Know About Depression

Everyone feels a bit low sometimes - it's the mental health equivalent of the common cold. But for some people it's much more serious, paralyzing their ability to get on with life.

What are the symptoms?
As with many mental health problems, there are a number of symptoms of depression and it's very rare for all of them to occur in one person. They include feeling generally miserable, as well as:

• Variation of mood during the day. It's often worse in the morning, improving as the day goes on - but the pattern can be the other way around.
• Disturbed sleep, usually waking early and being unable to get back to sleep. This is often because of the negative thoughts racing through their heads.
• A general slowing down of thought, speech and movement.
• Feelings of anxiety.
• Tearfulness for no reason.
• Short temper.
• Lack of energy and constant exhaustion.
• Inability to enjoy things.
• Lack of concentration.
• Difficulty making decisions.
• Feeling that you're forgetful.
• Negative thoughts about the future.
• Feelings of guilt.
• Loss of identity.
• Blaming self and low self-esteem.
• Feelings of hopelessness and despair.
• Unrealistic sense of failure.
• Loneliness, even when around others.
• Becoming preoccupied with illness.
• Loss of appetite and resulting loss of weight.
• Reduced desire for sex.

This presents a very bleak picture. However, it's important to remember that depression isn't an absolute - it's not simply a case of either you're depressed or you're not. There's a progression from feeling blue to the full clinical illness described above. Even then, you won't suffer from every symptom. It's also important to remember that depression is treatable and, if you take the right steps, avoidable.

How common is it?
Seven to 12 per cent of men suffer from diagnosable depression, and 20 to 25 per cent of women. There are many theories as to why the figure is higher for women. The incidence of post-natal depression certainly contributes to the higher figure.

Other explanations include the low status of women and the difficulties they face in achieving life goals. It could also be that women tend to be more honest about their emotions than men, so their depression is easier to detect.

Monitoring your mood and thoughts
This is the starting point for managing depression. It will help you learn to spot an episode of depression before it's too late. Using the thought monitoring technique, you can decide which thoughts represent an accurate picture of what's going on around you - and which are unrealistic and created by your mood beginning to fall.

Ask someone you trust to monitor your mood
You won't spot every episode of depression before it happens, but those closest to you will often be able to recognize the early signs. Talking to them about this problem is probably one of the most valuable ways to deal with it. An agreement with a family member or friend as to how and when they could point out the problem, and what the two of you do to address it, is invaluable.

It's important that you go through the agreed tasks to address the problem, even if you don't feel your mood is falling - you may be surprised by what they bring out. The kind of tasks you could do with your relative or friend includes: stress auditing, thought and mood inventories, and talking about any incident that's given the family member or friend cause for concern.

What support is available?
There's nothing like speaking to someone who's been through the experience and come out the other side. A listening ear is often the greatest help to a depressed person. Samaritans are available to listen 24 hours a day, seven days a week. It can also be useful to attend support groups. The national mental health charity MIND runs several.

A good place for further information about depression is the Royal College of Psychiatrists' series of leaflets.

Depression Alliance offers information, support and understanding to people affected by depression, including a network of self-help groups, a correspondence service and scheme, and free information leaflets on the many aspects of depression. Depression Alliance also campaigns to raise awareness of the condition.

What professional help is available?
Many of the self-help exercises on this site are based on a technique called cognitive therapy; there's a growing body of evidence for the effectiveness of this approach. However, some people need to see a professional for cognitive therapy to work for them. They may also need another form of therapy.

The first person to talk to about this is your family doctor, who may have a practice counsellor who you could talk to. Alternatively, you may be referred to the local community mental health team to see a community psychiatric nurse (CPN) or a clinical psychologist. For some people, therapy alone isn't enough. There are now a number of antidepressants available for doctors to prescribe, which can be used with cognitive therapy.

Working with your mental health team, it's possible to draw up a crisis card - an agreed plan detailing the type of care you want (or don't want) in the event of a crisis. The Institute of Psychiatry at King's College London has more information on how to develop joint crisis plans.

Other ways to help yourself
It's not unusual to experience some of the signs of depression from time to time. But if the feelings are very strong all the time, there are things you can do to help yourself.

• Notice 'thinking errors'. Are you overgeneralising. For example, do you imagine every pain is a deadly disease? Do you tell yourself everything is going wrong when only one thing has gone wrong? Do you forget about the good things in life and concentrate on the bad?
• Balance frightening thoughts with reassuring statements.
• Occupy your mind. Concentrating on something can lift your mood.
• Exercise. Physical activity relaxes you and makes you feel good.
• Pay attention to the way you look.
• Eat a regular diet of wholefoods. Vitamin B6 supplements are helpful too.
• Try a herbal antidepressant. St John's Wort can be effective (but you shouldn't mix it with other medication - consult your GP or a professional herbalist for advice).
• Avoid alcohol. It's a depressant, even if it makes you feel temporarily better.
• Investigate alternative and complementary therapies.

http://www.sph.umich.edu/news_events/findings/fall05/features/one.htm

http://www.bbc.co.uk/health/conditions/depression1.shtml

http://www.zizzoo.com/guides/depression/faq/index.php

http://www.menopauserx.com/health_center/health_Depression.htm

http://www.therapy-now.com/TherapyNowDEPRESSION.htm

http://www.nimh.nih.gov/publicat/depression.cfm