We often use the expression "I feel depressed" when we are feeling sad or miserable about life. Usually, these feelings pass in due course. But if the feelings are interfering with your life and do not go away after a while, or if they come back, over and over again, for a few days at a time, it could be a sign that you are depressed in the medical sense of the term. At its most severe, major depression (clinical depression) can be life-threatening, because it can make people suicidal or simply give up the will to live.
There are also various forms of depression:
- Seasonal affective disorder (SAD)
- Postnatal depression
- Bipolar disorder (manic depression)
What are the symptoms of depression
Depression shows itself in many different ways. People don not always realise what's going on because their problems seem to be physical, not mental. They tell themselves they're simply under the weather or feeling tired. But if you tick off five or more of the following symptoms, it's likely you're depressed:
- being restless and agitated
- waking up early, having difficulty sleeping, or sleeping more
- feeling tired and lacking energy; doing less and less
- using more tobacco, alcohol or other drugs than usual
- not eating properly and losing or putting on weight
- crying a lot
- difficulty remembering things
- physical aches and pains with no physical cause
- feeling low-spirited for much of the time, every day
- being unusually irritable or impatient
- getting no pleasure out of life or what you usually enjoy
- losing interest in your sex life
- finding it hard to concentrate or make decisions
- blaming yourself and feeling unnecessarily guilty about things
- lacking self-confidence and self-esteem
- being preoccupied with negative thoughts
- feeling numb, empty and despairing
- feeling helpless
- distancing yourself from others; not asking for support
- taking a bleak, pessimistic view of the future
- experiencing a sense of unreality
- self-harming (by cutting yourself, for example)
- thinking about suicide.
People who are depressed are often very anxious. It is not clear whether the anxiety leads into the depression or whether the depression causes the anxiety. A person feeling anxious may have a mind full of busy, repetitive thoughts, which make it hard to concentrate, relax, or sleep. They may have physical symptoms, such as headaches, aching muscles, sweating and dizziness. It may cause physical exhaustion and general ill health.
What can I do to help myself
Depression has one major characteristic that you need to be aware of when thinking about what you can do to defeat it. It can feed on itself. In other words, you get depressed and then you get more depressed about being depressed. Negative thoughts become automatic and are difficult for you to challenge. Being in a state of depression can then, itself, become a bigger problem than the difficulties that caused it in the first place. You need to break the hold that the depression has on you.
An important thing to remember is that there are no instant solutions to problems in life. Solving problems involves time, energy and work. When you are feeling depressed, you may well not be feeling energetic or motivated to work. But if you are able to take an active part in your treatment, it should help your situation.
What treatments are available
At a time when you may well find making decisions difficult, it can also seem like an added burden to try and choose between a range of treatment options. What is actually available to you may depend very much on where you live. Do not be afraid to ask your GP about the treatments offered and what the alternatives are.
Suggested treatments include talking treatments such as cognitive behaviour therapy (CBT), interpersonal psychotherapy (IPT), behavioural activation, and exercise programmes. For more severe depression antidepressants are appropriate. However, combining a psychological treatment with medication maybe the most effective course for severe depression, talk to your GP.
Your GP may offer you one of the following psychological treatments. The choice will depend on what's available, your own preferences, how severe your depression is and other factors
- Five or six sessions of problem-solving therapy can help people break down their problems into manageable portions and provide strategies for coping with them.
- Cognitive behaviour therapy (CBT) helps to identify and change negative thoughts and feelings affecting behaviour and may last up to 12 months.
- Interpersonal psychotherapy (IPT) focuses on relationships. Therapy can continue for 6 to 12 months.
- Psychodynamic counselling or psychotherapy focuses on how past experiences may be contributing to experiences and feelings in the present. Therapy can be short or long-term.
- Counselling can be short or long-term. It involves talking with someone who is trained to listen with empathy and acceptance. T his allows you to express your feelings and find your own solutions to your problems.
Psychotherapy is not usually available on the NHS. It is more frequent and intensive than counselling, and goes more deeply into childhood experience and significant relationships. We, like most psychotherapists work in private practice. We are qualified and regulated therapists by the UKCP. Painful experiences are hard to talk about, but we as healthcare professionals understand this. When you talk to us you can be as frank as possible and we will offer you the best help. Do not be afraid to ask questions about your condition.
Contact us for a first consultation.