What you must know about depression

What do you know about depression?

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?

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:

• 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?

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

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

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:

• Useful tool for self assessment of depression here.
• How to manage panic attacks here.
• 19 free mental health apps just for you here.

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