What is Depression?
When life creates difficult situations, it’s normal to feel sad or low for a while. Depression, however, is a persistent feeling of sadness or low-mood that can last for weeks and months.
If you are depressed you may find you lose interest in the things around you, even things you once enjoyed. Depression often impacts on a person’s ability to sleep, either sleeping too much or not enough and it can be hard to concentrate on everyday tasks. For some people eating patterns can be disrupted, either not eating enough or eating too much, either of which can contribute to the general feeling of just not feeling okay, as well as impacting energy levels. This can sometimes leave people with feelings of guilt, isolation and low self-esteem.
Depression is often described as a common mental health problem, given that so many people will struggle with it at some point in their life.
Some statistics about depression:
- 1 in every 10 people will experience depression in their lifetime.
- There are twice as many women with depression than men, often because men are less likely to seek help.
- There are 3 million people in the UK that are diagnosed with depression, and no doubt many more people that are struggling without support.
- 50% of people that have experienced depression can relapse and experience it again.
- A depressive episode can last 6-9 months.
What causes Depression?
The answer to this question is unique to each person that experiences depression. Everyone has their own strengths and weaknesses, so what might affect one person may not affect another. There are however some common factors that statistically are known to contribute.
Biological Factors: Experiencing significant illness or injury can bring on depression, especially if it impacts on a person’s ability to continue their life in a way that they choose. Having family members that also struggle with depression has been shown to increase the likelihood of depression developing, though it’s not definitive if this connection is based on genes or learnt behaviour. Our own bodies can cause imbalances in chemicals that can result in symptoms of depression, e.g. hormonal fluctuations such as menopause, overactive or underactive thyroid, a deficit in vitamin B12 is also linked to low mood, as is being overweight and having dementia.
Psychological/Social Factors: Experiences in childhood may leave someone more prone to bouts of depression as an adult. Stressful life events such as redundancy, changes in relationships, financial difficulties, bullying, housing issues, pregnancy, bereavement and natural disasters are all well-known contributing factors. The opportunity to be social is important too, too much overstimulation or not enough can impact on self-esteem. Having good friendships and a nurturing family can really help someone that is depressed, not having these things can add to the potential of a person becoming isolated and depressed.
Drugs and Alcohol: These can be a little chicken and egg in nature. Sometimes people that are not feeling in a good place will try to alter their mood by consuming alcohol or drugs, which often only alters their mood for a short time, which may leave them feeling worse than when they started and therefore try to repeat the experience. Alcohol is a depressant and so if consumed by someone who is feeling very depressed can lead to dangerous behaviour.
Even prescribed medication can cause depression, so if you are aware that the onset of your symptoms coincides with new medication, check the packaging and speak with your GP. Never just stop any medication you are on, speak to your GP about how to make a change.
Symptoms of Depression
Every person is unique and will experience depression in their own way, however, in order to diagnose and to help, it becomes necessary to gather together as many potential identifying features as possible so that consistent diagnosis can be made. It can also be helpful when talking to others about how depression feels for you, especially if you meet others that have experienced something similar and are able to understand how it feels. So you may recognise some of these symptoms but not all, you don’t need to be experiencing them all in order to have a diagnosis of depression.
- Feeling tired and having less energy than normal.
- Suffer aches and pains.
- Find it hard to cope with day to day life.
- Disrupted sleep patterns, sleeping too much or too little, waking frequently.
- Changes in appetite, not eating enough or overeating.
- Finding it hard to concentrate or focus on something, study, work, TV, reading.
- Feeling less confident in yourself and your abilities, feeling worthless as a person.
- Ongoing feelings of sadness, irritability, anger, hopelessness, helplessness, guilt.
- You may notice that you are restless, agitated, tearful, anxious or that your movements are slower than usual.
- You may not experience fun things that you would normally enjoy in the same way, you may feel you want to avoid them, or that you no longer want to do them. This might include meeting up with good friends or family.
- You may experience loss of sex drive or have sexual difficulties.
- You may have thoughts and feelings around self-harm or suicide.
Depression symptoms can change from mild to moderate to severe depression. If you think you experience symptoms of depression most days for more than 2 weeks you should book in to see your GP. If you are having thoughts about suicide you should contact your GP immediately.
This video created by the World Health Organization really shows how depression can take hold.
Are you Depressed?
Often when you go along to a GP or primary health care facility you will be asked to fill in a monitoring questionnaire, that will ask you to consider how you have felt about various aspects of your life over the last 2 weeks. These tests can a useful tool to both aid in diagnosis and to monitor your symptoms. The standard PHQ-9 Questionnaire used by various health organisations is linked below and can serve as a useful starting point for discussions with your GP or counsellor.
What can you do to feel better?
It is possible to make changes in your life that will help you to begin to feel better, however, millions of people struggle to make these changes, and what’s worse, is that they are potentially beating themselves up because of it.
The reason so many people struggle with recovery from depression lays in our brain. The frontal lobe is responsible for making decisions, emotional control, concentration, flexible thinking, planning and prioritising, judgements, memory and willpower. These are also the key skills that are required in order to devise and implement self-care, but unfortunately when a person is depressed the frontal lobe also becomes impaired. So not only does the day feel really bad because of depression, but the normal ability to make sense of, plan and improve upon is hampered as well.
Often people experience guilt, low self-esteem and low confidence as a result of not being able to implement self-care or ‘just get over!’ things, when quite clearly there is so much more going on that needs to be considered. Having depression isn’t laziness or just about trying harder, it’s a combination of physical, emotional and social hurdles that need to be seen exactly for what they are before recovery can begin.
Below are some self-help tips, they have been shown in studies to help, however, what also helps is not beating yourself up at the times you are unable to do them. Monitor the inner voice(s) in your head and ensure that the goals that you set for yourself are based in compassion and self-care and not the ‘shoulds’ of a harsher more unhelpful voice. Set your goals at a pace that is right for you.
- Admit how you are feeling and the struggles you are trying to conquer, share with a GP, friend, family or counsellor. Everyone needs help sometimes.
- Starting point, check in with yourself, what feels possible right now? What do you need right now? Simply just do that.
- Next step, what would be a small improvement? You’re moving from something you can do to something that might be a step forward. For example, if you have been getting up but not changing clothes, how about changing clothes, find ones that you like to wear and put them on. It might be a top one day and top and bottoms the next, the important thing is that you pace yourself and acknowledge how that feels.
- Maintenance of your body – in order to function, bodies need food, water and sleep, try to include these in your starting point. Then move on to activity, start at a level that’s right for you, it might be getting out of bed, or jogging/running, only you know what feels right for you. Exercise, whether walking or playing sports, have been proven to improve mental health.
- Maintenance of your mind – Try to recall what you like about yourself, what activities you enjoyed and why, and if you can, do them. Maybe consider new activities and how you might be able to achieve them. Even though you may not feel up to meeting with people, try to ensure you are talking to at least one person that helps you feel ok. Don’t forget to build this contact time with people up, maybe different people for different lengths of time.
- Mindfulness is a useful daily exercise as well as maintaining a diary. Both have been proven to help in recovering from depression.
- Create structure – Try to create a routine, that is ideally written down, so that even if you don’t feel like it or are not sure what to do you have it as a reminder. It needs to have things in it that are just for you, favourite film or book, maybe a place you like to visit, favourite food or just quiet time to relax in. Try to have some practical tasks in there too, something that is necessary for day to day living, so depending on how you are feeling, it might be to make a sandwich or a cup of tea, or it might be to tidy your home or go shopping, again only you will know what level of activity feels right for you.
Accepting how you are feeling and beginning to look after yourself with compassion and care is the first step to recovery. By caring for yourself and also challenging yourself with small goals you are also encouraging the frontal lobe to remain online.
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