Depression
Depression is the most common mental health condition with about 5-10% of adults experiencing it every year. It can be mild and last a relatively short time but about 25% of women and 10% of men have an episode of depression at some point in their lives that’s severe enough to need treatment. The average length of an episode of clinical depression is 6-8 months. It is a medical condition that can be serious, but most cases improve over time, and treatments such as lifestyle changes and talking therapies can help. It's very important to seek help early if you notice any persistent symptoms of depression.
Although depression affects people in different ways, the core symptoms are of persistently low mood or sadness, and a significant lack of enjoyment or interest in anything, even in activities you normally enjoy. It’s a marked difference from how you were before and you may also find it difficult to concentrate and focus. You may feel excessively tired, sluggish and lack motivation, and you may find it hard to start tasks or complete them. Your sleep may also change, such as sleeping in the daytime, finding it hard to get to sleep or to sleep through the night, and waking early in the morning. You may lose your appetite or begin over-eating. People with depression often describe feeling worthless or hopeless, and they often avoid seeing other people.
Depression can be categorized as mild, moderate or severe depending on the number of symptoms and how severely they are affecting you.
Everyone can feel a bit sad from time to time, if you are going through difficult times such as losing a loved one or a divorce, but this doesn’t necessarily mean you have depression. This can be a normal and appropriate response, and your coping strategies will help you get back on your feet.
This becomes more concerning if you’re feeling down for more than a few weeks and it’s getting worse, if it wasn’t in response to anything, or if you’re finding it hard to do your job or get everyday tasks done like washing or cooking. This is more like clinical depression.
Depression can lead to persistent thoughts of suicide or self-harm. This can have a significant impact on people's lives or be life-threatening and is why it is important to seek help if you are suffering from depression. Even the most severe depression can get better with the right support and treatment.
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Who gets depression?
Anyone can get depression and there's no exact cause for it. A combination of genetics, lifestyle, past trauma or stressful life events and a lack of coping strategies can all contribute to the onset of depression.
Depression is more common in women, and in particular around the time of giving birth and menopause, which relates to the disruption brought by both a change in hormones and a change in life, sleep, finances and social circumstances.
Depression is also more common if you or a family member have suffered from it in the past, if you have a long-term health condition or if you have had a significant negative life event, such as bereavement or losing your job. Challenging social or living circumstances may also cause loneliness and anxiety, which in turn can lead to depression.
How can I help myself?
Lifestyle changes can help, such as getting outdoors or doing regular exercise, meeting up with friends or sharing what's on your mind with a trusted friend or family member. Some people find self-help or support groups helpful, in knowing they are not alone and they may be interested in others’ strategies to get through things – sometimes people open up more to strangers.
Excessive alcohol consumption and smoking cannabis or other street or party drugs can put you at higher risk of developing depression, so it's best to stop these if you can, or seek specialist help if you're finding quitting difficult.
When should I see my doctor?
You should book an appointment to see your doctor if you think you have depression, or you are concerned that someone close to you is suffering. It is important to seek help early. You should speak to a medical professional urgently if you are having thoughts of self-harm or suicide. You can get urgent help via your doctor, or by visiting the emergency department, which is a safe place during a crisis.
The doctor will ask you about your medical history and your current symptoms. They may ask you questions from a screening questionnaire which can help to scale how severe your depression is, and they may also consider blood tests if they feel a medical condition could be causing symptoms similar to depression, such as an underactive thyroid, an underactive pituitary gland, polymyalgia rheumatica or early dementia.
If your depression is mild the doctor may recommend relevant lifestyle changes and monitor how you progress. They may also suggest a talking therapy or cognitive behavioral therapy (CBT), which helps to reduce the negative thoughts. The doctor will keep an eye on how you are doing and whether these interventions are helping.
If you have prolonged depression or moderate depression, your doctor may prescribe an antidepressant like a selective serotonin reuptake inhibitor (SSRI) alongside a talking therapy.
If you have severe depression your doctor may refer you to a specialist mental health team for support alongside prescribing antidepressants and talking therapy. It's rare, but if the doctor feels you are at a significant risk to yourself, they may refer you to a hospital.
Am I fit for work?
Your fitness to work will depend on the severity of your depression. The doctor will assess this with you. Sometimes a little time off to rest and deal with any significant life events or overwhelming feelings can be a good start to recovery. But it helps to keep a date in mind as a goal to return to work, so this can be something to aim towards.
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