Depression The Royal College of Psychiatrists Depression affects one in five people at some point in their lives. Anyone can get low at times, but with depression, the feelings don’t go away quickly or become so bad they interfere with everyday life.

In this article

Causes Symptoms

Treatment Support

The feeling of depression is deeper, longer and more unpleasant than the short periods of unhappiness that we all have from time to time.

This presents a very bleak picture. However, it's important to remember that depression isn't an absolute - it's not simply a case of either you're depressed or you're not. There's a progression from feeling blue to the full clinical illness described above. Even then, you won't suffer from every symptom.

Sometimes there may be an obvious reason for becoming depressed, sometimes not. There is usually more than one cause and different people have different reasons.

It may seem obvious why – a relationship breakdown, bereavement or even the birth of a child – but sometimes it’s not clear. Either way, it can become so bad that you need help.

Often people don’t realise how depressed they are, because the depression has come on gradually

Often people don’t realise how depressed they are, because the depression has come on gradually. They may try to struggle on and cope by keeping busy. This can make them even more stressed and exhausted. This can cause physical pains, such as constant headaches, or sleeplessness.

Symptoms of depression include:

• Losing interest in life
• Finding it harder to make decisions
• Not coping with things that used to be manageable
• Exhaustion
• Feeling restless and agitated
• Loss of appetite and weight
• Difficulties getting to sleep

There are two types of treatment available: talking treatments and medication. Both can be accessed through your doctor.

Talking treatments

• Counselling helps you to talk about your feelings in private with a sympathetic professional. Your GP may have a counsellor at the surgery.
• Cognitive Behavioural Therapy can help to overcome the powerful negative thoughts that are part of depression.
• Interpersonal and dynamic therapies can help if you have difficulties getting on with other people. A relationship counsellor might be helpful if you're having difficulties with your partner.
• If you have a disability or are caring for a relative, a self-help group may give you support.

Medication

Antidepressants can be effective if depression is severe or goes on for a long time. They may help feelings of anxiety and help you to deal with problems effectively again.

The effects of antidepressants won’t usually be felt straight away - people often don't notice any improvement in their mood for two or three weeks. As well as tablets, an alternative remedy called St John's Wort is available from chemists. There is evidence that it’s effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side effects. You should discuss taking it with your doctor, particularly if you‘re taking other medication.

Like all medicines, antidepressants have some side effects, though these are usually mild and tend to wear off as the treatment goes on. The newer antidepressants (called selective serotonin reuptake inhibitors) may cause nausea and anxiety for a short while. The older antidepressants can cause dry mouth and constipation. Unless the side effects are very bad, your doctor will usually advise you to continue with the tablets.

Four out of five people with depression will get better without help. The shorter the time you have been depressed, the better the chance that it will lift on its own. However, even with treatment, one in five people will still be depressed two years later.

It may be enough to talk things over with a relative or friend. If this doesn't help, talk it over with your family doctor.

• Talk to someone close to you about how you feel. Going over a painful experience and crying it out can help you come to terms with it.
• Get some regular exercise. This will help you keep fit and hopefully, sleep better. Do jobs around the house to take your mind off thoughts that make you depressed.
• Eat well, even if you don’t feel like it. Don’t drink alcohol as this makes depression worse, although it might not seem to at first.
• If you can't sleep, try not to worry about it. Do something relaxing in bed such as reading, watching TV or listening to the radio.
• If you know what is making you depressed, write it down and think of ways to tackle it, pick the best ones and see if they help.
• Keep hopeful, this is a very common experience and you will come through it, probably stronger and more able to cope than before.

Helping someone who is depressed

Listen to them but try not to judge them. Don’t offer advice unless they ask for it. If you can see the problem behind the depression, you can help the person to find a solution.

Spend time with them, listen to their problems and encourage them to keep going with activities in their routine.

If they're getting worse, encourage them to visit their doctor and get help.

This article was created in December 2008.