Tag: depression and anxiety

What you must know about depression

What do you know about depression?

Big red question mark with little which character of a man leaning against it

Before you go any further, count on your fingers the things you know about depression. Got it? Okay, keep that in mind. Let’s see if we can add to your knowledge here.

Trigger warning; the topics covered in this article may trigger emotional responses and you may wish to stop reading now.

So, what is depression?

Coloured image of man sitting on the floor, knees up and head leaning on his knees. Does he know what depression is?
Depression in men – Image by Holger Langmaier at Pixabay

Depression is a long lasting low mood disorder that affects your thoughts, feelings and behaviours. It can also affect your ability to feel pleasure, even in the things you used to enjoy. It can can render you unable to do everyday things and eliminate any interest in regular activities. And sometimes you may feel as if life isn’t worth living.

The NHS stipulates that depression is more than just a feeling of being unhappy or fed up for a few days. If you suffer from lasting feelings of unhappiness and hopelessness, and you are feeling tearful or you are loosing interest in everyday activities, make sure to take the depression self-assessment on their website.

Depression is a genuine health condition, it’s real and it has real soul-destroying symptoms. You can’t just ‘get over it’ or ‘snap out of it’, as some might suggest, and it’s most certainly not a sign of weakness.

Who does depression affect?

It can affect anybody, and it can also impact hugely on the depressed person’s family, carers or friends. Depression knows no boundaries and cuts across religion, faith, class, creed, race, gender, or age. Take a look at the following statistics, which have been borrowed from MHFA England:

  • Depression is one of the leading causes of disability worldwide and a major contributor to suicide and coronary heart disease
  • 24% of women and 13% of men in England are diagnosed with depression in their lifetime
  • Depression often co-occurs with other mental health issues and substance abuse
  • Depression occurs in 2.1% of young people aged 5-19

Do you know what causes depression?

Well, the jury’s out on this one. There is no one cause fits all with depression and there’s lots of different theories. However, as with lots of mental health disorders, a variety of factors could be involved, such as:

There are happy hormones such as dopamine, serotonin and endorphins, but also stress hormones that can trigger depression
Hormones might trigger depression
  • Life events such as loss (death, divorce, seperation), redundancy, loss of job status, loss of income, or loss of home appear to have a role to play in depression
  • Biological differences. People with depression seem to have physical changes in their brains.
  • Genetic/inherited traits. Depression is more common in people with blood relatives who also have it. But once again, it’s unclear and we can wonder — is it nature or nurture? Researchers are still trying to identify the genes involved in causing depression.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression.
  • Hormones. Changes in the body’s balance of hormones may be involved in triggering depression. These changes might occur during pregnancy or in the weeks or months after the birth (postpartum) and from pre-menstrual tension, the menopause or thyroid problems, or any one of a number of other conditions. See your GP; to rule out any other causes.
  • Low socio-economic status such as income, education, occupation, social class, or wealth and location/environment might also be the cause of depression.

How do people with depression think?

Educate yourself about depression, it will help to keep you motivated.
Changes in sleeping pattern may be a symptom of depression

Depression affects different people in different ways, and some describe it as feelings of sadness, loss, or anger. I’ve had all those feelings, and the thought of ending my life was/is never far away. But because I didn’t want to leave my sons with that legacy, I thought of how I could make it look like an accident. What if I run my car off the road? What if I fall in front of that lorry hurtling down the road on my way to work?

Obviously I can’t speak for others who’ve struggled with suicidal thoughts, but I’ve listened to many patients who’ve survived the experience. I now understand we had many things in common. One of which was that we didn’t want to die, it was that we couldn’t bear the pain, and if things were better we would choose to live. But there’s always impulsivity, or a perhaps window of opportunity arises and some people take it.

So, if you’re having thoughts of dying by suicide, please talk to someone urgently. Also, if you know someone who’s depressed and suicidal, please speak out. Ask them if they are having these thoughts — and soon.

If you’ve had a combination of the symptoms (below) for at least two weeks or more, and for most of the day, nearly every day, you might be depressed.

Symptoms of depression:

  • changes in eating patterns – either loss of, or increased appetite, weight gain or loss (when not dieting)
  • changes in your regular sleeping pattern like sleeping too much, too little, not at all, or waking regularly in the early hours of the morning
  • tiredness, fatigue or lack of energy where you can’t even do the little things
  • loss of interest in things like sex or activities you used to enjoy
  • unexplained physical problems, such as constant headaches, neck or back pain
  • feeling tearful, sad, empty, worthless or hopeless
  • feelings of self-loathing, self-blame, guilt, or fixating on past failures
  • having angry outbursts, being irritable or getting frustrated, even over little things
  • feeling anxious, agitated or restless and find yourself pacing or fidgeting
  • feeling lethargic, slowed down thinking, speaking or body movements
  • trouble concentrating, thinking, remembering, or making decisions
  • frequent negative and intrusive thoughts or recurrent thoughts of death, suicidal thoughts, suicide attempts, writing suicide letters – if this is you, please seek immediate support, from your GP in the first instance. You can also find a list of useful mental health contact numbers here.

Remember

This list above is not exhaustive and you may have other symptoms. If you are experiencing the above symptoms regularly, please speak to your GP or another mental health professional. If you’re reluctant to seek treatment, talk to someone you trust, like a loved one, a friend or faith leader. Recognizing that you’re depressed is essential to getting the right help. The earlier you receive support and attention, the better the outcome.

What helps with depression

Did you know full recovery from depression is a possibility?
You can make a full recovery from depression

I deliberately wrote ‘helps’ because currently, that’s all we have. There isn’t a cure as such. But the good news is, that with the right treatment and support, most people with depression can make a full recovery. Depression affects millions of people worldwide, and there are varying treatment options available. These might be anything from lifestyle changes, talking therapy to medication.

Prescription drugs and the treatment of depression

If you are suffering from depression, your doctor may choose to prescribe antidepressants. Antidepressants are medications used to treat depression. There are a variety of medications that can be used to treat depression. These antidepressants all work to take away or reduce the symptoms.

Antidepressants are classified into different types depending on their structure and the way that they work.

Seven types of antidepressant drugs:

  • Monoamine oxidase inhibitors (MAOIs)
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Serotonin antagonist and reuptake inhibitors (SARIs)
  • Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs)
  • Miscellaneous antidepressants.

Popular medicine for depression

The most popular medicine used in the treatment of depression are the serotonin reuptake inhibitors (SSRIs).

Popular SSRI’s include names such as Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine) and Lexapro (escitalopram).

Names of miscellaneous antidepressants are Wellbutrin (bupropion) – also used in the treatment of nicotine addiction – Trintellix (vortioxetine) and Spravato (esketamine).

Never take antidepressant prescription drugs without a prescription from a licensed psychiatrist or mental health care doctor.

Did you previously know :

  • that depression is one of the leading causes of disability worldwide?
  • and a major contributor to suicide and coronary heart disease?
  • the huge array of possible causes?
  • what causes depression?
  • that anyone can be affected by depression?
  • it can be treated successfully and people with depression can make a full recovery?

Over to you

What do you think?
Clipart.com

Okay my lovelies, for those of you who are not mental health professionals, did you learn anything new? For those of you ‘in the know’, have I missed something/anything? What are your experiences of depression? Maybe you have some tips to cope with depression? I’m looking forward to your comments, suggestions or questions.

In the meantime, you might find the following posts interesting:

Related: The best depression blogs of the year (1). Depression, anger and narcissistic vulnerability from the perspective of a depressed patient (2).

What causes mental illness?

While I can’t give you all the answers, take a look at this model which helps in identifying and treating mental illness.

The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition, has defined depression as 5 or more of the following symptoms that are present for 2 or more weeks and cause significant emotional distress and/or impairment in functioning:

Getty.com
  1. depressed or sad mood
  2. short-tempered or easily annoyed
  3. loss of interest or enjoyment in hobbies or activities that was previously enjoyed
  4. feeling of worthlessness or guilt
  5. thoughts of death or suicide
  6. difficulty with concentrating or making decisions
  7. feeling tired or fatigue
  8. feeling restless or slow
  9. changes in appetite such as overeating or loss of appetite
  10. changes in weight such as weight loss or weight gain, and changes in sleep pattern.1 

According to the National Institute of Mental Health, depression occurs due to a combination of genetic, biological, environmental, and psychological factors.2

Genetic vulnerability refers to the inherited characteristics passed on from parents to children that make it more likely that a person will develop a mental illness or addiction.

Biological theory suggests that depression is caused by an imbalance of naturally occurring substances called neurotransmitters (Serotonin and norepinephrine) in the brain and spinal cord.

Depression is said to be almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones (biological)

Psychological and environmental/social factors—such as lifestyle choices ie too much alcohol, past trauma, low self-esteem, substance abuse and loneliness can also play an enormous part in depression.

Treatment for depression consists of participation in psychotherapy, taking antidepressants, or a combination of both. However, many individuals don’t participate in psychotherapy or antidepressants due to factors such as side effects, lack of access/resource, or personal choice.

According to Agius et al 2010, the Stress Vulnerability Model is an extremely useful model for identifying and treating relapses of mental illness. We accept that humans carry genetic and other predisposition to mental illness. However, the question arises as to how stress impacts on a person in order to cause mental illness to develop. Furthermore there arises the issue as to what other effects such stress has on the human body beyond the human brain. 4.

The Stress Vulnerability Model explores the interrelationship between all these factors, and the genetic component which in large part constitutes the ‘vulnerability’ part of the model. Such problems occur in many Psychiatric illnesses, including Depression, PTSD, as well as Schizophrenia.

Vulnerability Factors predispose individuals to develop mental health problems e.g psychosis, clinical depression. Problems are triggered by stress. If vulnerability is high, low levels of environmental stress may trigger distress. Use and effectiveness of coping strategies goes some way to explain why some have problems and others don’t.

Let’s take a look at the model and I’ll share how my vulnerability lead to a psychotic depression:

Look along the bottom where it says Vulnerability – high to low. For me, because mental illness runs in the family (genetic) I have a predisposition to mental illness. I grew up with mum as single carer for four children, I was shy and had low self-esteem (psychological). We moved a lot, I went to more than ten schools and each time I was bullied because of my new accents (social/environmental), then there’s the childhood abuse (psychological), so — I have a high vulnerability to mental illness.

Now look at the left-hand side where it says stressful events: my ex had a baby with someone else, then the breakdown of my relationship, my ex was cheating, I experienced domestic violence, one of his girlfriend’s plagued me for eighteen months, I wasn’t sleeping, I felt suicidal, I was now a single parent and didn’t have any real coping mechanisms other than to bottle it all up. Therefore, you can add up all the stressful events and my arrow is very high, as in the diagram.

Follow that curve in the model and you’ll see how I have an extremely low stress threshold towards mental illness. Hence my psychotic depression, anxiety, panic attacks and anorexia.

While I still have a predisposition to mental illness, there’s been a huge reduction in my stressful events so I now have a higher threshold for stress.

So, back to the chart — Along the bottom line, I’m at the end, on the right ‘high vulnerability’. But along the left side, I’m presently low down on the scale as I have minimum stress at the moment (trace along the chart with your finger). So you’ll see, I’m currently in the mental health category, rather than mental ill-health.

Is this your empty toolbox? Photo by worthpoint.com

I still experience depression and anxiety but they tend to be reactive. I still take medication and I have an extensive toolbox of coping techniques that I can use, when necessary.

I found this model really helpful when working with patients and they liked how it might explain why they developed a mental illness. If you have a mental illness and you wonder why, try using the above chart to see if it’s helpful in determining the how or the why me?

Does this model fit with your ideas? Where would you sit on the graph? Do you think vulnerability needs more explanation? I’d really appreciate your thoughts.

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