Everyone feels low at one time or another and in most cases these feeling pass. The causes of depression vary from person to person and also vary between episodes. Some of the common causes are; life events, childhood experiences, other mental health issues (e.g. anxiety), physical health, genetics, medication or other substances, sleep or diet. The effects of depression are unique to every individual and sometimes occur without an obvious explanation.
Depression becomes a problem when the feelings are long-lasting, especially severe or are interfering with your day to day life. Usually it is classified as mild, moderate or severe. When severe depression can lead to suicidal thoughts or actions or giving up on life which can lead to self-neglect. Depression is unique to each individual so it is important that the approach be tailored to you.
Depression can affect both the way you feel and behave. Some of the common signs and symptoms are:
- Down, upset, tearful
- Lack of pleasure in life or hobbies
- Restless, agitated or irritable
- Guilty or worthless
- Detachment from reality
- Lack of confidence or self-esteem
- Hopeless and despairing
- Empty and numb
- Avoiding social events and activities
- Self-harming or suicide attempts
- Difficulty concentrating
- Changes in sleeping patterns
- Changes in appetite
- Difficulty speaking or thinking clearly
- Low libido
- Physical aches
- Moving slowly or being restless
Self-harm and Suicide:
Some individuals may use self-harming behaviours to cope with the feelings arising from severe depression. Self-harm can take many forms but is a dangerous practice which can bring up difficult emotions and could make you feel worse.
During episodes of severe depression, some people may also experience suicidal ideation. These feelings can be very frightening and difficult to control.
Sources of support:
Immediate help is available from your local A&E department and Samaritans (116 123). Mind also provides information on how you can cope right now with your suicidal feelings (http://www.mind.org.uk/information-support/types-of-mental-health-problems/suicidal-feelings/helping-yourself-now/#.WHtJSE1vjIU)
During episodes of severe depression it is possible to experience symptoms of psychosis including delusions, such as paranoia and hallucinations, such as hearing voices. These symptoms are likely to be linked to your thoughts and feelings during depression. These symptoms can be very upsetting and frightening as they can seem very real to you at the time, making them difficult to understand.
Types of depression:
Depression can be mild, moderate or severe and can be single episode or recurrent. There are also some specific types of depression.
Seasonal affective disorder (SAD) – in the UK this is most likely to occur between September and November continuing until March or they may occur in reverse beginning in March and ending in autumn. Symptoms can include; lack of energy, concentration problems, sleep problems, depression, anxiety and mood changes amongst others.
Dysthymia – also known as persistent depressive disorder or chronic depression. It is a continuous mild depression lasting for two years or more.
Prenatal depression – this type of depression occurs during pregnancy
Postnatal depression – occurs soon after becoming a parent. This is most commonly diagnosed in women but can also be experienced by men.
NICE guidelines (2009) suggest that Cognitive Behavioural Therapy (CBT), interpersonal therapy (IPT), mindfulness-based therapy and potentially medication are effective treatments for depression. Many factors need to be taken into account when deciding on the best treatment option including history, severity, the amount of time that the issues have been experienced for and whether any other difficulties are present (e.g. anxiety).
Cognitive Behavioural Therapy (CBT) –CBT is a therapy which assumes that a person’s mood is related to their patterns of thought. These thoughts then continue to affect a person’s mood, behaviour and physical state. CBT aims to stop the negative cycles of thought which cause you to feel low, therefore improving mood and leading to more positive behaviours.
Interpersonal Psychotherapy (IPT) – IPT is a structured and time limited psychotherapy used primarily in the treatment of depression. It focuses on exploring the reasons for a person’s problems but also on building relationships and improving the quality of existing ones.
Acceptance and Commitment Therapy (ACT) – ACT is a third wave behavioural therapy which uses acceptance and mindfulness techniques alongside commitment and behaviour changes strategies to increase the individuals psychological flexibility. Through these techniques clients learn to make healthy contact with their thoughts, feelings, memories and physical sensations which they have previously avoided or feared.
Compassion Focused Therapy (CFT) – CFT was developed for people with a range of difficulties who are typically highly self-critical and prone to strong feelings of shame and self-dislike. This approach helps us to stop judging and labelling ourselves as “good” or “bad” and teaches us to accept ourselves with kindness, caring and compassion.
Counselling and Psychotherapy – This approach is most suitable when anxiety is mild or below the clinical threshold. There are different types of psychotherapy available. Psychotherapy aims to help you to understand your personal needs and how to improve your future wellbeing.
Mindfulness – Mindfulness is a practice which has Buddhist origins and has been around for thousands of years. It is state which is achieved by focusing in on the here and now, acknowledging thoughts, feelings and sensations but not attempting to get rid of them or judge them.