Types of mental health conditions - DEPRESSION

Depression


The word depression is used in many different ways - everyone can feel ‘blue’ or a bit ‘down’ when bad things happen. People with the 'blues' may have short-term depression, but will generally manage to cope with their feelings, and recover - often with the support of their friends and family, and without medical treatment. This type of depression generally passes without seriously affecting a person’s lifestyle.


However, the type of depression described in this publication is clinical depression. Clinical depression lasts at least two weeks - and often for many months - and affects the person's behaviour and lifestyle. Clinical depression is a common but serious illness, and has significant and serious physical, emotional and cognitive effects. Clinical depression is also often recurrent.


Signs & Symptoms of Depression


  • An unusually sad mood that doesn’t go away.
  • Bursting into tears or crying for no apparent reason.
  • Loss of enjoyment and interest in activities that used to be enjoyable.
  • Lack of energy and tiredness.
  • Loss of confidence - always putting themselves down.
  • Feeling guilty when they are not really at fault.
  • Suicidal thoughts.
  • Looking unkempt.
  • Slow moving or speaking slowly.
  • Difficulty in concentration and decision making.
  • Difficulty in sleeping, or sleeping too much.
  • Loss of interest in food, or eating too much. Changes in eating habits leading to loss of weight, or putting on weight.


Levels of Depression


Depression can range from mild to severe, depending upon the number of symptoms, and the impact it has on their life. 


  • MILD DEPRESSION - FOUR out of at least 10 of the above symptoms over the last 2 weeks.
  • MODERATE DEPRESSION - SIX out of at least 10 of the above symptoms over the last 2 weeks.
  • SEVERE DEPRESSION - EIGHT out of at least 10 of the above symptoms over the last 2 weeks.


Depression affects the whole person!


Effects of Depression


There are FOUR main effects of depression:


  • EMOTIONAL - Effects on emotion include sadness, anxiety, guilt, anger, lack of emotional responsiveness, helplessness, hopelessness.
  • COGNITIVE - Effects of thinking include self-criticism, self-blame, worry, impaired memory and concentration, indecisiveness and confusion, tendency to believe that others view you negatively.
  • BEHAVIOURAL - Effects on behaviour include crying spells, withdrawal from others, neglect of responsibilities, loss of interest in personal appearance, loss of motivation.
  • PHYSICAL - Physical effects include chronic fatigue, lack of energy, sleeping too much or too little, overeating or loss of appetite, constipation, irregular menstrual cycle, loss of sexual desire, unexplained aches and pains.


Cross cultural variations


Note: There may also be cross cultural variations with people from different nationalities, and/or backgrounds. People from different cultural backgrounds may express signs and symptoms of depression differently, often through expression of feelings of isolation, shame and guilt, or in more physical terms.


Depression & Mania


There are some people who experience extreme swings between depression and mania (mania, also known as ‘manic syndrome’, is a psychiatric behavioural syndrome defined as a state of abnormally elevated arousal, affect, and energy level. During a manic episode, an individual will experience rapidly changing emotions and moods, highly influenced by surrounding stimuli). This is now known as bipolar disorder. Bipolar disorder strongly affects a person’s mood, and is usually classified alongside depression under the term ‘mood disorders’. Bipolar can also include symptoms of psychosis.


Treatments for Depression


Many people who experience depression will turn to their GP first for professional help. GPs can make a quicker diagnosis if the person tells them directly that they believe they are suffering from depression. A GP should take the time to listen to the person, and take into account the person's treatment preference. 


A GP can provide the following types of help: 


  • Identify possible physical cause, e.g. side effects of medication or physical health conditions.
  • Refer the person to a specialist mental health service, including psychological therapies and psychiatrists if necessary.
  • Self-help material: books, videos, computer-based therapies like Cognitive Behavioural Therapy.
  • Prescribing medication.
  • Refer to professionals such as counsellors, psychotherapists and clinical psychologists - these specialise in mental health issues. They are not medically qualified so cannot prescribe medication, but provide opportunities to talk about problems, listen to the person and provide specific methods for overcoming depression and preventing recurrence.
  • Prescribe medication to treat major depressive disorders, anxiety disorders, chronic pain conditions, and to help manage some addictions.
  • Suggest Cognitive Behavioural Therapy. When people get depressed they tend to think negatively about most things, and develop unhelpful thinking patterns. CBT helps to change those negative thoughts into positive and realistic thoughts.


What if the person does not want help with depression?


There are many reasons why a person might not want to seek help for their depression. These reasons could include:


  • Stigma - Stigma is when someone sees you in a negative way because of your mental illness. Discrimination is when someone treats you in a negative way because of your mental illness. Social stigma and discrimination can make mental health problems worse, and stop a person from getting the help they need.
  • The Negative Effect of a Diagnosis - Having an official diagnosis of depression (or any other mental illness) could affect conditions of current employment status, and the types of jobs people can apply for.
  • Cost - Private counsellors, therapists, psychotherapists, psychologists, etc., are often expensive.
  • How long they might have to wait - Waiting to see a doctor can often take weeks, and a doctor’s referral to a mental health department could take several months.
  • Hospital - The fear they may be sent to a psychiatric hospital, and the consequences that might follow.