Depression is common
One in five women and one in eight men will experience depression at some time in their life. The good news is that just like a physical illness, depression is treatable and effective treatments are available.
Symptoms of depression
You may have depression if, for more than two weeks, you have felt sad, down or miserable most of the time, or have lost interest or pleasure in most of your usual activities, and if you have also experienced several of the symptoms across at least three of the groups of symptoms below.
Remember that everyone experiences some of these symptoms from time to time – it may not necessarily mean you are depressed. Equally, not every person who is experiencing depression will have all of these symptoms.
Behavioural symptoms of depression
A person with depression may:
have stopped going out
not be getting things done at work or school
be withdrawing from close family and friends
be relying on alcohol and sedatives
have stopped their usual enjoyable activities
be unable to concentrate.
Thoughts caused by depression
A person with depression may have thoughts such as:
‘I’m a failure.’
‘It’s my fault.’
‘Nothing good ever happens to me.’
‘I’m worthless.’
‘Life’s not worth living.’
‘People would be better off without me.’.
Feelings caused by depression
A person with depression may feel:
overwhelmed
guilty
irritable
frustrated
lacking in confidence
unhappy
indecisive
disappointed
miserable
sad.
Physical symptoms of depression
A person with depression may experience:
fatigue
feeling sick and ‘run down’
headaches and muscle pains
churning gut
sleep problems
loss or change of appetite
significant weight loss or gain.
Causes of depression
Generally, depression does not result from a single event, but from a mix of recent events and other longer-term or personal factors, which cause chemical imbalances in the brain. These factors might include life events, family history, personality, serious medical illness, and drug and alcohol use.
You can’t always identify the cause of depression or change difficult circumstances. The most important thing is to recognise the symptoms and seek help.
Life events and depression
Continuing difficulties – such as long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, or prolonged stress at work – are more likely to cause depression than recent life stresses. However, recent events (such as losing a job) or a combination of events can trigger depression in people who are already at risk because of past bad experiences or personal factors.
Family history and depression
Depression can run in families, but this doesn’t mean a person will automatically experience depression if a close relative has had the illness. Other factors are still important.
Personality and depression
Some people may be more at risk because of their personality, particularly if they tend to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.
Serious medical illness and depression
Serious illnesses can bring about depression directly or can contribute to depression through the associated stress and worry, especially if it involves long-term management of illness or chronic pain.
Drug and alcohol use and depression
Drug and alcohol use can lead to and result from depression. Many people with depression also have drug and alcohol problems.
Changes in the brain and depression
We do not fully understand what happens in a person’s brain to cause depression. Depression may be related to changes in certain chemicals that carry messages within the brain – particularly serotonin, norepinephrine and dopamine, the three main chemicals related to mood and motivation. Changes to stress-hormone levels may also play a part.
Research suggests that behaviour can affect brain chemistry – for example, long-term stress may cause changes in the brain that can lead to depression. Changes in brain chemistry have been more commonly associated with severe depression than with mild or moderate depression.
Seek help for symptoms of depression
If you experience some or most of the symptoms of depression, seek advice from a doctor or counsellor. Don’t delay. Tackling depression early can help you address problems quickly and stop symptoms becoming worse.
Depression is often not recognised and can go on for months or even years if left untreated. A range of treatments, health professionals and services is available, and there are many things that people can do to help themselves. Different types of depression require different treatment.
Types of depression
Different types of depression often have slightly different symptoms. The main types of depression include:
major depressive disorder
bipolar disorder (used to be called ‘manic depression’)
cyclothymic disorder
dysthymia
seasonal affective disorder (SAD).
Major depression
Sometimes, this is called major depressive disorder, clinical depression, unipolar depression or simply depression. Symptoms can include:
low mood
loss of interest and pleasure in usual activities
significant sleep disturbance
loss of appetite
unexpected weight loss
loss of energy
feelings of guilt or worthlessness
suicidal thoughts.
A person with major depression will experience symptoms nearly every day for at least two weeks. Changes in lifestyle and attitude do not help. The symptoms interfere with all areas of a person’s life, including work and social relationships.
Major depression requires immediate professional help – it is a serious medical condition.
Melancholia
The term ‘melancholia’ describes a severe form of depression involving many of the physical symptoms of depression. For example, the person moves more slowly and is more likely to have depressed mood characterised by complete loss of pleasure in everything or almost everything.
Psychotic depression
Sometimes, people with a depressive disorder can lose touch with reality. Psychosis can involve hallucinations (seeing or hearing things that are not there) or delusions (false beliefs that are not shared by other people). A person with psychotic depression may believe they are bad or evil, being watched or followed, or that everyone is against them (paranoia), or that they are the cause of illness or bad events occurring around them.
Antenatal and postnatal depression
Women are at higher risk of depression during pregnancy and in the year following childbirth. The causes of depression at this time can be complex. In the days immediately following birth, up to 80 per cent of women experience the ‘baby blues’ – a common condition related to hormonal changes – but this is different from depression.
Depression is longer-lasting and can affect not only the mother, but her relationship with her baby, the child’s development, the mother’s relationship with her partner and other members of the family. Up to one in 10 women will experience depression during pregnancy. This increases to one in seven in the first three months after having a baby.
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