How Common is Depression?
Depression is a very common problem. It affects 1 in 5 people in the UK at some point in their lives, and this rate is increasing.
The Symptoms of Depression
The exact nature and severity of symptoms that people experience when they are depressed vary from person to person. However, when depressed most people will experience at least some of the following:
• A persistent feeling of low mood
• Feeling of hopelessness
• Feelings of fatigue or exhaustion
• Problems sleeping (either getting off to sleep or waking up very early)
• Change in appetite (usually a loss of appetite, but some people will comfort eat)
• Lack of interest in their usual activities and hobbies
• Lack of pleasure in things that they usually enjoy
• Poor concentration
• Poor memory
• Loss of libido
• Tearfulness
• Thoughts of suicide
Psychiatrist will make a clinical diagnosis of depression (“Depressive Illness”) if a person is has several of these symptoms for the majority of the time over a two-week period.
What Causes Depression?
The short answer is that no-one know for sure. However, the consensus amongst professionals is that depression is probably caused by the interaction of many different factors. Examples of likely factors that can cause depression include:
• Adverse social situation e.g. social isolation, poor housing, financial difficulties, unemployment
• Acute adverse events e.g. bereavement, divorce, physical illness, redundancy
• Significant events from the past e.g. childhood experiences, parenting styles, role models
• Traumatic experiences e.g. violence, sexual abuse, physical illness
• Genetic predisposition e.g. “runs in the family”
• Innate biological susceptibility to depression e.g. a personal history of recurrent bouts of depression
• Alcohol abuse (and the use of some other drugs e.g. the heavy use of ecstasy or cocaine)
• Depression can be a side effect of some prescribed medications e.g. some anti-malarial tablets
What Is The Treatment for Depression?
There are two main ways to help people suffering from depression – medication and “talking treatments”
Medication
Antidepressants have been around for over 50 years, and there are a vast number of different medications now available. The newer medications, such as Prozac, are effective and have less side effects than the older medications such as Amitryptilene.
If a doctor diagnoses you with clinical depression then she is likely to recommend you take an antidepressant. Usually this would be for a defined period of time (e.g. up to 6 months), but if you’re symptoms were particularly severe or were recurrent, then she may recommend you stay on them for longer.
Antidepressants take a few weeks to work, and whilst side effects tend to be worse at the start of treatment they often lessen as time goes on. Antidepressants are particularly effective when people are suffering from severe depression and are experiencing so-called “biological” symptoms such as insomnia, diminished appetite and weight loss, poor concentration etc. Antidepressants can also be combined with other medications such as Valium to provide some rapid symptom relief in severe cases.
Talking Treatments
There is a huge range of different “talking treatments” for depression. At one of end of the spectrum are the “counselling” approaches which provide short term advice and support, often for particular acute problems such as bereavement, illness, or relationship difficulties. At the other end of the spectrum are the “classical” psychotherapies such as were practised by Freud and Jung et al, which can last for years.
Falling somewhere in between are the cognitive and behavioural therapies first developed in the 1960’s. Of late these therapies have become more widely researched and have been shown to be as effective as medication for treating many emotional and psychological problems, including depression. Indeed, the NHS now recommends the use of CBT (Cognitive Behavioural Therapy) as the treatment of choice in OCD (Obsessive Compulsive Disorder), and is also promoting it’s use in other areas of mental health.
Which Treatment Is Right For Me?
I think that if you are severely depressed (e.g. barely sleeping and eating, losing weight, suffering with poor concentration and feeling hopeless about you situation and the future) then you are likely to benefit from an antidepressant and I would recommend you see your GP. This is particularly important if you have suicidal thoughts. Depression is a treatable illness and there is a lot of help available to get you through it – your GP may arrange for you to see a psychiatrist or psychologist, or receive a visit from a community nurse.
If your depression is of a milder sort (i.e. you feel depressed but are still managing to maintain your usual routine, more or less) or has been a problem for a long time, then talking therapies (and CBT in particular) may well help. CBT will also appeal to people who don’t want to take medication (for whatever reasons) – it’s safe and side-effect free (the worst case scenario being that it doesn’t help you at all).
Of course, if your depression results from some practical issue, then getting help with this is the priority. If you are depressed because you are being made homeless, then getting help finding alternative accommodation will do you much more good than either medication or talking therapy!