Depression

Depression is a disorder that is evidenced by excessive sadness, loss of interest in enjoyable things, and low motivation.

It is normal to experience feelings of sadness and despair in response to adverse life events. Such events could include loss, major life changes, stress, or disappointment. In most cases, the sad feelings resolve as you come to terms with the changes in your life. In situations such as bereavement, these feelings may persist for months and return at significant times, such as birthdays and anniversaries related to the lost loved one. Provided you have times when you can enjoy things, however, this sadness is not a sign of depression.

Depression is common. One in three people will experience a major depressive episode at some stage in their lives. While most cases of depression are mild, about one person in ten will have a moderate or severe episode.

What Are The Signs Of Depression?

The features of depression include:

Psychological Symptoms:

• Feeling miserable. This misery is present for much of the day but may vary in its intensity. The misery lasts for weeks.
• Loss of interest or pleasure in usual activities.
• Slowed or inefficient thinking with poor concentration, leading to difficulties sorting out problems or making plans or decisions.
• Recurring unpleasant thoughts, particularly about being guilty, being a bad and unworthy person,
• Thoughts that you would be better off dead or of harming yourself in some way.

Physical Symptoms:

• Loss of appetite with excessive loss of weight.
• Loss of interest in sex.
• Loss of energy, even when not physically active.
• Loss of sleep despite feeling exhausted. Sleep is typically restless and unsatisfying with early morning wakening (one to two hours earlier than usual). Some people, however, may actually sleep a lot more than usual.
• Slowed activity and speech.

Any of these features may serve as warning signs of depression. You need to exhibit at least five of these symptoms to be suffering with a depressive disorder.

What Causes Depression?

No one knows exactly what causes depression. It is clear that genetic factors are important in many cases of depression. Depression seems to run in families (as do other mood disorders), and about 30% of the predisposition for depression is due to genetic influences.

Stressful life events play a part in the onset or relapse of depression. Ongoing conflicts with others can take their toll on our well-being, as can other social and environmental stressors such as financial difficulties, retirement, unemployment, childbirth, loneliness, or loss of someone or something important. In vulnerable people, these unpleasant life events may be enough to cause or worsen a depressive illness.

A person’s personality characteristics are an important factor. When people are depressed, they usually have a very negative view of themselves and the world. They do not appreciate good things, and bad things seem overwhelming. Some people have a tendency to view things this way even when they are not depressed. In other words, they may have a depressive personality style.

Another possible cause of depression that should not be overlooked is physical illness or medications. Glandular fever, influenza, hepatitis, thyroid hormones, anaemia, diabetes, birth control pills, alcohol and other substances of abuse, or other medications such as those for heart or blood pressure conditions, may all cause symptoms of depression.

How To Deal With Depression

There are a range of ways to deal with depression, and often they are best used in conjunction with each other. The primary medical options are Cognitive Behavioural Therapy (CBT), antidepressant medication, and in some severe cases, Electroconvulsive Therapy (ECT). Education and coping strategies are also important when learning to manage your depression.

Cognitive Behavioural Therapy

Getting better means getting control of your depression. The key components are;

• Learning to control the negative thoughts that lead to a loss of interest in things and feelings of worthlessness
• To combat the emotions of sadness and hopelessness
• Counteract the feeling of loss of energy
• Counteract the behaviours related to poor concentration and thoughts of death

Medication

For some people medication will be the first line of treatment to eliminate a severely depressed mood. It is unadvisable to try and manage a severely depressed mood without trialling medication.

For mild to moderate depression, CBT is often recommended as a first line treatment.

This to remember about medications are;

• They need to be taken daily
• Not to stop them suddenly without discussing with your doctor
• Side effects diminish as your body adjusts to it
• Don’t stop when you feel better without discussing with your doctor

Coping With The Symptoms Of Depression

The symptoms of depression can be addressed to help you feel better. Here are some ways to deal with these symptoms.

BEHAVIOURAL STRATEGIES:

• Set goals for daily activity. Plan full days of useful activity by making a list of the activities you are going to engage in at different times during the day. Try to stick to this plan as closely as possible.
• What activities do you enjoy? Try to increase the amount of time you spend on these enjoyable activities.
• Avoid comparing the way you are behaving or feeling now while you are depressed with the way you used to behave or feel before becoming depressed.
• Reward yourself for your efforts. Ask others around you to encourage and praise you for each small step you take. Recovering from depression is a bit like learning to walk again after breaking your leg.
• If a task seems too difficult, do not despair. Break the task down into even easier steps and start again more slowly.

LOSS OF APPETITE

Eat small portions of food that you particularly like. Take your time and do not feel under pressure to finish if you are eating with others. Drink plenty of fluids.

SLEEP DISTURBANCE

• Get up at the same time every morning.
• Avoid sleeping during the day.
• Reduce tea and coffee intake if excessive (no more than two or three cups per day and none after about 4:00 p.m.).
• Do not lie awake for more than about thirty minutes—get up and find a relaxing activity.
• Try relaxation exercises.

WORRYING OR INEFFICIENT THINKING

Put your worry to a useful purpose. Rather than endlessly pinpointing your problems, pick out one or two that seem really important and make a decision to resolve them. You may like to ask a friend to help you.

Go through the following steps:

• Say exactly what the problem (or goal) is.
• List five or six possible solutions to the problem. Write down any ideas that occur to you, not merely the good ideas.
• Evaluate the good and bad points of each idea in turn.
• Choose the solution that best fits your needs.
• Plan exactly the steps you will take to put the solution into action.
• Review your efforts after attempting to carry out the plan. Praise all efforts. If unsuccessful, start again.

With assistance, the right treatment, and a solid understanding of the disorder, you can overcome depression. If you’re worried you might be suffering from depression or that your symptoms could be better controlled, make a booking with one of us at GS Health to discuss your concerns.

If you feel worried about your safety or are having thoughts of self harm you can call;
Lifeline 131114
NSW Statewide Mental Health Line
1800 011 511