Depression Support: What you need to know about it, the symptoms and how to start overcoming it.
This is an ultimate guide designed to give you all the factual information you need about depression, how Cognitive Behavioural Therapy can support you to recover from it and even prevent it.
I will start by saying that Depression is an incredibly common mental health disorder. Globally, it is estimated that 5% of adults suffer from depression, that's about 280 million people. In the UK alone, 1 in 6 adults will experience depression at one time.
It is considered as a priority issue by 'World Health Organisation' but sadly numbers are still on the rise and many people cannot or do not access the mental health support needed.
As a Cognitive Behavioural Therapist I work with depression regularly and have supported many adults in overcoming their illness. I understand the psychology but also the impact of depression, and how difficult it can be 'get started' on the road to recovery.
This guide will provide you with the simple facts about depression and give you some effective first steps to overcoming it.
What is Depression?
Depression is a serious medical illness that negatively affects the way your feel, the way you think and how you behave. The severity of depression can vary but is characterised by experiencing persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities.
In its mildest form, depression can mean being in a low mood consistently. It doesn't stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be debilitating and life-threatening because it can make you feel suicidal.
What are the symptoms of Depression?
Symptoms can vary but typically during a depressive episode, the person experiences depressed mood and a loss of pleasure or interest in activities, for the majority of the day, for at least two weeks.
Whilst depression is a mental illness, that doesn't mean the symptoms are all in the mind. It can be felt very physically and very commonly shown through behaviour. Some of the common symptoms are split out below to help you identify what is a feeling, what is a behaviour and what is a thought - this is a key starting point for understanding your own depression or the depression of someone close to you.
Thoughts you might have
I'm worthless/useless/not good enough
My family would be better off without me
I shouldn't feel like this and the fact I do means I'm weak/not as good/defective
Thoughts of death or suicide
I'll never get better so what's the point in trying
How you may feel, emotionally and physically
sad, upset or down
irritable and agitated
guilty, worthless and self loathing
hopeless and defeated
empty and numb
no pleasure from activities you used to enjoy
isolated and disconnected from others
anxious and worried
no self confidence or self esteem
lack of motivation
aches and pains for no apparent reason
tired all of the time or physically fatigued
headaches or migraines
digestive issues including nausea, indigestion, diarrhea, or constipation
changes to your menstrual cycle
change in appetite - weight loss or gain which is unrelated to dieting
How you might behave
withdraw from friends and family
struggle to focus or remember things
struggle to make decisions
loss of libido
sleep too much or too little
excessively struggle to get up in the morning
not speak as clearly or articulately
stop basic personal hygiene habits such as showering or brushing your teeth
slow movement or speech
increase the amount you drink (alcohol), smoke or take drugs
avoid eye contact
Are there different types of Depression?
There are five main types of depression and not all depression is the same. It's important to get the right diagnosis and depression support to ensure you tackle the problem most effectively, as each type varies in the treatment process.
Depression can be classed as mild, moderate or severe. If you get a diagnosis you will be assessed and told this. This describes what sort of impact your symptoms are having on you currently, and what sort of treatment would be best. It's normal to move between mild, moderate and severe depression during one episode, particularly depending on whether you seek mental health support or not.
There are also some specific types of depression:
Postnatal depression (PND) – depression that occurs in the first year after giving birth
Prenatal depression – depression that occurs during pregnancy. This is sometimes also called antenatal depression
Seasonal affective disorder (SAD) – depression that occurs at a particular time of year, or during a particular season
Dysthymia – continuous mild depression that lasts for two years or more. Also called persistent depressive disorder or chronic depression.
It's very normal to experience depression as a result of another mental illness too. It's important when being assessed to be clear on what is the core problem and what is the secondary problem in order to treat the root cause first. Some of the co-mental health illness (not all) are included below.
borderline personality disorder (BPD)
What causes Depression?
There are many different reasons for being depressed but no single cause. It can occur for a variety of reasons and it has a lot of different triggers. A professional can help you establish what has led you to experience depression so you know your triggers for the future and can take helpful action.
Some causes may seem very obvious, some less so, but generally the causes include one or some of the below.
life events ( divorce, redundancy, bereavement, illness, financial problems)
other mental health problems
physical health problems
medication, recreational drugs and alcohol
sleep, diet and exercise
I would like to point out that just because someone in your family experiences depression it does not mean that you will. It is a risk factor but there is no evidence that it's 100% hereditary and other factors can balance it out.
Can Depression be treated?
YES, depression is a very treatable illness, through CBT, antidepressants and Mindfulness Based Cognitive Therapy. The National Institute for Clinical Excellence recommend CBT as one of the most effective treatments for depression (and anxiety). Research suggests that people who have CBT may be half as likely as those on medication alone to have depression again within a year.
So what is CBT? Cognitive behavioural therapy (CBT) is a form of talking therapy, also known as psychotherapy, used to treat many different mental health illnesses. CBT helps people with conditions such as depression learn how to change their typical negative thinking patterns and identify unhelpful behaviours maintaining depression.
Research published in 2016, found that 43% of those who had received CBT had reported at least a 50% reduction in symptoms of depression, compared with 27% who continued with their usual care alone.
As many of the techniques for managing your thoughts and behaviours can be used long-term once you have completed a number of CBT sessions, the effectiveness of the treatment in preventing your depression from returning can help you reduce the impact of depression on your life well into the future.
Depending on the type and severity of your depression, CBT can also be used alongside antidepressant medication, which can help make therapy sessions more effective as symptoms of depression are reduced. It is recommended that you don't start CBT in the first two week period of starting antidepressants, whilst your brain and body adjust.
Medications and treatment is something you should speak to your GP about, or a private psychiatrist who will be able to advise you and support you through the initial steps.
If you are taking medication for depression, it is really important not to stop suddenly. Withdrawal symptoms from antidepressants can be very difficult to cope with, and can result in relapse. Speak to your GP of professional overseeing your recovery to create a reduction plan.
Does self care make a difference with depression?
Absolutely. Whilst is is not as effective as clinical treatment such as CBT or medication it does have an impact and is something anyone can do to help themselves.
When you have depression or anxiety, exercise often seems like the last thing you want to do as you are lacking in motivation and energy, however, regular exercise helps to improve mood and create motivation. We know that endorphins are released when we exercise and can create more of the happy hormone, dopamine, that people with depression lack.
Exercise can also distract you in a healthy way as whilst you are focusing on movement you are stepping away from the cycle of negative thoughts that feed depression.
Start with a short walk, low effort and low energy but it get's you moving and also outside which crosses over into another form of self help - getting out into nature. See my previous post for more on how nature is free therapy.
Talk to someone you trust
It can feel scary to start the conversation but many people find that by being open about how they are feeling can help in itself. You can come away from the conversation realising that you do have support and you are not alone.
If you don't have anyone you can speak to the Samaritans run a 24-hour helpline where you can speak to someone confidentially.
Mindfulness based cognitive therapy is also proven to be an affective treatment for depression. It combines elements of mindfulness meditation with CBT to teach people healthier ways of managing racing thoughts, negativity, and how to calm both your mind and body during periods of difficulty. Whilst attending an 8 week course is required for it to be an affective treatment alternative, people with depression can easily access free, short meditations via youtube to start practicing the skill. Alternatively you can go to my free meditations page.
Getting enough sleep on a regular basis, spending time in a calm environment, consuming a healthy diet and avoiding alcohol (a depressant) and consuming low amounts of caffeine can also help reduce symptoms of depression. These may sound like small things but small change can add up to one big change.
Maintain your hygiene
When you're experiencing depression, it's easy to give in to not caring and for hygiene to not feel like a priority with all the negative chat going on in your head. But small things, like taking a shower, brushing your teeth and getting dressed can make a big difference to how you feel about yourself.
Do what used to make you happy
When depressed, people often stop enjoying activities as much as they used to so therefore often stop doing them. However if you don't do anything that brings you any joy then you aren't going to experience any lifts in mood.
Consider what used to make you happy, what you liked doing, places you felt good, music you liked listening to and which people bought you joy. Start trying to schedule one of these things a day and observe whether your mood does lift at all.
Depression in a nutshell
Remember that depression is a very real and common illness, you are not alone and help is available. With proper assessment and treatment, the vast majority of people with depression will overcome it and develop skills for the future to handle difficulties in a healthier way. CBT is a process and it takes commitment to reap the rewards of recovery but a professional can guide you in how to start small and build upon progress. Every journey out of depression is different but it is always worth the result.
To find out more about CBT or depression follow my instagram @happyhealthy_cbt or contact me.