Depression

What is depression?

Depression is more than just spending a few days feeling down. Depression can make you feel persistently sad and unhappy for long periods of time.

Depression is the most common mental health problem worldwide and affects around 1 in 10 people over the course of their lives. But with the right support and treatment, most people make a full recovery.

Depression can be very similar to grief, but there are some important differences between them. Grief is a natural response to a loss – it comes and goes, and will eventually pass – whereas depression is continuous and lasts longer.

Types of depression

Depression can be mild, moderate or severe. If your symptoms meet a set of criteria, you may be diagnosed with a specific type of depression:

• Dysthymia: mild depression that lasts for two years or more, also known as ‘chronic depression’
• Clinical depression: severe depression, also called ‘major depression'
• Seasonal affective disorder (SAD): depression during a particular time of year, usually the winter 
• Prenatal depression: depression during pregnancy, sometimes also called ‘antenatal depression’
• Postnatal depression (PND): depression after becoming a parent, usually affecting women, but it can also affect men
• Bipolar disorder: also known as ‘manic depression’, it involves periods of both depression and mania (excessively high mood).

What causes depression?

Sometimes there’s a direct cause for depression, such as a stressful event or a combination of stressors. Other times there may be no obvious reason.

Here are some of the causes of depression:

• Stressful events: Triggers for depression can include, losing a loved one, redundancy, or relationship difficulties
• Genetics: If someone in your family has depression, you may have a higher chance of experiencing it too. You can also be more susceptible to depression if you have low self-esteem, or you tend to see things as hopelessly difficult while feeling helpless about changing them
• Childhood experiences: There’s evidence that you’re more vulnerable to depression if you had a traumatic experience as a child
• Illness: You may have a higher risk of developing depression if you have a chronic or life-threatening condition.

What are the symptoms of depression?

Depression effects your thoughts, mood and behaviours, which can also result in physical symptoms. It can affect people in different ways, but generally those who suffer from it can experience the following symptoms.

Psychological symptoms can include:

• sadness and gloominess
• feeling tearful (if your depression is milder)
• being unable to cry (if you depression is more severe)
• feeling numb and empty
• low self-confidence and self-esteem
• loss of motivation and concentration
• feeling irritable and restless
• feeling anxious or worried
• feeling isolated
• feeling hopeless or worthless
• loss of interest in things you used to enjoy
• getting no pleasure out of life
• experiencing a sense of unreality
• thinking about suicide or death.

Behavioural symptoms can include:

• avoiding social situations and distancing yourself from others
• neglecting hobbies and interests
• struggling to get out of bed in the morning (dysania)
• difficulties at work
• finding it hard to do simple things like having a shower
• self-harming.

Physical symptoms can include:

• changes in your weight or appetite
• constipation
• aches and pains with no physical cause
• tiredness or fatigue
• struggling to get to sleep, stay asleep and fall back to sleep (insomnia)
• sleeping too much (hypersomnia)
• lack of sex drive.

How is depression treated?

It can feel like you’re the only one feeling this way, but you’re not alone, and there are many ways to get support.

If you’ve had symptoms of depression every day, for two weeks or more, you should see a GP as soon as possible, so they can get you the right help. This is particularly important if you’re self-harming or having thoughts about suicide.

Treatment for mild to moderate depression usually involves a combination of therapy and lifestyle changes. For more severe depression, medication may also be prescribed.

Therapy

The things you think, feel, and do when you’re depressed can actually keep depression going. Therapy aims to break this ‘vicious cycle’.

Here are the main types of therapy on offer:

• Cognitive Behavioural Therapy (CBT): This is a talking therapy that can help you change how you think and act. During CBT, you and your therapist work together to challenge your unhelpful thoughts, feelings and behaviours, and replace them with more helpful ones, so that you can proactively prevent depression in the future.
• Online therapy: We offer therapist guided online therapy and self-guided online therapy, both of which give you the tools to improve your mental health.
• Counselling: This is another type of talking therapy, best suited for when you're going through a change and aren't sure how to move on. Counselling allows you to discuss your thoughts and feelings with your counsellor, so they can help you find a way forward.
• Self-help groups: Some people find it helpful to meet up with people going through the same thing to share their experience and offer mutual support.

Lifestyle changes

Making small changes to your lifestyle can help you to ease depressive feelings.

What might be beneficial for one person, might not be for another, so you should try a few things to see what works best for you:

• Exercise regularly as it releases mood-enhancing hormones, while acting as a healthy distraction
• Take part in activities that bring you into the present, so you aren't worrying about the past or future, e.g. going for a walk, reading or doing something creative
• Try relaxation techniques such as yoga, meditation and mindfulness
• Spend more time outside in nature
• Use wellbeing apps 
• Create a morning routine to give you something to get out of bed for
• Improve your a bedtime routine to help you unwind and sleep better
• Limit alcohol consumption
• Write in a journal to let out your thoughts instead of dwelling on them.

Coping with depression

With the right help, you can live with and overcome depression:

• Follow your healthcare provider's advice consistently
• Learn as much as you can so you understand depression
• Read people’s stories of beating depression
• Speak to friends and family for support – they may have been through it too.

Related problems

Many of the symptoms of depression can overlap with the following conditions:

• Anxiety: A feeling of unease, worry and dread, it has some of the symptoms of depression, but also panic attacks
• Stress: This is the feeling of being overwhelmed and unable to cope with demands due to a build-up of stressful situations, which can lead to depression.

Reviewed by: Gosia Bowling