Depression

By Dr Simon Kinsella, Clinical Psychologist


Living with depression is like walking waist deep through treacle, everything seems hard from the moment I wake up. Even waking up is hard. I might sleep 10 hours a night, but my eyelids feel as if they are made of lead. When I do drag myself out of bed, everything I do is hard. It's like too much effort to get to the bathroom, to get breakfast, or to get dressed.

Whether or not I make it to work is always a question. Sometimes I just have to call in sick because I can’t face other people. And it’s not like I’m staying home to have fun, nothing is fun. I used to like getting out on my bike. Now it seems like too much effort. I used to love listening to music, now it all irritates me. Not even eating, nothing has any flavour any more. And as for sex – forget it.

--------------------------------------------------------------------------------

What does it look like? (Symptoms)

Depression can present itself in many different ways. It may come about suddenly, or have built up over time. It can last months to years. There are some things that all depression sufferers have in common though. Sadness would be the number one common theme. A lack of drive or motivation would also be very common. Third would be a sense of helplessness, “there is nothing I can do to feel better”, or “there is nothing I can do to fix my problems”.

Depression has many different names. The “blues”, “down in the dumps”, “the black dog”, or “the sads” are all common terms. But what is it really? To be diagnosed with depression, a person must experience a minimum number of symptoms, such as:


•Feeling sad most of the time (more than 50%), most days, for more than 2 weeks
•Crying easily, or often
•Feeling lethargic, tired, or unmotivated
•Losing interest in things you used to enjoy
•Feeling flat, or not feeling any emotion (feeling empty)
•Feeling restless, and unable to sit still
•Feeling guilty or embarrassed beyond what is reasonable
•Worrying excessively
•Suicidal ideas, thoughts or actions
•Rapid weight gain or loss
•Loss of sex drive
•Poor quality sleep, or excessive sleep
•Trouble with concentration and or memory

The gradual appearance of symptoms may be an early warning that depression is developing. Sometimes people experience just a few symptoms that are more of an irritation than anything else. When these symptoms persist over years they are sometimes called “dysthymia”. When it comes on suddenly with a lot of symptoms it is called a “major depressive episode”. Sometimes it comes and goes for no apparent reason. Other forms of depression include bipolar disorder (or manic depression), post natal depression and cyclothymia. Diagnosing depression properly can be a difficult task!



How can it cause a problem in my life?

Depression can be a problem in many ways, because it shuts people down. They struggle to perform at work or school, they have more problems with their friends, their family and their partners. And they stop having fun!

At the least, depression might just interrupt life. It might make a short period of life difficult, like a blip on the radar. Commonly though, it hangs around for long enough for others to notice, and to make it hard to progress in life. Whether that’s at school, work, as a parent, a partner or a friend. At it’s worst, depression can make it impossible to work, or to function socially. It has been the reason for some people dropping out of work, breaking up marriages, and taking drugs. In the most tragic circumstances it has also lead to people taking their own lives.


Who else experiences it?

Major depression is described as the “common cold of mental health”.

•Estimates vary from 10% to 25% for women, and 5% to 12% for men.
•Many people have symptoms that are not diagnosed. At any one time almost 1 in 10 people will be suffering from a major depressive episode, plus people suffering the other forms of depression, like dysthymia, bipolar disorder (manic depression), or post-natal depression.
•Increasingly, media personalities such as Premiers, AFL footballers, TV presenters have told of their depression.
•Depression can occur at any age, from early childhood upwards. Most commonly it will occur for the first time by the early 20’s. It varies greatly in how long it lasts.


What can I do about it? How can I manage it?

•Self-Help: In cases where depression is mild, self help books can be a great way of dealing with the problem. There can be a great sense of satisfaction in conquering the problem using your own resources.
•Professional Support: For many people, self-help is simply not enough. Medical practitioners are often a good place to start for advice. They can tell you about the range of medications available, and the pros and cons. A GP is also best placed to tell you whether a psychiatrist, psychologist or other professional is likely to be the best placed to help you if he or she cannot offer all you need. Current research shows that the level of treatment required depends on the severity of the condition. For a mild depression, “talking therapies” are often all that’s required. Therapists can help you find more effective ways of approaching problems.
•Medication: Moderate depression might require a combination of medication and talking therapies. Sometimes however, finding the best medication can be a difficult process, as not all medications suit all people. In severe cases a person may require medication in order to benefit from talking therapies.

What Outlook can I expect?

The best approach with depression is to get in early. The sooner you deal with symptoms the faster you will recover, the less support you’ll need, and the smaller the chances you will relapse. The more depressed you become, the harder it becomes to recover. It is important to not lose hope. Persist with treatment, and if you’re not satisfied with your progress talk to your doctor or therapist. Don’t be afraid to get a second opinion; remember there is a huge amount of information and support available!


What resources are available for help?
Support Groups
ADAVIC Support Group
Grow www.grow.net.au Ph: 1800 558 268

Websites
depressionServices www.depressionservices.org.au

beyondBlue www.beyondblue.org.au

Books
Wigney, Parker, Eyers (2007). Journeys with the Black Dog.

Andrews (2006). Back from the Brink: Australians tell their stories of overcoming Depression.

Davidson (2007). What Does Blue Feel Like?