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Dr Shelagh Wright - Systemic and Family Psychotherapist and Family Mediator

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DEPRESSION

What Is Depression?

The word 'depression' is used to describe everyday feelings of low mood, which can affect us all from time to time. Feeling sad or fed up is a normal reaction to experiences that are upsetting, stressful or difficult: those feelings will usually pass.

Depression is a feeling of persistent sadness, involving feelings of helplessness and hopelessness. It involves not only mood but also feelings of being physically ill and of not being able to think clearly. It is one of the most common conditions in the UK , affecting at least one in five people during their lifetime.

No one should fear depression; the vast majority of people affected will make a full recovery. Successful treatment can involve a variety of different approaches, including self-help, psychotherapy or medication.

If you are affected by depression, you are not ‘just' sad or upset. You have an illness which means that intense feelings of persistent sadness, helpless and hopelessness are often accompanied by physical effects such as sleepiness, a loss of energy, or physical aches and pains.

Sometimes people may not realize how depressed they are, if they have been feeling the same way for a long time, if they have been trying to cope with their depression by keeping themselves very busy, or if their depressive symptoms are more physical than emotional.

Here is a list of the most common symptoms of depression. As a general rule if you are experiencing four or more of these symptoms, for most of the day nearly every day, for over two weeks, then you should seek help.

Symptoms Of Depression Include:

Types Of Depression

Everyone's experience of depression is different. However, several specific types of depression have been identified:

Reactive Depression

This type of depression is triggered by a traumatic, difficult or stressful event. People affected by this will feel low, anxious, irritable, and even angry. Reactive depression can also follow a prolonged period of stress and can begin even after the stress is over.

Endogenous Depression

Endogenous depression is not always triggered by an upsetting or stressful event. Those affected by this common form of depression will experience physical symptoms such as weight change, tiredness, sleeping problems and low mood, as well as poor concentration and low self-esteem.

Manic Depression (also known as bipolar depression)

People with manic depression experience mood swing with ‘highs' of excessive energy and elation, to ‘lows' of utter despair and lethargy. Delusions or hallucinations can also occur. Most people with this condition have their first episode in their late teens or early twenties.

Seasonal Affective Disorder

This type of depression generally coincides with the approach of winter. It is often linked to the shortening of daylight hours and a lack of sunlight. Symptoms will include wanting to sleep excessively and cravings for carbohydrates or sweet foods. Special ‘light boxes' can be used to treat this kind of depression.

Post-natal Depression

Many new mothers will experience baby blues; mood swings, crying spells and feelings of loneliness three or four days after giving birth. Post-natal depression will however last for much longer and will include symptoms such as panic attacks, sleeping difficulties, having overwhelming fears about dying, and feelings of inadequacy and being unable to cope.

Post-natal depression is a common condition, affecting between 10% and 20% of new mothers. Starting two or three weeks after delivery, it often develops slowly, making it more difficult to diagnose. Often it goes unrecognized by the woman herself, or by her family. For more information about post-natal depression, contact depression alliance for their free information leaflet 'depression during and after pregnancy'.

Most types of depression can be experienced in mild, and moderate cases as a persistent low mood accompanied by some physical symptoms, and in cases of severe depression the person affected experiences a persistent low mood, intense physical symptoms, and even delusions or hallucinations.

Depression and anxiety are often closely linked. Anxiety disorders include panic disorder (unpredictable episodes of intense fear, shortness of breath, dizziness, or sweating), phobias (persistent and extreme fear of certain situations), obsessive-compulsive disorder (intrusive, distressing, and senseless thoughts, repetitive illogical behaviour to ward off misfortune), and post-traumatic stress disorder (this usually occurs after a catastrophic or unusual experience, with flashbacks, dreams of the event, and insomnia).

Where To Get Help

Friends and family: Talking to a positive and supportive friend or relative will help. It will also make you feel less isolated. Remember that depression often affects your self-esteem and makes you feel that no one can love you. This can stop you contacting friends and family - which leaves you more depressed. Don't get into this vicious circle - ask for, and accept, the love and support of people who care about you.

Your local family doctor (GP): The average GP will see one person with depression during each surgery session, so don't feel awkward or embarrassed about telling him or her how your feeling. Your GP will be able to help you decide upon the most appropriate form of treatment for you, as well as being able to answer any queries you may have about depression.

Treatments For Depression

We believe that the successful treatment for depression can involve a variety of different approaches. Often people find that a combination of different treatments works best.

All antidepressants work by normalizing the activity levels of the brain chemicals, which affect our mood. Typically, antidepressants take a week or two to begin to work. Some have side affects, although these usual lessen after the first three weeks of treatment.

There are many different types of antidepressant. If one type has unpleasant side effects or does not help your depression, your GP will be able to offer alternatives, which may be more appropriate to your needs.

Antidepressants are not addictive. If you stop taking them suddenly however, you may experience withdrawal symptoms such as headaches or nausea. It is always better to stop taking them gradually, and you should not stop taking them without talking to your GP first. Even if you are feeling better, you may need to continue taking them for a while to ensure that the depression does not return. For more information about anti depressants contact your GP.

Although antidepressants will lift your mood, they do not tackle any underlying problems. ‘Talking treatments' can help you explore what may have contributed to your depression in the first place, and what might be keeping you depressed.

Talking treatments refer to psychological therapies, which aim to help you understand why you are depressed and what might be keeping you depressed.

They can be very helpful in alleviating and sometimes preventing episodes of depression, but will involve time, energy and commitment to work effectively.

There are many different kinds of talking treatments, and your GP will need to decide which is most appropriate for you.

The most common kinds of talking treatments are cognitive therapy (which works by challenging negative thought patterns and changing your behaviour), interpersonal therapy (which focuses on people's relationships and on issues such as difficulties in communication) and psychodynamic therapy (which helps people understand past conflicts, release aggression and reduce feelings of guilt or inadequacy).

Relaxation

Depression is frequently associated with tension, stress and anxiety. There are many ways to relax - yoga, reading, listening to a relaxation tape, going away for a short holiday - find out what works for you and give yourself time to wind down.

Exercise

Many people with depression experience a loss of energy and constant feelings of tiredness. Taking some form of gentle exercise will make you feel more positive.

Changes To Your Diet

Depression can affect your appetite so try to make sure that you eat regular, appropriate amounts. Missing out valuable nutrients can also make you feel tired and run down. So try to include fresh fruit and vegetables in your diet.

Pursuing Interests

Try to continue with any hobbies or interests you have. It may be difficult whilst you are depressed, especially if you have difficulty concentrating, but this will help you feel better.

Do You Think You Are Depressed?

Some people say that depression feels like a black curtain of despair coming down over their lives. Many people feel like they have no energy and can't concentrate. Others feel irritable all the time for no apparent reason. The symptoms vary from person to person, but if you feel "down" for more than two weeks, and these feelings are interfering with your daily life, you may be clinically depressed.

Most people who have gone through one episode of depression will, sooner or later, have another one. You may begin to feel some of the symptoms of depression several weeks before you develop a full-blown episode of depression. Learning to recognize these early triggers or symptoms and working with your doctor will help to keep the depression from worsening.

Most people with depression never seek help, even though the majority will respond to treatment. Treating depression is especially important because it affects you, your family, and your work. Some people with depression try to harm themselves in the mistaken belief that how they are feeling will never change. Depression is a treatable illness.

Life With Depression

Working with your doctor, you can learn to manage depression. You may have to try a few different medications to find the one that works best for you. Your doctor may also recommend that you see a therapist and/or make certain lifestyle changes.

Change won't come overnight—but with the right treatment, you can keep depression from overshadowing your life.

Also Of Interest

Do you know the common symptoms of depression?

Try this questionnaire.


Depression and Anxiety Audio