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DEPRESSION

A traumatic event isn’t the only thing that triggers depression even giving birth does

Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression is not a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression?

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy or feeling very emotional or angry. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, anxiety or low mood during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression.

What causes depression?

Depression is often trigger by life changing events. When these stressful events occur, your risk of becoming depressed is increased for example:

  • Bereavement
  • Giving birth: Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as the added responsibility of a new life, can lead to postnatal depression.
  • Relationship breakup or problems
  • Losing your job
  • Stress
  • Low self-esteem or being overly self-critical.
  • Family history: If someone in your family has had depression in the past, such as a parent or sister or brother, it's more likely that you'll also develop it
  • Loneliness
  • Alcohol and drugs: When life is getting them down, some people try to cope by drinking too much alcohol or taking drugs. This can result in a spiral of depression
  • Illness: You may have a higher risk of depression if you have a longstanding or life-threatening illness
  • Financial worries

When to see a doctor

If you experience symptoms of depression for most of the day, every day for more than 2 weeks, you should seek help from a doctor.

It's particularly important to speak to a doctor if you:

  • have symptoms of depression that are not improving
  • find your mood affects your work, other interests, and relationships with your family, friends or partner
  • have thoughts of suicide or self-harm

Sometimes, when you're depressed it can be difficult to imagine that treatment can actually help. But the sooner you seek treatment, the sooner your depression will improve.

There are no physical tests for depression, but a GP may examine you and carry out some urine or blood tests to rule out other conditions that have similar symptoms, such as an underactive thyroid.

Treatment for depression

The treatment recommended by your doctor, will be based on the type of depression you have.

1. Mild depression 

  • Wait and see:

If a doctor diagnoses you with mild depression, they may suggest waiting a short time to see if it gets better by itself. In this case, you'll be seen again by the doctor after 2 weeks to monitor your progress. In UK this is known as watchful waiting.

  • Exercise

There's evidence that exercise can help depression, and it's one of the main treatments for mild depression.

  • Self-help

Talking through your feelings can be helpful. You could talk to a friend or relative, or you could ask a doctor or local psychological therapies service if there are any self-help groups for people with depression in your area. 

      2. Moderate to severe depression

If you have moderate to severe depression, the following treatments may be recommended by your doctor.

  • Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focuses on your relationships with others and problems you may be having in your relationships, such as difficulties with communication or coping with bereavement.

There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed.

  • Antidepressants

Antidepressants are medicines that treat the symptoms of depression. There are many different types of antidepressant.

They have to be prescribed by a doctor, usually for depression that's moderate or severe.

  • Combination therapy

A doctor may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe.

A combination of an antidepressant and CBT usually works better than having just one of these treatments.

  • Mental health teams

If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists.

These teams often provide intensive specialist talking treatments as well as prescribed medicine.

  • Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) aims to help you understand your thoughts and behaviour, and how they affect you.

CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present. It teaches you how to overcome negative thoughts – for example, being able to challenge hopeless feelings.

CBT is available on the NHS for people with depression or any other mental health problem it's been shown to help.

If CBT is recommended, you'll usually have a session with a therapist once a week or once every 2 weeks.

The course of treatment usually lasts for between 5 and 20 sessions, with each session lasting 30 to 60 minutes.

In some cases, you may be offered group CBT.

  • Psychodynamic psychotherapy

In psychodynamic (psychoanalytic) psychotherapy, a psychoanalytic therapist will encourage you to say whatever is going through your mind.

This will help you become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems.

  • Counselling

Counselling is a form of therapy that helps you think about the problems you're experiencing in your life so you can find new ways of dealing with them.

Counsellors support you in finding solutions to problems, but do not tell you what to do. You can talk in confidence to a counsellor, who supports you and offers practical advice.

On the NHS, you may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years.

It's ideal for people who are generally healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or a serious illness.

EXTERNAL HELP

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