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Although it is natural for everyone to go through times when they feel sad or unhappy for a few days, this does not always mean that they have depression.
Depression is a medical word that is used to describe a low mood that lasts for a long time. It has a range of different symptoms that can affect everybody differently. It can change how you think, how you feel, and your ability to get on with normal daily activities.
Depression can range from mild to severe, and is thought to affect 1 in 10 people throughout their lives.
There are many different ways in which someone can feel depressed. People may have only a few symptoms of depression, or many symptoms at once.
It isn’t always possible to tell that you’re having symptoms of depression straight away, because they can take some time to develop. Many people try to cope with their symptoms without realising that they are unwell. It is often a family member or a friend who suggests that something could be wrong.
Symptoms of depression are split into the following categories:
Psychological symptoms are symptoms that are felt in the mind. Examples of these symptoms include:
Physical symptoms are symptoms that are experienced in the body. Examples of these symptoms include:
Social symptoms are symptoms that affect how you behave. Examples of these symptoms include:
If you have very severe depression, you may also experience something called psychosis. This can be an extremely frightening and upsetting experience and may include developing the following symptoms:
Even though these things are not actually happening, they feel extremely real to the person going through them. This can make it really hard to understand that they are also a symptom of your depression and that you need help to get better.
It is also very common to have depression and anxiety together as some of the symptoms of these conditions can overlap. For example:
When some people are feeling low, they may feel that harming themselves will help them cope with their feelings. Although doing this might give you a sense of relief in the very short term, it is very dangerous and can make you feel so much worse in the long term.
If you’re feeling very low and see no hope in the future, you may often find yourself thinking that things would be better if you were no longer here.
These thoughts can be very scary, and you may think that things would be better if you were dead, or you may even begin to plan how you might end your life. These thoughts can feel like they are always there and controlling you, which can be really frightening. If you are having these thoughts, it is incredibly important that you try to find help as soon as possible.
If you are thinking of ending your life, this is an emergency and you should find help straight away.
Please call 115 AS SOON AS POSSIBLE if you are having suicidal thoughts.
No, depression is not contagious. It cannot be passed from person to person.
However, spending a lot of time with someone who is depressed, and trying to care for them, can be really demanding and hard. It can have a knock on effect on your own mood, and can also make you to feel down as well. If you are feeling like this may be happening to you, it is best to speak to your doctor, who can assess you in more detail.
Depression cannot kill you in the traditional way that a serious infection or cancer might, but it can increase your risk of death.
For the majority of people, their depression will be treated successfully and be kept under control, allowing them to continue enjoying their life. In some cases however, people who have very severe depression, or those do not seek help for their depression at all, may end up taking their own life.
In addition to a higher risk of suicide, people who suffer from depression may find it more difficult to seek help for or manage their physical health issues. This therefore puts them at greater risk of dying from them.
There are many different types of depression. These include:
Many people have heard the term ‘clinical depression’. This just simply means that a doctor has given you a diagnosis of depression based on your symptoms. It does not necessarily mean that your depression is more severe if you have clinical depression, it just means that it has been recognised by a doctor.
This is the name that doctors give to describe your time of depression when they make a diagnosis. They might say that you are going through a ‘depressive episode’.
Your depressive episode might be described to you as mild, moderate or severe.
Grading your depression as mild, moderate or severe, is a way of describing how much of an effect your symptoms are having on your daily life. This grading system normally helps doctors decide what types of treatment you should be offered.
Mild depression has some impact on daily life, but most people can continue to function well.
Moderate depression has quite a big impact on daily life, such as at home or with work/school. For example, having moderate depression may mean that:
Severe depression makes it almost impossible to get through daily life, and carrying out simple tasks can become very difficult. It can also cause working or personal relationships to break down.
Recurrent depressive disorder
Some people only have one ‘depressive episode’ during their lifetime, with their mood fully recovering afterwards. However, in some cases:
Having more than one ‘depressive episode’ is called recurrent depressive disorder. Women are twice as likely to have recurrent depressive disorder than men.
Dysthymia is also called persistent depressive disorder or chronic depression. Your doctor might tell you that you have dysthymia if you have felt low for over 2 years.
People with dysthymia tend to go through a longer period of mild depression. They often go to see their doctor complaining about a long-standing feeling of tiredness and a lack of interest in doing things. They can also have a more severe depressive episode, but not return back to their normal mood afterwards.
If your low mood is linked to a particular recent stressful event in your life, then your doctor may call this reactive depression. The stressful event could be things like:
Reactive depression can cause a lot of stress, and can make people feel down for a long period of time.
Seasonal affective disorder (SAD) is a mental health condition that is brought on by the change in seasons.
Generally, a person with SAD begins to feel depressed during the winter months of the year when there is less sunlight. They then start to feel better again in the spring and summer months. This tends to happen every year.
As it can happen every winter, it can also be considered as a recurrent depressive disorder.
Psychotic depression is sometimes seen in people with more severe depression. If you have severe depression, you probably feel extremely sad and low for most of the day, everyday. You may also have no interest in doing anything. Even completing the most simple task can feel impossible.
Some people with this level of depression may also start to develop a condition called psychosis. Having psychosis alongside depression means that you also experience either delusions or hallucinations.
What are delusions?
Delusions are strong, unshakable beliefs about something that isn’t true.
What are hallucinations?
Hallucinations are hearing, feeling, smelling, seeing or tasting something that is not there.
These delusions or hallucinations are often something negative about oneself. For example, thinking you have committed a terrible crime, or feeling like you have an illness.
People with psychotic depression are more likely to have thoughts about harming themselves or others, and are more likely to think about ending their own life.
Postnatal depression, also called postpartum depression, is depression that happens in the first 12 months after a woman gives birth. It is more than just baby blues, which is when women can feel anxious, sad and teary in the two weeks after delivery.
Postnatal depression can happen at any time in the first year after giving birth. It can be difficult to recognise, as it often starts gradually. Signs that you could have postnatal depression include:
Can men get postnatal depression?
It’s important to note that having a baby can be a huge life change for many people. More recently men suffering from postnatal depression has been discussed too. Men feeling very low after the birth of a child should take it seriously and see their doctor to discuss their symptoms further.
What is postpartum psychosis?
In the most severe cases, women with postnatal depression can also have psychosis. This is often called postpartum psychosis. It occurs in around 0.1% of women who have given birth, and it is more common in women with pre-existing mental health problems.
Postpartum psychosis is most likely to happen in the first four weeks after a woman gives birth, and it is extremely serious. The mother can experience delusions or hallucinations in relation to her baby, putting her baby at risk. For example, she may hear voices telling her to hurt her baby or herself, or believe that someone is trying to harm them both.
Although bipolar disorder is a different mental health condition to depression, it is important to know about because someone with bipolar disorder can have symptoms of feeling extremely low for a long period of time. This is called bipolar depression or manic depression.
Someone with bipolar disorder can also have periods of time with extreme behaviour, which are known as high’s or mania. If you see a doctor about low mood, they may also ask you about extreme highs to check if you may have bipolar disorder.
Everyone is completely different. It can be a combination of things that can cause people to feel low. Some people may even feel depressed for no specific reason that they can think of.
Serious events that happen in your life can often be a trigger for depression:
Suffering with a long-term health condition can increase your risk of getting depression. In particular, people with the following medical conditions have been seen to have an increased risk:
Research has shown that going through something traumatic or difficult in childhood can increase your risk of suffering with depression in adulthood.
Drinking excess alcohol and taking illicit drugs have both been linked to a higher risk of depression. Those suffering from depression also have higher rates of drug and alcohol misuse, as some people use them to self-medicate their symptoms. These substances actually worsen depression and should be avoided. Your doctor will be able to help you if you are concerned about drug or alcohol use.
Some prescription medications can also contribute to the development of depression. If you are taking a medicine and think it could be causing you to have a low mood, please speak to your doctor about it.
Research has shown that if you are surrounded by a difficult environment growing up, then it can have an impact on your mood later in life. This includes:
There has been a lot of research in brain chemicals called ‘neurotransmitters’ and how they are involved in causing depression. However, the way in which they might do that is still poorly understood.
Often, if you cannot link your depression to a specific life event, your doctor may say that you have a ‘chemical imbalance’ in the brain. The three main chemicals they are referring to are:
Some research suggests that having too little of a specific chemical in your brain can lead to depression. In reality however, it is probably much more complicated than this, which is why researchers cannot say for sure at the moment how this process works.
Having someone else in your family who suffers, or has had depression, may make it more likely for you to get depression.
Depression can really affect anyone of any age, but it often starts in adulthood.
Until recently, children having low mood and getting depressed wasn’t really talked about. However, more recently it is being recognised as an increasing problem in children. Research shows that children suffer with anxiety before going onto experiencing low mood and depression. They can also complain of physical problems like headaches and stomach aches.
Children having problems at school, being unable to concentrate or being disruptive may also be a sign of depression. In childhood, boys and girls are affected equally.
Depression in children can be caused by a combination of things, or even nothing specific at all. Generally things that increase the risk of a child suffering with depression include:
As children become teenagers, girls are twice as likely to be depressed as boys. Going through puberty can be difficult, and teenagers begin to become more aware of things happening around them.
Symptoms of depression in teenagers are very similar to those in adulthood, and are most likely to be caused by a stressful life event.
Teenagers can go onto to develop other more serious problems as a result of their depression, such as:
It is important that depression in children and teenagers is recognised early, and that help is given to try and treat it.
Women are more likely to be diagnosed with depression than men. There are a few different factors that researchers have thought make women more vulnerable to depression:
It may also be the case that more women are diagnosed with depression because it is more acceptable for women to talk about their feelings with family, friends or their doctor.
It is thought that men are less likely to suffer from depression than women. More recently, doctors have recognised that depression is actually a serious and underdiagnosed condition in men.
It is thought that this could be because traditionally, men were not encouraged to talk about their feelings with others in order to appear more masculine. They are also less likely to visit their doctor complaining of low mood.
If you are a man experiencing low mood, it is really important that you seek help.
Recent research has shown that men do not necessarily experience depression less than women, but they can show their symptoms in a different way. This means that depression can be harder to recognise in men.
Symptoms of depression that men are more likely to have than the traditional low mood include:
Depression in older people is extremely common. It can be caused by a number of different things and can have a big impact on their health.
As we get older, we are more likely to suffer with other health conditions such as high blood pressure or chronic pain. If an elderly person is also depressed, they may be less likely to take their medications, and less likely to engage with doctors and therapists to get better.
Older people may also be more difficult to treat as they may take a lot of other medications which make it unsuitable to take antidepressants. Some of the causes of depression specifically linked to elderly people are:
Depression is usually diagnosed by going to see your family doctor. If you experience the symptoms of depression for most of the day, every day for more than two weeks, then you should go to see your doctor.
It is especially important to go and see them if you feel like you are not getting better, or if you are having thoughts of harming yourself or others.
They will usually start by asking you some questions about how your general health is and how you have been feeling.
They may suggest doing a blood test to rule out other medical conditions that could cause similar symptoms to depression, such as thyroid problems or low vitamin D levels.
Your doctor may also work with you to fill out a questionnaire to help show if your depression is mild, moderate or severe. They may also use a questionnaire to see if you also have symptoms of anxiety.
If your doctor has any further questions about your diagnosis, or if they think that it may be another mental health condition, they may refer you to a specialist called a psychiatrist. This is a type of doctor who looks after people with mental health conditions.
Psychiatrists may have access to different treatments or therapies that may be beneficial to you.
Having depression can have a huge affect on your quality of life. It can affect so many different aspects of your life that it can seem that it is taking over. This is why it is important to seek help as soon as possible to try to manage your depression.
When depression is treated, the majority of people find that they can return to the old way of life they had before they started feeling low.
Untreated depression or people with moderate or severe depression find that their depression has a bigger effect on their quality of life. They may feel that it is taking over, or even ruining their life. For these people, it can be very difficult to function as normal without depression affecting their:
There are some conditions in which the low mood can look like depression, but actually has another cause. This is why it is important for your doctor to do a thorough assessment, so that they can exclude any other causes before giving a diagnosis of depression.
Hypothyroidism is a common cause of low mood in women especially. The thyroid gland is a gland found in the neck that produces hormones that have an effect on different parts of the body.
If your thyroid begins to produce too little thyroid hormones, it can lead to a condition called hypothyroidism. One of the symptoms of hypothyroidism can be low mood.
In most cases, a medication can be given to increase the levels of thyroid hormone in the body, meaning that the thyroid gland can go back to normal again.
If you speak to your doctor about having symptoms of low mood, they may suggest doing a blood test to rule out hypothyroidism.
Hypothyroidism can also cause the following symptoms:
Vitamin D is needed to keep bones and muscles strong. The body can get vitamin D from fish and red meat, as well as sunlight. People that stay inside, or are often covered up when they go outside, may not get enough vitamin D.
Symptoms of low vitamin D levels include:
ADHD stands for attention-deficit hyperactivity disorder. If this has not been diagnosed as a child, it can sometimes be mistaken for depression in adulthood. There are a lot of symptoms that cross-over between depression and ADHD, but some symptoms that may be more in line with ADHD include:
Grief is a very normal thing for people to go through after someone they love dies. Feeling extremely sad and being low in mood when someone dies is a natural experience that can last for a different amount of time, depending on the person. Grief can often come and go when you think of the person you lost.
Just because you remain sad about someone that has died for a long time, it does not necessarily mean that you are depressed. However, if you notice that you are experiencing other symptoms of depression such as worthlessness, hopelessness and persistent low mood, then you should speak to your doctor.
Dementia is a disorder of the brain which can cause memory loss, behavioural changes and low mood. Telling the difference between the early stages of dementia and depression in the elderly can be very difficult. They share a lot of the same symptoms, and often develop over a long period of time. Your doctor may ask you questions specifically to test your memory to try and distinguish between the two.
Premenstrual dysphoric disorder (PMDD) is often referred to as severe premenstrual syndrome. PMDD can affect up to 10% of women. It is a serious condition described by severe mood disturbances such as:
Unlike depression, the symptoms are only there at certain times within the menstrual cycle, often in the lead up to your period. It can be extremely distressing and have a real effect on your quality of life.
The information in this article is written for general information purposes only, and is not a substitute for professional medical advice, treatment or care. It is incredibly important that you do not make decisions regarding any symptoms based on this information alone. If you are worried about any symptoms you may be having, or have any further questions about this condition, please speak to a qualified and trustworthy medical professional.
There are a number of different treatment options available that can help to treat depression. Your doctor can work with you to decide the best treatment plan for you.
If you have mild depression, you might make a decision with your doctor to not use any medical treatment. In this case, your doctor may recommend some lifestyle things that you can do at home instead.
They may recommend:
If your doctor recommends these lifestyle changes, they will probably arrange a follow up appointment to reassess your mood again in a few weeks after trying them.
If your depression is more severe, or you want to start being treated immediately your doctor may recommend the following treatments:
The most common type of talking therapies offered is Cognitive Behavioural Therapy (CBT). CBT is a type of talking treatment that tries to change your behaviour by focusing on your beliefs and thoughts, and how they affect your feelings and behaviour. This technique can help you make sense of overwhelming behaviours by breaking them down into smaller parts.
CBT helps to stop negative ways of thinking that can make you feel sad, and instead leads you to feel better about yourself.
Ideally after doing CBT, you would have learnt some tools you can use in your mind that can help you break this cycle of negative thinking in the future.
CBT can come many forms, such as:
There can be other talking therapies available if your specific trigger for depression is trauma related. Please ask your doctor about these.
Medications used to treat depression are called antidepressants.
For people beginning treatment with an antidepressant it is worth considering:
There are a few different types of antidepressants:
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that work by increasing the amount of serotonin in the brain. Serotonin is one of the chemicals found in our brain that is linked with depression.
SSRIs are the most common type of antidepressant prescribed. Examples of SSRIs include:
Be patient when taking SSRIs
It can take at least 6 weeks to notice any changes after you start taking an SSRI, but they can be very effective when they do start working.
If after a while of taking SSRIs you feel that they have had some effect, but that you still have low mood, your doctor may consider increasing your dose.
SSRIs are commonly used to treat depression as they are less likely to cause problems with other medications that you may be taking at the same time. If you are also taking anti-inflammatory painkillers (such as ibuprofen), your doctor may give you another medication to protect the lining of your stomach.
What are the side effects of SSRIs?
Some of the most common side effects of SSRIs are:
Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs) are another type of antidepressant that can be prescribed for depression. The most common ones are:
What are the side effects of SNRIs?
Side effects usually happen in the first few weeks after treatment has started. Over time your body gets used to the medications, and the side effects often go away.
The most common side effects caused by SNRIs are:
Tricyclic antidepressants (TCAs) are the oldest type of antidepressants, originally used in the 1950s. They work by increasing the amount of time that serotonin and noradrenaline stays in the brain.
It would be quite uncommon to use this medication these days, unless someone could not have, or did not tolerate using an SSRI or SNRI.
Someone that may have been on a TCA for a long time and who responds well to it, might be advised to stay on it by their doctor to avoid withdrawal side effects of coming off it again. Anyone on a TCA should see their doctor regularly for check ups.
What are the side effects of TCAs?
They can can cause quite a lot of unpleasant side effects including:
Monoamine Oxidase inhibitors (MAOIs) are another type of antidepressant medication. They also make serotonin and noradrenaline last longer in the brain by stopping them from being broken down.
They are not a common type of antidepressant and are often only used if you’ve tried all other types of antidepressants and they haven’t worked for you.
They should only be prescribed by a specialist mental health doctor (psychiatrist).
There are also some other treatment options available:
If your depression is very severe or you have made an attempt to take your own life, it may be recommended that you stay in a hospital bed while you are treated for your depression.
This can be voluntary or, in some cases if you continue to be a danger to yourself by trying to harm yourself, it can be involuntary.
Whilst you are in hospital, you will be given your regular medication and you will have mandatory talking therapy sessions to try and help you recover.
Depending on where you live or if you can afford to pay for it, there may be an option to attend a rehabilitation centre.
These are places that people can go and stay when they’re depressed to undergo intense treatment such as talking therapies. These are mostly private facilities that cost a lot of money to attend.
Electroconvulsive therapy (ECT) is a treatment used less commonly these days. It is a procedure performed by a specialist doctor, and it tends to be used in patients who have severe depression and who have not responded well to any form of antidepressant medication.
How does ECT work?
A patient is put under general anaesthetic which makes them unconscious so that they do not hear, feel or see anything. Then, small electrical currents are passed through the brain to cause a seizure.
It is thought that this technique changes the chemicals in the brain, which may help treat depression. It can be very successful if it is used on the right patient, and it can have quick results.
Depression does not have a specific cure that can be used for everyone. However, it is a very treatable condition with a lot of treatment options available to try.
It is important to speak to your doctor about all the options available for you, and it is better to do this as early as possible. It may take some trial and error before you find the right treatment that works best for you.
Remember it is normal for everyone to feel sad or a bit low from time to time, so it is not something that can be prevented entirely. It is recommended that practicing some self-care can be a great way to try and prevent more prolonged periods of feeling low, and therefore depression. This can include:
If you have been depressed in the past, it is worth being mindful of what your triggers were for that episode. Doing this could make you more aware if you start to feel low again in the future, and it can enable you to seek help as early as possible.
Is there a test or quiz I can take for depression?
Please be aware however, that this test does not give you a formal diagnosis, and does not replace a full assessment by a qualified mental health professional.
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