Depression

By: Joe Swails


What is depression?
Depression is a mental illness which can affect anyone and strike at any time.

A distressing condition of which experiencing an abnormal state of sadness is the core symptom, depression can be a hugely debilitating illness. Until recent years, it has also been much misunderstood, with sufferers often being told by family, friends and colleagues to ‘pull their socks up’, or to ‘just snap out of it’. Thankfully, due to greater awareness about depression, these days sufferers are not treated in such a stigmatised way and are able to make use of a range of treatments and self-help options which have all been proved effective in coping with and even overcoming the illness.

Types of depression
Often labelled by healthcare professionals as the ‘common cold’ of psychological problems, depression is a mood disorder. It is the most common affective disorder which accounts for 50 per cent of all psychiatric hospital admissions.

Depression tends to run in families and symptoms are similar across cultures, genders and ages. This suggests that biological mechanisms play a strong part in the development of depression.

The two main types of depression are Uni-Polar (persistent low moods) and Bi-Polar Disorder (or Manic Depression) which consists of alternating bouts of long depression and mania.

Symptoms
Symptoms of depression include:

Low mood

Loss of interest in life

Loss of enjoyment

Lack of motivation, energy, appetite and ability to concentrate

Sleeping problems

People with depression can also experience physical symptoms such as aches and pains, heart palpitations, headaches and chest pains.

Where depression is particularly severe, sufferers may resort to suicide. Worryingly, having come to the decision to commit suicide, the sufferer can experience an improvement of mood – masking their intentions to those around them (who may have been able to help them) through appearing ‘on the mend’.

Causes
The cause of depression is not known. However, many clinical psychologists worldwide suggest that depression may develop where an individual:

suffers a loss of status (such as losing a job, or relationship partner or a bereavement)

perhaps has a genetic predisposition to developing the illness (one of their parents or grandparents suffered from depression and so the vulnerability to the next generation developing the illness is ‘passed down’)

is under a lot of stress (through being under pressure to meet a target at work, for example, or through struggling to cope with paying household bills while on a low income)

experiences chemical changes in the brain (due to fluctuating hormonal levels, or a decrease in dopamine perhaps). Clinical Psychologists often put forward a biochemical explanation for depression, suggesting that Serotonin (a neurochemical) plays a role in regulating noradrenalin and dopamine – neurotransmitters which control emotional behaviour. When these levels are low, depression results.

More on biological explanations: While it has been proved that increasing Serotonin levels can indeed alleviate depression in people of all cultural backgrounds, genders and ages, the matter is more complex as anti-depressants can affect other neurochemicals apart from Serotonin. So it cannot be guaranteed that Serotonin is the only neurochemical involved.

As a cognitive explanation, it has also been suggested that people suffering from depression are effectively trapped in a perpetual cycle, or a Cognitive Triad comprising of: 1. negative views of themselves; 2. negative views of the world; and 3. negative views of the future.

Bottled up anger: One theory into depression suggests that the illness develops as a result of repressed anger (which may be expressed via dreams and hypnosis) which leads to low self-esteem and a loss of self. Losses may be natural loses (of a loved one, for example), or symbolic losses such as a loss of status, as mentioned earlier.

Unreliable statistics: A problem which may hinder research into depression is that for some people (particularly men) reluctance to admitting to feelings of depression (and therefore seeking treatment) may render statistics as unreliable. This unreliability of data may also be compounded by the fact that many people might be unable to clearly/accurately articulate how they feel and so could resist visiting their GP for this reason (or, if they do seek treatment, make diagnosis difficult).

Diagnosis
If you think you may be suffering from depression, then arrange an appointment with your GP. He or she will consider your mental (and medical health) history to date, and then, perhaps after requesting that you undertake a physical examination, will ask you some questions as to how you are feeling and how often you feel the way you describe (for this, you may be asked to complete a tailored questionnaire).

Only in rare cases are sufferers of depression referred to a psychiatrist.

Note: part of the purpose of the physical examination is to rule out factors which may be contributing to your mood – such as an under-active thyroid, for example.

Treatments
Treatments for depression can include:

Talking treatments – confiding in a close family member or friend about your feelings

An exercise programme – easing symptoms of depression through regular exercise taken in, say, three weekly sessions

A self-help programme – gaining a better understanding about your illness can help you to cope with it (and in some cases, even overcome it) through books, audio tapes, pamphlets with explanatory information about depression, and also through joining a self-help group for depression in your local area.

Prescribed anti-depressants – not usually recommended by GPs as a first treatment, anti-depressants such as SSRI’s (selective Serotonin reuptake inhibitors) can be effective particularly if taken whilst also attending some kind of depressive illness counselling.

Counselling – a form of therapy with a sympathetic, trained professional who will listen to you, and not judge, but help you to think about the problems you are experiencing, with a view to finding coping mechanisms.

Advice & Support
Depression Alliance
212 Spitfire Studios, 63–71 Collier Street, London N1 9BE
Tel 0845 123 23 20
Website: www.depressionalliance.org

Saneline
Saneline is a national out of hours telephone helpline providing information and support for anyone affected by mental health problems.
Tel. 0845 767 8000
Website: www.sane.org.uk/

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