Depression is when someone feels down for an extended period of time, not just a few days, but for a few weeks or months, and feels this way for most of the day, most days. They may feel hopeless, unhappy, tearful or lose interest in things which usually interest them. The things people did before to cheer themselves up no longer work. It may affect how they think, feel or deal with everyday situations like eating, sleeping and working, even seeming gradually more impossible. Even though they know this all seems illogical, they can’t stop how they feel. Physically they may also feel tired, achy, not sleep well, have a lower sex drive or lose their appetite.
As a result of depression people can have the following symptoms:
- low self-esteem
- a change in appetite
- anhedonia (not being able to enjoy life)
- suicidal thoughts
- continuous low mood
- withdrawal
Mind (2019) lists the following types of depression:
• Seasonal affective disorder (SAD) occurs in relation to the seasons and can be cyclical.
• Dysthymia (also known as ‘persistent depressive disorder’) is mild but continuous, and lasts two or more years.
• Prenatal depression happens during pregnancy for some women.
• Post-natal depression may arise after giving birth.
Harvard Health Publishing (2020) also includes:
• major depression.
• bipolar disorder (fluctuating moods from euphoria to depression).
• pre-menstrual dysphoric disorder (PMDD – a severe form of premenstrual syndrome).
According to the WHO (2021), depression is the leading cause of disability worldwide, with around 5 % of adults suffering from it. According to the Ministry of Health in Spain, in 2019, three in ten people had some kind of mental health issue. In the latest Spanish National Health Survey, over 6% of the population had a related illness. The Covid pandemic has worsened the situation and a European report has shown that there was an increase in anxiety and depression of around 25% in the population from 2020 to 2022.
In some cases, people may not understand why they are depressed, and so their recovery process may take longer. However, some factors which are thought to cause depression are our environment and our behaviour. For instance:
- giving birth
- problems sleeping
- being isolated
- a bad diet
- alcohol or drug use
- traumatic and stressful life events
- worry over money and debt
- insufficient exercise
Other factors which are thought to cause depression are our biology and our genetics. For instance:
- having a family member with depression
- having physical health problems
- side effects of some medications
- it is debated as to whether a chemical imbalance (of serotonin) in the brain could be a cause (recent studies show that it is not a cause)
There are several ways to deal with depression. With mild depression a common option is to wait and see how it progresses by learning to self-care. With severe depression it is usual to seek the help of a specialised mental health team.
However, with mild to moderate depression talking therapies are a common option. Cognitive Behavioural Therapy (CBT) focuses on identifying and changing negative thought patterns and behaviours that contribute to depression. It helps people develop coping strategies, challenge negative beliefs, and improve problem-solving skills. Interpersonal therapy (IPT), psychodynamic therapy (such as humanistic integrative therapy) and mindfulness-based therapies can also be effective, depending on the person’s needs and preferences.
For people with moderate to severe depression, antidepressant medication can be prescribed alone or in combination with talking therapies. Antidepressants boost the activity of particular brain chemicals, which are involved in regulating mood. The effectiveness is said to vary according to the severity of the depression and there are those who even maintain that no medication is best.
Counsellor Richard Worsley thinks that depression can act as a journey towards becoming mentally healthier and autonomous, ‘I want to suggest that depression is in some of its manifestations life-promoting in the long run. It is essentially evidence that we are taking seriously in our whole selves the tensions between our need to self-actualize and the restrictions felt from our past life-scripts.’
Here are some strategies from the NHS in the UK which people can use themselves to help them cope with depression.
- Staying in touch: people shouldn’t withdraw from life. Socialising can improve our mood. Keeping in touch with friends and family means we have someone to talk to when we feel low.
- Being more active: we can take up some form of exercise. There’s evidence that exercise can help lift our mood. If we haven’t exercised for a while, we can start gently by walking for 20 minutes every day.
- Facing our fears: trying not to avoid the things we find difficult. When people feel low or anxious, they sometimes avoid talking to other people. Some people can lose their confidence in going out, driving or travelling. If this starts to happen, facing up to these situations will help them become easier.
- Not drinking too much alcohol: for some people, alcohol can become a problem. We may drink more than usual as a way of coping with or hiding our emotions, or just to fill time. But alcohol won’t help us solve our problems and could also make us feel more depressed.
- Trying to eat a healthy diet: some people don’t feel like eating when they’re depressed and are at risk of becoming underweight. Others find comfort in food and can put on excess weight. Antidepressants can also affect our appetite. If we’re concerned about weight loss, weight gain or how antidepressants are affecting our appetite, we should talk to our GP.
- Having a routine: when people feel down, they can get into poor sleep patterns, staying up late and sleeping during the day. We should try to get up at our normal time and stick to our routine as much as possible. Not having a routine can affect our eating, so we need to try to carry on cooking and eating regular meals.
- Seeking help for depression: we should get help from our GP if we’re still feeling down or depressed after a couple of weeks.
References:
Armitage, S-A. (2023). Working with Clients with Depression Part 1 [lecture].
Counsellor CPD. Counselling Tutor. [07/05/2023].