Depression

What is depression?

Everyone has spells of feeling down, but depression is more than just spending a few days feeling sad or unhappy. Depression can make you feel persistently sad and down for weeks or months at a time.

While some people believe that depression is trivial or not a genuine health problem, it’s actually a real condition that affects around one in 10 people over the course of their lives. It impacts people of all genders and ages – including children. Studies show that around 4% of children in the UK between the ages of five and 16 are depressed or anxious.

With the right support and treatment, most people recover fully from depression.

Do I have depression?

Depression has a range of different symptoms, and it can affect everybody differently. The symptoms include feeling very tearful, feeling hopelessness and sadness, and losing interest in things you enjoyed before. It’s also common for people with depression to have symptoms of anxiety.

Physical symptoms happen with depression too – these can include feeling tired all the time, getting poor sleep, losing your sex drive, losing your appetite, and feeling aches and pains.

If the symptoms are mild, you might simply experience a persistent low mood. It’s common to feel stressed, sad or anxious during difficult times in your life, and a low mood can get better after a short time, rather than being a symptom of depression.

Learn more about low mood and depression here.

Severe symptoms of depression can make people feel suicidal – as if life is no longer worth living. Read more about depression symptoms here.

Seeing a doctor about depression

Big changes in your life, like bereavement, losing a job, or even having a baby, can cause symptoms of depression. You’re also more likely to experience depression if you have a family history of depression. However, it’s also possible to become depressed without there being an obvious reason.

Symptoms and causes of depression

Symptoms of depression can be very different from person to person. However, as a general rule, if you are depressed you feel hopeless, sad and lacking interest in things that used to make you feel happy.

Depression symptoms are bad enough to interfere with work, social life and family life, and can persist for weeks or months.

Doctors describe depression in one of three ways, depending on how serious it is:

• mild depression – it has some impact on daily life
• moderate depression – it has a significant impact on your daily life
• severe depression – this makes it nearly impossible to get through your life day to day

A few people with severe depression may have symptoms of psychotic depression.

Below is a list of depression symptoms – it’s unlikely that one person would have all of them.

Psychological depression symptoms include:

• continuous sadness or low mood
• losing interest in things
• losing motivation
• not getting any enjoyment in life
• feeling tearful
• feeling guilty
• feeling anxious
• feeling irritable
• finding it hard to make decisions
• feeling intolerant of other people
• feeling helpless
• feeling hopeless
• low self-esteem
• feeling worried
• thinking about suicide
• thinking about harming yourself

Physical symptoms include:

• speaking or moving slower than usual
• aches and pains that can’t be explained
• losing, or sometimes gaining, appetite or weight
• constipation
• loss of interest in sex
• disturbed sleep (having trouble falling asleep, for example, or waking up very early)
• loss of energy
• changes in your menstrual cycle (the time of the month when you get your period)

Social symptoms are common too. These include:

• avoiding talking to or spending time with your friends
• taking part in fewer social activities
• neglecting interests and hobbies
• doing poorly at work
• difficulties with your family or home life

It’s not always possible to tell that you’re having symptoms of depression right away – it can start and progress gradually. A lot of people don’t realise they’re ill and try to carry on and cope with their symptoms. Sometimes it takes a friend or family member to notice that there’s a problem.

Depression and grief

Depression and grief have a lot of the same features, and it can be hard to tell them apart. However, they’re different in many important ways. Depression is an illness – grief is a completely natural response to loss.

If you’re grieving, you may find your feelings of sadness and loss come and go, but it’s still possible to enjoy things in life and look forward to the future.

People with depression feel sad persistently, find it difficult to be positive about the future, and don’t get enjoyment from anything.

Learn more about the differences between grief and depression here.

Different types of depression

There are different types of depression, and there are some conditions where depression is a symptom. These conditions include:

• Bipolar disorder – people with bipolar disorder, which is also known as “manic depression”, experience times of depression, where the symptoms are similar to clinical depression. They also go through phases when they have excessively high moods (known as “mania”). Bouts of mania can include harmful behaviour like unsafe sex, spending sprees and gambling.
• Seasonal affective disorder (SAD) is also called “winter depression”. It’s depression that is related to weather, usually winter, so it happens seasonally.
• Postnatal depression happens to some women after they’ve had a baby. It’s treated similarly to other types of depression, with antidepressant medication and talking therapy.

Learn more about how depression is diagnosed here.

Causes of depression

Depression doesn’t have one single cause – it can have a range of triggers, and there are many different reasons a person can develop the condition. Some people are affected after a stressful life event, like a bereavement or divorce. Other people experience depression related to illness, job loss, or money worries.

Different reasons can combine and trigger depression. If you’re feeling low after a job loss or health issues, and then experience something traumatic, like a bereavement, you can develop depression.

It’s common to hear about depression being brought on by a “downward spiral” – one thing causing other problems that combine to cause depression. For example, losing your job could make you feel sad, so you spend less time with family and friends and maybe drink more alcohol. These things all make you feel worse, which triggers depression.

There are studies that suggest people are more likely to become depressed when they get older. There’s also evidence that depression is more common for people whose economic and social circumstances are difficult.

Depression and illness

Long-lasting or life-threatening conditions like cancer or coronary heart disease can put you at higher risk of developing depression.

Many people don’t know that head injuries can cause depression, and a severe head injury can lead to emotional problems and mood swings.

Underactive thyroid (hypothyroidism) can happen as a result of immune system problems. It’s also possible, although rare, for a minor head injury to damage the pituitary gland. This is a gland the size of a pea which sits at the base of the brain and produces hormones that stimulate the thyroid. Damage to the pituitary gland can cause symptoms, including severe tiredness and a lack of interest in sex, which can then cause people to develop depression.

Depression and drugs and alcohol

“Drowning your sorrows” is actually a bad idea when it comes to depression. Alcohol is categorised as a “strong depressant” which can make depression worse, and drinking or taking drugs to cope can lead to a downward spiral by having a negative affect on other parts of your life.

There’s evidence that cannabis can cause depression, particularly in teenagers, even if it helps you relax.

Other causes of depression

There are a number of things that can lead to developing depression.

• Stressful events – big changes in your life, like bereavement, the end of a relationship or the loss of a job, can be difficult to deal with. When these things happen, it’s important to keep seeing friends and family instead of trying to deal with problems alone – this increases your risk of developing depression.
• Giving birth – pregnancy and birth can make some people vulnerable to depression. Postnatal depression can happen as the result of physical changes, hormonal changes, and the responsibility of taking care of a new baby.
• Loneliness – your risk of depression gets higher if you aren’t in contact or spending time with family and friends.
• Personality – some personality traits can put you at a higher risk of developing depression. These include low-self esteem or a habit of criticising yourself too much. These personality traits can come from your genes, which you get from your parents, or they can be as a result of experiences in your early life.
• Family history – it’s more likely for someone to develop depression if a family member, like a sibling or parent, has experienced it before.

Diagnosing and treating depression

There’s no physical test for depression.

If you experience depression symptoms most of the day, every day, for more than two weeks, you should visit your GP. This is especially important if:

• you have symptoms of depression that aren’t getting any better
• you have thoughts of self-harm or suicide
• your work, relationships with friends and family, or interests are affected by your mood

It can be hard for people with depression to imagine that anything can help them – but the sooner you seek help, the sooner the symptoms start to get better.

Your GP may examine you and perform blood or urine tests to make sure there isn’t another condition causing your depression symptoms, like an underactive thyroid.

When you see your GP, they’ll try to find out if you have depression by asking you questions. These are likely to be about your health, how you’re feeling, and how that is affecting you mentally and physically.

Telling your doctor your symptoms and the affect they are having on you will help your GP to tell if you have depression, and how severe the condition is. It’s important to be as open as possible.

Your conversation with your GP will be confidential. This rule can only be broken if your GP thinks there is a significant risk of harm to you or others, and that telling a family member or carer would make that risk lower.

Treating depression

The first place to go is your GP – they will refer to you local talking treatments for depression that are available on the NHS.

You may also have the option to self-refer, depending on where you live, so you can go directly to a professional therapist if you’d rather not talk to your GP.

Talking treatments for depression

Counselling

Counselling is a type of therapy that works really well if you have good mental wellbeing overall but need help coping with a crisis that’s currently going on in your life. These can include anger, bereavement, infertility, relationship problems, job loss and serious illness.

On the NHS, counselling usually takes place over six to 12 sessions, each an hour long. The sessions are confidential.

A counsellor helps you to think about what’s going on in your life and find new ways of dealing with the problems. They’ll offer practical advice, support you, and help you find solutions, but they don’t tell you what to do.