Depression

This factsheet aims to explain depression. You will find a description of depression, its symptoms and the treatments available. If you are experiencing depression, you will find suggestions of ways that you may help yourself and the options open to you. You will also find ideas on how friends and family may help.

What is depression?

People often use phrases like “I’m depressed” to describe a temporary low mood, or how they are feeling about a particular situation in their life. In most cases, these low spirits lift of their own accord after a short period of time. However, if these feelings of unhappiness worsen and begin to interfere with how you live your everyday life, then it is possible that you may be developing major or clinical depression. The word “clinical” simply means that the condition is severe enough to need some form of treatment.

If you are experiencing depression, you may feel unhappy, that everything you do is a struggle, and perhaps not worth the effort. Often people experiencing depression feel hopeless about the future and unable to see any positives in life. You may feel apathetic and unable to participate in activities you used to enjoy. At its worst, depression can lead to such feelings of helplessness and lack of worth that people may give up the will to live, or begin to consider suicide.

What are the symptoms of depression?

Depression can affect different people in many different ways. Some people experience depression primarily through psychological and emotional symptoms, whilst others may experience a wide range of physical effects.

The following is a list of possible symptoms of depression:

Feeling in a low mood for long periods of time
Feeling anxious much of the time
Finding it hard to concentrate
Feeling unusually irritable
Failing to derive pleasure from usually enjoyable activities
Feeling tired and lacking energy
Losing self-confidence and self-esteem
Feeling numb and empty
Feeling hopeless and helpless
Feeling pessimistic about the future
Having problems getting to sleep
Waking up early in the morning
Losing interest in sex
Feeling guilty about things
Feeling restless and agitated
Being preoccupied by negative thoughts
Feeling like you want to commit suicide
Having thoughts about harming yourself
Experiencing physical aches and pains

What causes depression?

There is no one cause of depression. It varies from person to person. Broadly speaking there are three main triggers for developing depression. Social factors such as losing your job, isolation, divorce or bereavement can trigger depression in some people. For other people, triggers may include psychological factors such as chronic anxiety, childhood rejection or family background. A third trigger for depression may be physical factors such as infectious diseases like influenza or glandular fever; having a long-term physical health problem like multiple sclerosis; or as a side-effect of medical treatments like chemotherapy. It is also thought that some people may have a genetic predisposition towards depression.

How common is depression?

Depression can affect anyone at any time. Depression can occur in people from all backgrounds, any occupation, and at any time of life. Current research suggests that one person in six will become depressed at some point in their lives, and, at any one time, one in twenty adults will be experiencing depression.

What treatments are available?

Most people diagnosed with depression are treated by their family doctor, although a small minority of people may be referred to a psychiatrist or a member of the local Community Mental Health Team for more specialised help. Depending on your symptoms, the severity of the depression, and your circumstances, the doctor may suggest anti-depressant drugs, some form of talking treatment or a combination of both.

Antidepressants
Antidepressant drugs are the most commonly prescribed treatment for depression. Antidepressants affect the chemicals in the brain that lift your mood. These drugs can be effective in treating depression. However, they are not in themselves a cure. The drugs treat the symptoms of the depression, but cannot treat the root cause of the depression itself. This is why talking treatments are often prescribed in conjunction with antidepressants, so that people can be helped to address the reasons why they became depressed in the first place.

It may take a few weeks before medication starts to have a noticeable effect, but it is important that you continue to take them or the treatment will not be effective. It is normally recommended that you stay on the drug treatment for a period of around six months in order to minimise the chance of the condition recurring.

As with any medication, some people may experience unwanted side-effects. If this happens to you, it is important that you discuss this with your doctor as they may be able to prescribe a different antidepressant drug for you. There are several different types of anti-depressant drugs available. Some types are more appropriate and effective for some people than others and it can take a bit of time to find the right one for you.

For more information on drug treatments please see: Medical Methods of Treatment

Talking treatments
Talking treatments alone can be effective in combating depression for some people, for others a combination of talking treatments and anti-depressant drugs may be most effective. Talking treatments aim to help people recognise triggering factors in their lives, and work out coping strategies in order to be able to deal with these.

A wide variety of talking treatments are available, ranging from counselling and psychotherapy to cognitive behaviour therapy. A referral for talking treatments can be arranged by your doctor. However, frequently there are long waiting lists for these types of treatment on the NHS. Free or low-cost counselling is also provided by a number of charities and voluntary organisations and, for those who can afford to pay, there are many private practitioners.

For more information on talking treatments please see: Psychological Methods of Treatment

Admission to hospital
In extreme cases of depression, in-patient hospital treatment may be appropriate. This could occur when the condition has proved to be resistant to treatment, where the person is so severely depressed that they cannot cope at home, or where the person is assessed as being at a high risk of suicide.

Hospital admission can provide a severely depressed person with levels of care and attention that could not be provided at home. It can give medical staff the opportunity to accurately assess a person’s condition over a period of time, and to provide a broader range of drug treatment than might be possible at home.

Most people who are admitted to hospital go in voluntarily. However, in some extreme situations you can be admitted to hospital compulsorily under the Mental Health Act 1983.

ECT
Electro-Convulsive Therapy (ECT), is another method of treating severe depression. ECT may be considered in cases where drug treatment has failed to lift the depression, and in very urgent cases because patient response is much quicker than conventional drug treatment.

ECT treatment involves being given an anaesthetic and a muscle relaxant then a small electric current is passed through your brain. ECT can be very effective in treating depression, however, some people do experience side effects, the most common of which is short-term memory loss.

For more information on ECT please see: Medical Methods of Treatment

Which treatment may be right for me?

Individuals respond to different treatments in different ways. What works well for one person may not work well for another. Speaking to your doctor will help you weigh up the pros and cons of the different treatments available. Your doctor should be able to provide you with information on how treatments work, how effective they are, and what side-effects you may experience. Drug treatment may be extremely effective for some people, while others may find talking treatments the best option. Sometimes a combination of drug treatment and talking treatments may work most successfully.

What can I do to help myself?

There are many ways in which you can help yourself cope with depression. It is important that you come to understand the nature of your illness, its causes and symptoms. If you can recognise the early signs of a relapse or deterioration in your mental health, you can seek help and treatment before your condition worsens.

When you are feeling depressed, it can be difficult to see beyond the day-to-day problems in life. It can be very difficult finding the energy and motivation to actively try to help yourself. However, if you are able to take an active part in your treatment it should help your situation improve.

Self-help groups
Depression can be a very isolating experience. Many people find it helpful to meet with others in a similar position. It can be very useful to share experiences with those who may be going through the same thing you are. There are opportunities for mutual support, and you may get ideas of what things other people have found helpful to them. Above all, it is an opportunity to help you realise that you are not alone in how you are feeling.

Fighting negative attitudes
Depression can cause people to sink into a cycle of negative thinking. The more depressed you become, the less you are able to find the motivation to help you fight the depression. It can be extremely helpful if you are able to recognise patterns of negative thinking, challenge these yourself, and try and replace them with more positive, constructive thoughts.

Physical Activity
Although it may be difficult finding the motivation to exercise, it can be very therapeutic to take part in physical activities. Jogging, swimming, sport, even brisk walking can stimulate production of chemicals in the brain called endorphins. These endorphins can help lift your mood, give you more energy and make you feel better.

Care for yourself
When you are feeling depressed it is extremely important that you care for yourself. Many depressed people lose the motivation to look after themselves properly. You will feel better if you are able to eat properly, pay attention to your physical appearance, and don’t abuse alcohol or drugs. Be kind to yourself, allow yourself treats, and try not to cut yourself off from other people.

Complementary therapies
Some people find non-medical treatments helpful. However, it is important that you discuss such treatments with your doctor first in case of any interaction with any treatment they have prescribed. Herbal medicines such as St Johns’s Wort can help to lift your mood. Massage can help to alleviate stress and make you feel better. Some people benefit from meditation, yoga, homeopathy and acupuncture .You may find creative therapies such as art and poetry can help channel energies.

What can friends and family do to help?

Supporting a friend with depression can be frustrating and hard work. However, it can also be immensely satisfying and an opportunity to build a closer relationship. Depression can make people withdraw from social situations and relationships and make them reluctant to confide in people and ask for help and support. Friends and relatives can be of great help. They can provide emotional and practical support and encourage people to seek appropriate support and treatment. Friends and family can become involved in treatment plans and, above all, make a depressed person feel wanted, needed and loved.

Where can I find help and support?

There are a wide range of services providing help, care, support and information to people experiencing depression, their friends, relatives and carers. You may find some of the following useful:

SANEline / SANEmail
1st Floor Cityside House, 40 Adler Street, London, E1 1EE
helpline:0845 767 8000, fax: 020 7375 2162
email: sanemail@sane.org.uk
web: www.sane.org.uk
SANEline and SANEmail offer emotional support and information to those experiencing mental health problems, their families and carers.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9 – 13 Silver Street, Bury, BL9 0EU
tel.0161 797 4484, fax: 0161 797 2670
email: babcp@babcp.com
web: http://www.babcp.com/
The full directory of psychotherapists is available online.

British Association for Counselling and Psychotherapy (BACP)
BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire, LE17 4HB
tel. 0870 443 5252
email: bacp@bacp.co.uk
web: http://www.bacp.co.uk/
See website or send A5 SAE for details of local practitioners.

British Psychoanalytic Council
West Hill House, 6 Swains Lane, London N6 6QS
tel. 020 7267 3626, fax: 020 7267 4772
email: mailto:mail@bcp.org.uk
web: http://www.bcp.org.uk/
A linking body of psychoanalytical psychotherapist societies.

Carers UK
20–25 Glasshouse Yard, London EC1A 4JT
carers line: 0808 808 7777, tel. 020 7490 8818, fax: 020 7490 8824
email: mailto:info@ukcarers.org
web: http://www.carersonline.org.uk/
Information and advice on all aspects of caring.

Depression Alliance
Suite 212, Spitfire Studios, 63-71 Collier Street, London N1 9BE
tel. 0845 123 2320
email: information@depressionalliance.org
web: www.depressionalliance.org
Support and understanding for anyone affected by depression.

Fellowship of Depressives Anonymous
Box FDA, Ormiston House, 32-36 Pelham Street, Nottingham, NG1 2EG
tel. 0870 774 4320, fax: 0870 774 4319
email: fdainfo@aol.com
web: http://www.depressionanon.co.uk/
Mutual support and self-help for anyone affected by depression.

Rethink
(formerly the National Schizophrenia Fellowship)
28 Castle Street, Kingston-upon-Thames, Surrey KT1 1SS
tel. 0845 456 0455, advice line: 020 8974 6814
email: advice@rethink.org
web: http://www.rethink.org/
Working together to help everyone affected by severe mental illness to recover a better quality of life.

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF
helpline: 08457 90 90 90, fax: 020 8394 8301
email: jo@samaritans.org
web: http://www.samaritans.org/
24-hour telephone helpline offering emotional support for people who are experiencing feelings of distress or despair, including those that may lead to suicide.

United Kingdom Council for Psychotherapy (UKCP)
167–169 Great Portland Street, London W1W 5PF
tel. 020 7014 9955, fax: 020 7436 3013
email: ukcp@psychotherapy.org.uk
web: http://www.psychotherapy.org.uk/
Umbrella organisation for psychotherapy in UK. Regional lists of psychotherapists are available free.

About Mental Illness