Depression is common and can strike any one of us at any time. According to the Mental Health Foundation 10% of the population in the UK and USA will experience some form of depression every year. There are several different types of depression ranging from mild to severe, and within each type, the symptoms, their intensity and duration, will all vary from person to person. Milder forms of depression may have little impact on someone’s life and will often spontaneously disappear after a relatively short period of time, Bipolar Depression is characterised by intense fluctuations between mania and depression, Seasonal Affective Disorder or SAD is a type of depression occurring during the winter months and is believed to be related to a lack of sunlight, Post Natal Depression can affect a woman after the birth of a baby, but the most common form of depression is Clinical Depression, sometimes called Unipolar depression or major depression.
Clinical depression can be defined as a depression so severe as to require the intervention of a health professional. It is much more than feeling down, or fed up, something that all of us experience at times. Someone who is clinically depressed can’t just escape from it, and can’t switch it off so if the symptoms of depression persist for more than a couple of weeks and they interfere with a person’s normal routines on a daily basis, perhaps affecting their eating and sleeping patterns, their work, relationships or their ability to take pleasure in activities they once enjoyed, and it cannot be attributed to an obvious cause such as bereavement, or alcohol or substance abuse, then clinical depression could be diagnosed. Intervention is necessary in order to help someone with clinical depression get back to normal as without treatment, it could go on indefinitely.
Symptoms of clinical depression
There are numerous symptoms associated with clinical depression but the most common include:
o Low moods and sadness for most of the time
o Disinterest and lack of pleasure in most activities including sex
o Weight gain or loss with associated increased or diminished appetite
o Sleep disturbances – both insomnia and hypersomnia
o Feeling exhausted when waking up
o Irritability, agitation and restlessness
o Feeling guilty, worthless and/or helpless
o Inability to concentrate and focus
o Fatigue and loss of energy
o Physical aches and pains or digestive problems
o Recurrent thoughts of death or suicide
Symptoms can range from mild to severe and they will vary with each individual. In other words, there is not a single identifiable set of symptoms that indicate clinical depression and the only way to ensure a correct diagnosis is to seek the expert help of a GP or other health professional who will ask about the symptoms, their duration and severity, personal circumstances and medical history, and any cases of depression recurring in the family. The most appropriate treatment options can then be considered.
Clinical depression will normally require the use of anti-depressants for a period of time, usually for six months or so and sometimes longer. It can take several weeks for any medication to take effect so it is important to persevere with them even if there is no initial improvement. There are several different types of antidepressants and the effect of any medication, both positive and negative, will vary but as a general guideline, if there is no improvement after six weeks or so, or if there are significant side effects, then the GP may prescribe another medication until one is found that suits the individual. Antidepressants should never be stopped suddenly as this can be harmful, it is necessary to reduce the dose slowly over a period of time under the guidance of a qualified physician.
Talking therapies and counselling may also be an option for mild to moderate depression. These types of therapies can be helpful in changing negative thinking patterns and behaviours that contribute to the state of depression. Talking through problems and looking at issues in more depth can offer new insights and possible coping strategies.
For extremely severe and persistent depression that hasn’t responded to other treatments, ECT is a possibility, which involves giving short electrical shocks to the brain.
There is no one single cause of clinical depression and no way of knowing who will develop it. Certainly, some groups of people appear more at risk of becoming clinically depressed than others, such as the socially isolated, the long term sick and disabled, single parents, and the unemployed. Low levels of neurotransmitters like serotonin and essential fatty acids are found in people who are depressed suggesting biological factors can be involved and depressive disorders appear to run in families indicating that genetics could play a part. Sometimes, even the way we view the world or how we think about ourselves can cloud our perception and trigger depression. The important thing is to seek advice if it begins to affect your daily life because regardless of its cause, help is available, depression can be treated and life can return to normal.