4. Depression

5. Depression

 

 

When people are severely depressed, they feel that life has little to offer them and that things will never get better. This low mood is more than being fed-up or unhappy. We can all feel sad from time to time, especially after a recent loss or for no reason at all.

 

Depression is an illness that can be treated and should not be ignored. With skilled help and the chance to talk, most people will recover after several months. For others it may take longer and the depression may return. Occasionally people feel so hopeless that they think about, or even commit, suicide.

 

In manic depression or bipolar affective disorder, people will suffer not only from episodes of depression, but also episodes of mania. At these times a person’s mood becomes very ‘high’ and there will be a change in behaviour. The person who is ill may act recklessly, for example spending lots of money and running up large debts.

 

At least one person in five will suffer from a depressive illness at some point in their life. It appears to be more common in women than men because women are more likely to seek help than men. It occurs at any age, even in children and young people. Bipolar affective disorder is less common affecting one person in 100 and affects both men and women.

 

There are a number of reasons why people become depressed. These may include: reactions to life events and stresses, and genetic or biological factors. Early experiences in life and losses through bereavement or the break-up of a relationship may trigger episodes of depression, and perhaps mania. A number of physical illnesses are also linked with depression, such as infections like influenza, and disorders of the thyroid gland.

 

Family studies suggest that manic depression in particular sometimes runs in families. There may be an abnormality in brain biochemistry involving a chemical messenger called serotonin.

 

 

In a mild episode of depression a person may find that, with support from family or friends, the symptoms improve by themselves. Talking through problems can help resolve any life stresses that may have caused the illness. If the symptoms persist for more than two weeks, people may need to seek professional advice, initially from their family doctor.

 

There are a number of ways of treating depression. Medication with antidepressants can help relieve the symptoms and prevent future episodes. The drugs work by acting on the chemical messengers in the brain.

 

Talking therapies such as relationship based psychotherapy can be useful; also problem-solving therapies and cognitive therapy in which the therapist, often a psychologist, helps a person learn to identify and challenge faulty, negative patterns of thinking. Support from family and friends is vital. Other activities, such as regular exercise, can help lift the depression.

 

If the symptoms do not improve, or a person feels suicidal, the family doctor may refer the individual to a specialist mental health team. Members of the team will have a range of skills which enable them to make a full assessment of a person’s background, social, psychological and living skills, in order to understand their problems and to formulate a treatment plan. The team may be able to offer more intensive support at home, and if needed, hospital admission.

 

The person with depression can help himself by learning how to relax, to do the things he enjoys and by taking exercise. If he learns about his symptoms and what makes them better or worse, he can learn to control them. He can also see that they do not last forever, which can help him to feel more hopeful about the future.

 

 

Public education can help us to have a better understanding of the nature of depression. With this understanding should come increased tolerance. We need to understand that depression and manic depression are more than ordinary feelings of unhappiness. They can have a major effect on someone’s ability to carry on with day to day living. People with these disorders, and their families, need support in seeking help and getting treatment. Educating employers about depression and the way it affects a person’s ability to work, should improve opportunities for training and employment. Better social conditions, such as improved housing and lower levels of unemployment, would help reduce some of the environmental stresses people experience.

 

Acknowledgements