to SSRI medications because they change the levels of noradrenaline and serotonin in the body. They are not commonly prescribed because they often cause a rise in blood pressure.
- St John’s wort- this is a natural remedy which many people take to treat depression when they don’t want to go to their GP for treatment. It has been proven to be effective to a degree, but doctors do not recommend it to patients because the ingredients of the medication differ according to which brand it is and where it is sold.
Severe depression
Severe depression is also usually treated initially with a combination of counselling and therapy and antidepressant medications; however, if these treatments don’t work, alternative treatments may be recommended; these include:
- Electroconvulsive Therapy (ECT)- this treatment involves sending a series of electric shocks to the brain; it is not painful as general anaesthetic will be given prior to the procedure to relax the muscles. It is common to have a number of ECT treatments. Side-effects are rare but they may include issues with memory loss. This treatment is considered as a last resort in most cases and is always carried out in hospital under general anaesthetic.
- Lithium- lithium is given to patients in one of two forms, lithium carbonate or lithium citrate. Both forms of lithium have proven to be effective but patients must have blood tests regularly to ensure the amount of lithium in the blood is at a suitable level.
Recovering from depression and tips for preventing depression
In order to recover effectively from depression the NHS recommends the following actions:
- Taking medication at the times your doctor has advised and not missing out any days
- Talk to your doctor before you make any changes to your medication or the way you take it
- Start exercising
- Eat well
- Identify sources of anxiety and start tackling them one by one (remember that there are people out there to help you do this)
- Reduce stress (you can do this by doing an activity you enjoy, spending time with friends or family, having a massage or simply taking time out to have a hot bath)
Preventing depression
There are a number of things you can do to reduce the chance of suffering from depression; these include:
- Exercise regularly (exercise allows you to get out and about, increases confidence and self-esteem, nurtures ambition and enables you to make new friends, as well as making positive changes to your physical and mental health)
- Eat a healthy and balanced diet (diet can make a huge difference to your mental and physical health and can help you keep your body weight at a healthy and stable level. Eating foods containing high proportions of Omega acids such as oily fish, nuts and avocadoes and proteins are thought to boost serotonin levels.
- Avoid foods such as cheese and cakes and products that are high in sugar and caffeine; these foods affect blood sugar levels which can cause low energy levels and a drop in mood.
Support for people with depression
If you think you might be suffering from depression, you should arrange to see your GP as quickly as possible, don’t struggle in silence. Your GP can discuss your symptoms and talk through any reasons you might be feeling so low with you; they can also suggest treatments and offer you advice on how to cope with problems. Initially, your GP may recommend a two week ‘watching’ period, when they will monitor your symptoms but not offer treatment. If the symptoms don’t subside, they will then arrange treatment for you which will usually include therapy and medication to boost your serotonin levels.
If you feel that you can’t talk to your loved ones, friends, colleagues or your GP, there are a number of charities that can offer you support and advice; these include Depression UK, Mind and the Mental Health Foundation; you can consult their websites or give them a call on their confidential help lines; the NHS website also has lots of information and links to organisations that could help you.