What is depression?
Depression is a complex mental illness which presents itself in people differently and has a huge variety of symptoms and causes. The low mood which characterises depression is not the same as just having a bad day. To be diagnosed clinically with depression, someone must have suffered low mood, tearfulness or joylessness for at least two weeks.
Sufferers of depression often have to cope with a wide range of troubling emotions and physical effects, which impact day to day life and can stay with a person for a long time. Depression can lead people to withdraw from relationships and normal life, leading them to become isolated or feel trapped within their mental illness. The fear of rejection and stigma often stops people opening up and talking about what they are feeling. Depression presents itself in such a way which can feel unconquerable, another reason why people might hesitate to get help when they need it.
Depression is one of the most common mental health disorders in the UK and worldwide. It affects around one in 10 people, so if you haven’t experienced it yourself, the likelihood is you know someone who has. Or perhaps you didn’t know how to identify this condition when you were feeling low.
Depression can take many forms and vary in severity: from suicidal thoughts to general feelings of hopelessness and apathy. You can see read more about this in the ‘Symptoms of depression’ section below.
Depending on the depth of a person’s depression, different treatments will be used. Even in the most severe cases, depression is a treatable illness, even though it may not feel like it to the person suffering. In cases of mild depression, exercise and self-help groups could be sufficiently helpful. In more severe cases, a range of antidepressants are available. For both mild and severe depression, talking therapies are extremely effective. You can learn more about types of depression and the role of counselling for depression below.
NHS Choices has made a podcast about depression and low mood that you can listen to here
Symptoms of depression
Depressive symptoms include:
- feeling tired, disinterested, joyless, unmotivated
- having difficulty concentrating and making decisions
- emotionally detaching yourself from people and situations
- feeling isolated and misunderstood
- feelings of worthlessness, hopelessness and powerlessness
- feeling constantly anxious, tearful and worried
- irritability and intolerance of others
- low self-esteem
- Excessive and inappropriate guilt
- recurring thoughts of death or suicide
- hallucinations (in rare and extreme cases some people may experience psychotic symptoms)
Physical symptoms of depression:
- change in sleeping patterns: insomnia or feeling constantly tired
- change in eating behaviour: under or overeating, change in appetite
- loss of libido
- chronic pain
- slowness in movement or speech
- changes in menstrual cycle
- constant headaches or stomach upsets
Types of depression
At one end of the spectrum is what's often referred to as low level or mild depression. Mild depression is not the same as a general sadness as it persists for longer than a couple of days, like a low mood might. Mild depression can be quite hard to describe and might lead people to become frustrated and anxious, struggling to understand their feelings as they might feel that they have no reason to feel the way they do. This kind of self-blame leads to sufferers feeling they should just ‘snap out of it’, and as a result they become reluctant to seek help or open up because they don’t want to be considered overly sensitive or weak. Sufferers of both mild and deep depression can experience a feeling of flatness and detachment. Socialising and other activities may feel like too much effort.
Clinical depression (deep depression)
Someone in the depths of a deeper depression may experience some or all the things described earlier, but this type of depression is typically more consuming and lasts for longer. Deep or clinical depression can be extremely debilitating; people may find that they are stuck, unable to move forward with life, let alone with their day. Day-to-day tasks may seem impossible to carry out and it may be hard for those with deep depression to see the point in trying. People with this level of depression often report feeling constantly tired and may wish to spend most of their time in bed, both as a remedy for feelings of tiredness, and as a means of escape - clinically depressed people often feel the only relief they have from their condition is when they are asleep. Or they might try to self-medicate to relieve the symptoms, such as drinking too much. People experiencing clinical depression need help from an outside source, so it is worth going to the GP or to a counsellor, even though this may feel very difficult. At such times, intervention is definitely needed and it is worth going to the GP, even though this may feel very difficult.
Bipolar disorder is a form of manic depression characterised by extreme highs and lows. Learn more about it here.
Post-natal depression is a serious condition that can develop after childbirth. It can affect both mothers and fathers, though it is more common in women. Learn more about it here.
Seasonal Affective Disorder (SAD)
SAD is a form of depression that has a seasonal pattern. Learn more about it here.
What causes depression?
There is no known cause for depression, nor any decisive explanation as to why it is a gradually occurring problem in some people, and a sudden illness in others. A tendency to depression can be inherited genetically. It can also be the result of traumatic past experiences, neglect or abuse, or can be triggered by an upsetting event, such as a bereavement or the end of a relationship. In general, depression is thought to be the result of negative interactions between genetics, life experience and body chemistry.
It is important to remember that anyone can get depressed, regardless of their age, background, advantages or disadvantages; so sympathy is key.
What can I do to help myself?
Though there is unfortunately no single solution, thankfully there are lots of small things you can do to help yourself. A regular routine can be helpful for many people; one which involves a focus on healthy eating, reducing or eliminating the use of drugs or alcohol, ensuring enough sleep.
There is now much evidence to support the idea that exercise is a valuable tool to remedy low moods. It increases energy levels, improves sleep, regulates hormones and you benefit from the boost of endorphins. If exercise seems too much, just going for a walk or spending time outside has also been proven to be effective in dealing with depression.
Artistic or creative pursuits can be a good supportive technique for many and can provide a healthy outlet for feelings, whether this is through painting, playing music, knitting or writing - whatever you enjoy.
There is increasing evidence of the benefits of mindfulness meditation to help with depression. We have a great collection of mindfulness articles on the site, you can find them here. There are also many free or low-cost apps to use on your smartphone, to make daily mindfulness practice easy and accessible.
How to care for a loved one with depression
Depression impacts not just the depressed person but also their family and friends. It can therefore be very difficult to know how to care for a loved one with depression, or whom you suspect is depressed, as you may feel shut out or disconnected from them at this time.
Though you may share in some of the depressed person’s feeling of hopelessness when faced with this situation, it is important to remember that you are an invaluable support network. You may have more energy and motivation than the person in question to research depression and potential treatments, you are more likely to spot the signs of depression in another, you can support your loved one in getting treatment and whilst they receive it. You can help by being encouraging, positive and above all, just by being there with them, supporting and listening to them without judgement. It is important not to put pressure on someone with depression, not to expect any quick-fixes and not to discount their feelings. Caring for someone with depression might be the hardest thing you do, it may also be the kindest.
How can counselling help with depression?
Alongside trying to do things on your own to improve your wellbeing, a lot of people find it beneficial to seek help in the form of counselling or psychotherapy, and at times this is absolutely necessary. According to the NICE guidelines, CBT is amongst the most highly recommended types of therapy to treat depression, but many talking therapies can be helpful.
Therapy provides a safe, non-judgemental space where you can be heard and can have the time to explore what has happened to you in your life. A trained depression therapist or counsellor will understand the impact depression can have. Talking may feel like a struggle and going to see a stranger might not appeal, but chances are that once you start it might be quite a relief to be able to unburden yourself with a professional who may be able to help you develop some other strategies to deal with it. Importantly, if they have prior experience of working with depression, a counsellor or psychotherapist will also understand what you are going through, and they can hold onto the hope for you that things will improve even when you perhaps can't believe in this yourself.
Last updated on 30 April 2019