Major Depression (Clinical Depression)
1. What is Depression?
Nearly everyone has felt depressed, sad, or down in the dumps at one time or another. Feeling depressed can be a normal reaction to a stressful event, such as when one suffers a loss or endures another of life’s various struggles or stresses.
Sometimes, however, these feelings of depression can become intense, last for long periods (weeks or even months), and prevent a person from doing their normal day to day activities. This is what is known as ‘major’ or clinical depression.
It is a serious medical illness that affects how you feel, think and behave.
Depression has a lot of features, but the most common are a deep feeling of sadness or a loss of interest or pleasure in activities which you previously liked doing.
These symptoms must be present for at least a few weeks before clinical depression can be considered as a possibility.
Other associated features include:
- Changes in appetite (generally a loss of normal appetite)
- Changes in sleeping pattern (generally reduced sleep)
- Loss of energy.
- Difficulty in thinking, concentrating, or making decisions.
- Irritability and restlessness.
- Feelings of worthlessness or of being a failure or bad person.
- Thoughts of death, of life not being worth living or of suicide
- Physical aches and pains
2. What causes Depression?
It can affect anyone and at any age – women are affected almost twice as commonly as men, the reason for this is still unclear.
Depression is thought to occur in about 1 in 7 people at some stage during their life and about 1 in 20 people will have a more severe form of the illness. Generally, several factors play an important role in someone developing depression. It is more common after a stressful event such as a breakup of a relationship, a loss of a loved one or employment loss etc., but it may also occur “out of the blue” in someone who appears to live in ideal circumstances.
We know that there are physical changes in the level of certain chemicals in the brains of people who are depressed (these chemicals include serotonin and noradrenaline). There is also evidence that if your close relative has depression, you are at greater risk of developing it too because of a genetic vulnerability.
Other contributory causes of depression can include:
- Alcohol and drug abuse
- Serious physical and mental illnesses
- Lack of social support, confiding friendships etc
- Lack of good coping skills in dealing with stress or ongoing problems or conflicts.
3. How is Depression Treated?
Depression is one of the most treatable mental illnesses: the vast majority of people will eventually respond to treatment and recover fully, and almost all patients gain some relief from their symptoms. Treatment is always tailored to the individual and dependent on the severity of depression can include psychological (or talking treatments) and/or medical treatments.
For those with moderate to severe depression, medication and psychological treatments should be combined for best outcomes.In severe treatment resistant cases, electroconvulsive therapy is an important and effective option to be considered.
Medical treatment includes antidepressant medication (which assist the brain to restore its usual chemical balance) and psychological treatments or psychotherapy can include a doctor, psychologist or other mental health professional talking with the person about their symptoms and stresses, and discussing ways of thinking about and coping with them.
4. What else can I do to manage my depression?
There are many lifestyle changes you can make to help you cope with your depression and which may help prevent another episode of depression from occurring
- If your depression is being triggered by stress or pressure, for example in your job, stress management may help.
- Try to get regular exercise and eat a well-balanced diet.
- Try to avoid alcohol and illegal drugs – such substances can actually worsen depression.
- Make sure you get enough rest and maintain a regular sleeping pattern
- Improve your social outlets e.g. hobbies, meeting with friends, evening courses etc. This may be difficult during the acute stage of depression, but it is important that you don’t isolate yourself as this will only make depressed feelings worse in the long run.
- Confide in trusted friends or family about how you are feeling – don’t keep things bottled in. Sometimes just talking can help lighten the load a little. Seek professional help early and follow through on any advice that your doctor or therapist gives you.
5. Helping a depressed person
It can be upsetting and frustrating at times to see a loved one become depressed and often well-meaning relatives or friends can misunderstand symptoms of the illness and add to the stress by either playing down the depressed person’s experience (e.g. “Cheer up! Things aren’t that bad!”) or by being overly directive (“Stop moaning and sulking and go to work!”). This can lead to conflict or to the depressed person further withdrawing or feeling misunderstood.
Below are some suggestions for living with someone who is depressed that may help everyone involved:
- Understand that depression is an illness and not a character weakness. It is not something that someone can just “pull themselves out of”. Make sure that the depressed person knows you are aware of this
- Understand that when people are depressed they will be more irritable and have a tendency to wish to isolate themselves – this is a feature of the illness and not of personal rejection
- Encourage the depressed person to seek professional help. Accompany and support the depressed person, but make it clear that the responsibility for getting better lies with him or her.
- Support opportunities for the depressed person to be rewarded, such as visiting friends or going out for activities. However, don’t force these situations.
- Praise any improvement or increase in activities: e.g. “I’m glad you’re taking care of the kids again; I’ve always appreciated that”. Leave time for yourself and your own needs.
Depression makes people lethargic, irritable, and self-focused; this will wear on you. Take breaks from the depressed person from time to time. It will help both of you.
Further Information on Depression
Further Information can be found using the following web links:
- Depression: The Key Facts (Royal College of Psychiatrists, UK)
- Understanding Depression – a helpful and clear guide to the core features of depression and how to cope (from helpguide.org – an extensive American online resource for mental health)
- Facts about Depression (from netdoctor.co.uk – an excellent UK based web resource with information written in clear and understandable terms by doctors for the general public)
- Electroconvulsive Therapy – information about the uses, effectiveness and side-effects of ECT (Royal College of Psychiatrists website, UK).