Depression

What is depression?

It’s normal to feel sad or miserable sometimes. But if your low mood persists for weeks at a time, keeps returning, or interferes with your life, it could be a sign of depression.

Depression is not the same as being sad, and it is not a sign of weakness or a character flaw.

It is an illness and can have a serious effect on a person’s life and the lives of those around them. In severe cases it can make everyday life extremely difficult and may even lead to suicide.

It is one of the most common mental health problems and can affect anyone. It effects on average around one in four of us at some point in our lives.

Research has found that changes in brain systems or the chemical balance of the brain may be at the root of depression.

These changes can be triggered by stressful events in life, such as a bereavement, the breakdown of a relationship or losing your job.

They can also be caused by inflammation resulting from physical illnesses in the body. For some people, the illness occurs for no apparent reason.

People with a family history of depression are more at risk of developing the illness, but not everyone in this situation will develop depression.

Some people are prone to suffering from depression at particular times in their lives.

For example, some women may be particularly vulnerable to episodes of depression in relation to childbirth.

Depressive symptoms are also a part of bipolar disorder.

Most people with depression do get better with the right treatment and support, but it can come and go.

Symptoms of depression

Depression affects everyone differently, but there are some common symptoms.

It’s important to note that a person with depression might not experience all these symptoms – for example, someone can be suffering from depression without feeling particularly sad:

feeling sad or low for long periods of time
feeling hopeless or helpless
feelings of guilt or blaming oneself
being anxious or worried a lot
feeling tired all the time and having no energy
having no motivation or being unable to concentrate
losing interest in things that you normally enjoy
losing interest in sex
changes in your appetite – eating too much or too little
having trouble sleeping, or needing to sleep more than usual
moving or speaking more slowly than usual
thoughts of suicide or hurting yourself
in severe cases, a person with depression might experience symptoms of psychosis (e.g. hallucinations, such as hearing voices).

Getting support

If you or someone close to you has been experiencing low mood for a period of two weeks or more, speak to a GP or other health professional.

At first, they may suggest some lifestyle changes and monitoring your mood for a short period in case it improves on its own.

If this doesn’t happen, you may need to discuss other treatment options.

People with mild depression sometimes get better without any treatment, but in more severe cases they may need lots of help.

Lifestyle changes are usually the first method of treatment to try. Getting more exercise can have a particularly powerful effect on our mood, it can also improve sleep and help us regulate our weight.

Daily exposure to natural light, eating more fresh foods and having at least three alcohol-free days a week have also been shown to improve sleep and energy levels, and improve mood.

Self-help websites can also be useful and you can find a list of sites at the end of this webpage. These sites are recommended by medical professionals as a good source of information and practical advice on coping with depression.

Talking therapies such as counselling and cognitive behavioural therapy (CBT) are the next step. Group therapy, couples therapy or bereavement counselling can also be helpful depending on the root cause of a person’s depression.

CBT is a treatment that helps change the way a person thinks and behaves. It identifies unhelpful ways of thinking and can help to break the cycle of negative thoughts.

In moderate to severe cases, antidepressant medication may be required. These medicines work by increasing the availability of certain chemicals in the brain that control our moods.

Many people find them effective, but they can have drawbacks. Some people experience unpleasant side effects. Antidepressants can take between two and six weeks to work.

A combination of lifestyle changes, talking therapies and medication is often the most effective way to treat depression.

When moderate-to-severe depression occurs with immune disorders in the body, anti-inflammatory medications may also be helpful..

Tips for people with depression

Talking to people you trust about how you feel can be helpful and may make it easier for you to talk to your GP.
Depression might feel like it will never go away, but in most cases, it does get better with the right help.
Try to stay connected to the people you care about. Keeping in touch with friends and family can help you to get perspective and avoid feelings of isolation.
Depression can become a cycle – you become depressed, then feel more depressed about being depressed. Remember that it is a real illness, and not your fault.
Keep occupied and do things that you like. Whether you enjoy gardening, writing, making music or sports, doing something helps take your mind off depressive thoughts.
Avoid using alcohol or drugs to get you through hard times. Alcohol is a depressant, and can stop medication from doing its job, and while it may seem to make you feel better temporarily, it will eventually make things worse.
Get plenty of exercise – even a 20 to 30 minute walk every day can make a difference. It releases chemicals called endorphins into your body, which are a natural antidepressant. Losing weight can also reduce inflammation in the body which is linked to depression.
Eating well and getting enough sleep can also help.
If something in particular has triggered your depression, try to tackle the cause if you can.
Remember that treatment can take a few weeks to work – try to be patient and allow enough time for it to take effect.

Tips for partners, families and carers

One of the best ways to help a person with depression is to listen to their problems. This can help with tackling the root of their depression or just remind them that people do care about them.

If someone you care about is depressed, encourage them to get help rather than dealing with it by themselves. Don’t make them feel bad about taking medication or seeing a therapist.

Telling someone with depression to ‘snap out of it’ or ‘pull themselves together’ is likely to make things worse. Remember that depression is not just being unhappy, it’s an illness.

Remember that people don’t need to be depressed ‘about’ anything in particular. It can affect anyone, regardless of their situation.

If someone you care about is depressed, it can help just to talk to them or spend time with them. It will make them feel cared about and help take their mind off their depression.

People who are depressed can sometimes be irritable or difficult to deal with. Try to be patient with them.

Look after yourself – if someone close to you is depressed it can be very hard on you too. It’s easy to fall into the same trap and become depressed yourself.

If someone with depression talks about hurting themselves or not wanting to live anymore take it seriously. Encourage them to tell their doctor how they feel.

Resources

NCMH leaflet: Depression

NCMH leaflet: Depression in young people