Depression

What is depression?

Every one of us knows what it feels like to be 'down in the dumps' or sad. We may even refer to ourselves as 'feeling depressed'.

However depression is a very serious condition which can affect a person both mentally and physically and seriously affect quality of life.

When a person feels down or sad, these feelings usually pass relatively quickly. However depression is when these feelings go on for at least a few weeks, affecting all parts of the person's life. It is estimated that around one in ten people in Ireland will have depression at some stage in their life.

Depressed people cannot 'snap out of this condition' or 'pull themselves together'. They need professional help. Therefore if either you or somebody you knows is showing signs of depression, talk to your doctor. Do not suffer depression in silence hoping it will just go away on its own.

Depression is a treatable condition.

What are the symptoms of depression?

Depression can be associated with both psychological and physical symptoms. These may include any of the following:

Psychological symptoms

  • Continuous low mood
  • Anxiety
  • Emotional numbness
  • Lack or loss of interest in things you used to enjoy
  • Lack of confidence/low self-esteem
  • Feeling irritable or angry
  • Concentration and memory problems
  • Feelings of guilt or shame
  • Feelings of hopelessness or worthlessness
  • Lack of motivation
  • Thoughts of suicide, self-harming or death.

Physical symptoms

  • Increase or decrease in appetite/weight
  • Loss of interest in sex
  • Tiredness
  • Sleeping problems (this can include too much sleep or having trouble getting to sleep)
  • Constipation
  • Period irregularities
  • Recurrent headaches that don't go away with treatment.

How can I tell the difference between just being down and being depressed?

Everybody feels down at some stage, however low moods are thought of as depression if they persist for a long time rather than just a few days, and become so overpowering that it is making life difficult to cope with.

If you have a number of the symptoms of depression (listed above), which have lasted for two weeks or more, you should consult your doctor.

Your doctor can assess whether you need more help, or can reassure you that the feelings you are having will pass.

What causes depression?

In some cases, there is an obvious reason for a person to become depressed. They may have experienced some sort of traumatic event, such as the death of a loved one, ending of a relationship or the loss of a job. These are known as ‘environmental factors’, and this type of depression is sometimes called ‘reactive’ depression – as the depression results as a direct reaction to an event.

However sometimes there is no obvious cause. In these cases, depression may have a biological or genetic basis: e.g., it may be triggered by changes in hormone levels, or the person may have inherited a tendency to develop depression.

Often, depression may be due to a combination of psychological, biological, genetic and environmental factors. Whatever the cause, it has been found that people with depression have an imbalance of certain chemicals in their brain, which affect mood.

There are a number of factors that are thought to increase a person’s risk of developing depression. These include:

  • Gender: Women are twice as likely to be diagnosed as depressed than men.
  • Genes: Depression can run in families. This does not mean if a close family member has depression, you will definitely get it too. However if depression runs in your family, you should be aware of the symptoms.
  • Personality: There is no one type of personality that makes a person more prone to depression than others. However people who tend to be rigid, anxious, obsessive or who hide their feelings may be more at risk than others.
  • Family environment: There are a number of factors which may lead to depression within the family environment, for example, the death of a parent or sibling or if there is/was sexual abuse in the family.
  • Medical conditions: Various medical conditions can be associated with depression, particularly those where a person may lose their independence and become dependant on others for their well-being – e.g., stroke, cancer and dementia.
  • Drugs: Alcohol or drug abuse can lead to depression. Use of certain medications can also be associated with depression.

It is important to note that having any of these risk factors does not necessarily mean that you will develop depression – it may simply increase your risk.

Is there more than one type of depression?

Yes. There are many different types of depression. These include:

  • Mild depression: This form of depression is often triggered by a specific event, such as the loss of a job. Symptoms include feeling low and anxious. Sometimes a change in lifestyle is all that is required to lift this kind of depression.
  • Severe depression: This could potentially be a life-threatening illness. A person with severe depression experiences intense symptoms, and the illness interferes significantly with their daily life. It is important that medical help is sought.
  • Bipolar depression: This is also known as manic-depression or manic-depressive illness. A person with this condition experiences sustained high moods alternating with periods of sustained low moods. High moods can see the person feeling elated and needing less sleep or food than usual. Low moods can range from mild to severe depression.
  • Dysthymia: This is a mild form depression, but is more persistent. The condition may come and go, but if it has gone on for more than two months in a two-year time span, dysthymia may be diagnosed. One of the main symptoms is low self-esteem. People with dysthymia are at increased risk of developing full depression.
  • Postnatal depression: This is depression which arises after a woman has a baby. It can occur straight after the birth or in some cases, it doesn't develop until up to a year later. Medical treatment is recommended, however many women do not seek help as they feel that this is something they must endure or they put it down to tiredness or adjustment.

How is depression treated?

If you suspect you may be suffering from depression, seek help from your doctor. Depression is treatable and yet many people put up with symptoms that impact on their quality of life for years on end.

There are a number of treatment options available.

Psychological therapy

Psychological or ‘talk’ therapy, such as counselling or cognitive behavioural therapy has been found to be very effective in people with mild to moderate depression, and can also be an important part of treatment for severe depression. Therapy may be provided by psychologists, psychotherapists or counsellors. It can help you to develop a more positive way of thinking and to find ways of dealing with your problems.

Psychological therapy can also be particularly useful in children and adolescents, for whom medical treatment may not always be appropriate.

Medication

If you have severe depression, or mild depression that hasn’t improved with counselling, your doctor may recommend taking a course of antidepressants. Antidepressant drugs work to restore the imbalance of certain chemicals in the brain, which occurs in depression.

There are many different types of antidepressant drugs, and there have been major improvements over the past 20 years, with newer classes of drugs proving to be very effective with less side effects than the older drugs. However, they take some time to work so make sure that you complete the courses prescribed for you.

Complementary medicines have also become increasingly popular in recent years. It is important that you inform your doctor of any complementary treatment you are receiving. Examples may include acupuncture and homeopathy.

Remember that depression is a treatable condition.

What else can I do to manage my depression?

There are many lifestyle changes you can make to help you cope with your depression and which may prevent another episode of depression from occurring.

  • If your depression is being triggered by stress or pressure, for example in your job, stress management may help. This can include relaxation exercises, massage and aromatherapy.
  • Try to get regular exercise and eat a well-balanced diet. This will help to maintain good health and improve overall wellbeing.
  • Try to avoid smoking, alcohol and illegal drugs – such substances can actually worsen your depression.
  • Make sure you get enough rest and maintain a regular sleeping pattern.
  • Join a support group – meeting people and sharing your feelings with those who have shared similar experiences can often help. In Ireland, the organisation Aware runs support groups around the country. See www.aware.ie. They also have a helpline at 1890 303 302.

What should I do if somebody close to me seems to be depressed?

This can be a particularly difficult situation because as part of their depression, the person you wish to help may continually withdraw from you.

Try to be as sympathetic as possible. If the person wants to talk, listen. Try not to be impatient.

Strongly encourage them to seek help from their GP or ask them if they would like you to arrange an appointment on their behalf. If they are not keen on seeing a GP, suggest that they look elsewhere — perhaps to a counselling service. Remind them that depression can be successfully treated.

If at any stage, the person talks about or hints at suicide, medical advice should be sought immediately. Even if a child mentions suicide, take this very seriously. If they don't want to talk to a doctor, give them the phone number of somebody like the Samaritans.

If the person is in immediate danger of hurting themselves, phone 999 immediately. Do not leave the person on their own.

 

The irishhealth.com Depression clinic offers comprehensive information on depression, from symptoms and diagnosis to treatment.

 

Reviewed: November 20, 2006