Depression

Depression is more than feeling unhappy: it is a continued state of deep unhappiness that is experienced over a long period. Sometimes the depression is 'reactive' in that it follows a distressing life event such as bereavement or divorce. But sometimes there is no apparent reason for it. Common symptoms of depression are:

  • being unable to concentrate or remember things
  • being unable to effectively express yourself
  • being unable to smile
  • being unable to talk naturally to others
  • eating more or less than usual
  • feeling detached from others and not being able to experience loving feelings others have towards you and of loving feelings you have towards others
  • feeling isolated and alone, feeling no one understands you
  • feeling sad and hopeless, despairing of anything ever changing
  • feeling tired and lethargic
  • feeling useless
  • feeling worthless
  • having bursts of anger or impatience
  • increased anxiety
  • insomnia or excessive sleeping
  • lack of drive and motivation
  • lack of sex drive
  • losing interest in things you previously liked
  • not washing as often as you should and not taking care of yourself
  • overworking to dull your mind
  • suffering from multiple minor aliments
  • tearfulness
  • thinking about death and suicide.
    • Depression can be triggered by certain illnesses; by hormonal disorders/imbalances such as those caused by birth control pills and by hormone replacement therapy; by disturbing and/or traumatic events or changes in life; by tension or stress; by chemical imbalances in the brain; by thyroid disorders; by poor diet and lack of exercise, and by premenstrual and postnatal effects.

      Clinical depression may be diagnosed if you have had five or more of the following symptoms for at least two weeks (and they are severe enough to affect your social and working life) and they can't be accounted for by bereavement (or another disturbing or traumatic event), the effects of a drug or medication, or a medical condition:

      • having a persistent low mood or being anxious most of the day, most days
      • too little or too much sleeping most days
      • loss in appetite and weight loss; or gain in appetite and weight gain (the weight changes need to be more than 5 per cent of your body weight per month)
      • having difficulty concentrating, remembering or making decisions
      • restlessness or slowing down of your body movements to the extent that it is noticeable by other people
      • significant or complete reduction in interest in things you previously enjoyed, most days
      • having persistent physical symptoms that don't respond to treatment such as headaches and back ache
      • fatigue or loss of energy most days
      • feeling guilty, hopeless or worthless
      • thinking about death and suicide.
        • Dysthymia is a mild but enduring form of depression and a diagnosis may be made once you have been suffering from a low mood for most of the time for most days for at least two years (without a major depressive episode) and this has caused problems for you socially and at work, and you have at least two of the following symptoms: overeating or loss in appetite; sleeping more or less than is usual; feeling tired all the time; finding it hard to concentrate or make decisions; having a low self-esteem and having feelings of hopelessness (and these symptoms aren't attributable to drugs or medication or another diagnosable medical condition).

          Another common form of depression is Seasonal Affective Disorder (SAD) where sufferers feel depressed during the winter months because of a lack of sunlight reaching their brain. If you suffer from this you may benefit from light therapy where you are exposed to light from specially made lamps or you may benefit from a holiday in the sun or from spending more time outdoors.

          If you are depressed, support from family and friends is essential. (They need to know that a depressed person cannot 'pull himself together'.) Help from your doctor is also essential: the dark, dismal feelings you have are very unpleasant. It also makes you at risk from suicide.

          How to help guard against depression
          Although when you are in a depressed state it is very hard (or impossible) for you to get out of it alone, if you are prone to depression, or can identify what is happening before you stop caring, there are some things you can do to help.

          Depressed people stop caring about themselves and other people. They lose touch with their feelings of affection for others and do not register others' feelings of affection for them. Bearing this in mind, it makes sense to do all you can about caring about yourself, and others.

          Caring about yourself
          Take good care of yourself: watch what you eat (avoid too much sugar and fat, and eat plenty of fresh fruit and vegetables); ensure you get a good balance of exercise and rest, and plenty of sleep; do the best with your appearance that you can (and try not to compare how you look with either people you know, or people in the media – concentrate on doing the best with yourself); wear clothes you like and enjoy wearing, and ones that suit you and enhance your good points and play down your bad points (borrow or buy a style and colour book to help you).

          Part of taking care of yourself is also protecting yourself – from unkind comments (learn to be assertive); from too much alcohol and smoking (or from taking illegal or other dangerous substances); from fast and dangerous driving (either from you as a driver or passenger), and from putting yourself in situations that will damage you (for example, spending time with a friend that does not behave as a true friend should, and pushing yourself hard to achieve a level at work that is beyond your capabilities which means that you are unduly stressed).

          You also need to be kind to yourself – don't be hard on yourself for real or perceived failures and regularly treat yourself, especially if you are going through a difficult time. Treats can include a peaceful time alone, meeting or calling a friend, having something nice to eat, reading a magazine, having a hot bath – perhaps by candlelight, and a walk.

          Caring about others
          Work hard at your relationships (but do not make your self-esteem suffer by becoming a doormat). Stay in touch with people you always meant to stay in touch with; don't let friends, or potential friends fall by the wayside unless you are already fulfilled friendship-wise (and do not have time for more).

          Treat your friends well, and don't take them for granted, only seeing them when you have a problem or want their advice on something. Be there for them too. Share your experiences and feelings with them and be a good listener when it is their turn to talk about issues in their life. Show your friends that they can go to you when they are in trouble. These things help to 'anchor' you.

          Tell your friends that you have a problem with depression so that if they don't hear from you for a while they will contact you to see if you are all right. (When you are actually depressed, you may not feel able to contact them yourselves to say you need help.) Explain how bad you feel when you are depressed and that you'd like them to be able to notice the difference between how you are now and how you are when you are very down. Tell them what helps (such as having someone to listen to you, to just sit with you and keep you company or to hug you or take you out with them).

          Look out for needs people have to see if you can help in some way, and make yourself useful if you can. Having a child or pet to care for can help keep you interested and caring so that you do not lose touch with your feelings and others' need for you.

          Once you are through a bad patch, don't forget those who have helped you out of it and look for opportunities to be a good friend back. If there are none, you can still repay the kindness by noticing someone else who needs help and giving unconditional support (without expecting, or needing, anything back).

          Please note: if you are prone to depression, it is vital you see your doctor, as there is a strong risk of suicide. If you have been treated for depression in the past, and you feel that it is coming back, again see your doctor. The points above can give additional help so that with these and medication working together, you might not suffer quite so much.

          For more help with depression, read my book, Take Charge of Your Future Banish Your Past (Right Way Books, Constable & Robinson).