We all feel fed up, miserable or sad at times. These feelings don't usually last longer than a week or two, and they don't interfere too much with our lives. Sometimes there's a reason, sometimes not. We usually cope - we may talk to a friend but don't otherwise need any help (62). However, in depression your feelings don't lift after a few days – they carry on for weeks or months; are so bad that they interfere with your life.
What does it feel like?
Most people with depression will not have all the symptoms listed below, but most will have at least five or six.
You feel unhappy most of the time (but may feel a little better in the evenings); lose interest in life and can't enjoy anything; find it harder to make decisions; can't cope with things that you used to; feel utterly tired; feel restless and agitated; lose appetite and weight (some people find they do the reverse and put on weight); take 1-2 hours to get off to sleep, and then wake up earlier than usual; lose interest in sex; lose your self-confidence; feel useless, inadequate and hopeless, avoid other people, feel irritable; feel worse at a particular time each day, usually in the morning; think of suicide (62).
You may not realise how depressed you are for a while, especially if it has come on gradually. You try to struggle on and may even start to blame yourself for being lazy or lacking willpower. It sometimes takes a friend or a partner to persuade you that there really is a problem which can be helped.
You may start to notice pains, constant headaches or sleeplessness. Physical symptoms like this can be the first sign of depression (62).
Why does it happen?
As with our everyday feelings of low mood, there will sometimes be an obvious reason for becoming depressed, sometimes not. It can be a disappointment, a frustration, or that you have lost something - or someone – important to you. There is often more than one reason, and these will be different for different people (62).
The neurotrophic hypothesis of Depression is related to depression associated with stress.
Depression may result from damage of hippocampal neurons, possibly stress-induced and amplified by the hypercorticosterolaemia of depressed individuals. People suffering from depression exhibit some symptoms that indicate a deregulation of the main neuro-endocrinological system implicated in the stress response.
Depression can be a particularly devastating illness that affects your body, mood, behaviour and thoughts. If treatment does not occur, symptoms can be present for years. Particularly concerning is the potential for suicidal thoughts.
A range of psychological interventions are recommended by the National Institute for Health and Clinical Excellence (NICE) for the treatment of depression including: Cognitive Behavioural therapy, Counselling, Interpersonal therapy, behavioural activation, Behavioural couples therapy, and Psychodynamic psychotherapy.
Simply talking about your feelings can be helpful, however depressed you are. Sometimes it is hard to express your real feelings even to close friends. Talking things through with a trained counsellor or therapist can be easier. It can be a relief to get things off your chest, and it can help you to be clearer about how you feel about your life and other people (62).
Many of us have habits of thinking which, quite apart from what is happening in life, are likely to make us depressed and keep us depressed. CBT helps you to identify any unrealistic and unhelpful ways of thinking; then develop new, more helpful ways of thinking and behaving (62).
This helps you to be clear about your key problems, how to break them down into manageable bits and how to develop problem-solving skills (62).
If you are not able to get over the death of someone close to you, you need to talk about it with a specialist bereavement counsellor (62).
This may be more suitable if you have had long-standing difficulties with your life or relationships. This tends to be a longer-term treatment, and helps you to see how your past experiences may be affecting your life here and now (62).
If you require help and advice Counselling and Psychotherapy may be provided via Skype and FaceTime in the comfort of your home, office or any place of your choice.