Depression

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Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won’t go away, you may have depression. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. Just trying to get through the day can be overwhelming.

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. However you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation.

No matter how hopeless you feel, you can get better. By understanding the cause of your depression and recognising the different symptoms and types of depression, you can take the first steps to feeling better and overcoming the problem.

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

1. Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
2. Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
3. Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
4. Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
5. Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
6. Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
7. Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticise yourself for perceived faults and mistakes.
8. Reckless behaviour. You engage in escapist behaviour such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
9. Concentration problems. Trouble focusing, making decisions, or remembering things.
10. Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.

Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. They’re also more likely to experience symptoms such as anger, aggression, reckless behaviour, and substance abuse.

Women are more likely to experience depression symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain. Depression in women is also impacted by hormonal factors during menstruation, pregnancy, and menopause. In fact, postpartum depression affects up to 1 in 7 women experience depression following childbirth.

Irritability, anger, and agitation are often the most noticeable symptoms in depressed teens—not sadness. They may also complain of headaches, stomachaches, or other physical pains.

Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression: things like fatigue, unexplained aches and pains, and memory problems. They may also neglect their personal appearance and stop taking critical medications for their health.

Depression comes in many shapes and forms. While defining the severity of depression—whether it’s mild, moderate, or major—can be complicated, knowing what type of depression you have may help you manage your symptoms and get the most effective treatment.

Mild and moderate depression are the most common types of depression. More than simply feeling blue, the symptoms of mild depression can interfere with your daily life, robbing you of joy and motivation. Those symptoms become amplified in moderate depression and can lead to a decline in confidence and self-esteem.

Major depression is much less common than mild or moderate depression and is characterised by severe, relentless symptoms.

• Left untreated, major depression typically lasts for about six months.
• Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.

Atypical depression is a common subtype of major depression with a specific symptom pattern. It responds better to some therapies and medications than others, so identifying it can be helpful.

• People with atypical depression experience a temporary mood lift in response to positive events, such as after receiving good news or while out with friends.
• Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.

For some people, the reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). SAD affects about 1% to 2% of the population, particularly women and young people. SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love. SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.

While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid pain killers, and specific blood pressure medicine can trigger depression symptoms in some people—as can hyperthyroidism (an under-active thyroid gland). But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.

Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. 

Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factors—such as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choices—can also play an enormous part.

Depression most often results from a combination of factors, rather than one single cause. For example, if you went through a divorce, were diagnosed with a serious medical condition, or lost your job, the stress could prompt you to start drinking more, which in turn could cause you to withdraw from family and friends. Those factors combined could then trigger depression.

The following are examples of risk factors that can make you more susceptible to developing depression:

Loneliness and isolation. 

There’s a strong relationship between loneliness and depression. Not only can lack of social support heighten your risk for depression, but having depression can cause you to withdraw from others, exacerbating feelings of isolation. Having close friends or family to talk to can help you maintain perspective on your issues and avoid having to deal with problems alone.

Marital or relationship problems. 

While a network of strong and supportive relationships can be crucial to good mental health, troubled, unhappy, or abusive relationships can have the opposite effect and increase your risk for depression. 

Recent stressful life experiences. 

Major life changes, such as a bereavement, divorce, unemployment, or financial problems can often bring overwhelming levels of stress and increase your risk of developing depression.

Chronic illness or pain. 

Unmanaged pain or being diagnosed with a serious illness, such as cancer, heart disease, or diabetes, can trigger feelings of hopelessness and even lead to depression.

Family history of depression. 

Since it can run in families, it’s likely some people have a genetic susceptibility to depression. However, there is no single “depression” gene. And just because a close relative suffers from depression, it doesn’t mean you will, too. Your lifestyle choices, relationships, and coping skills matter just as much as genetics.

Personality. 

Whether your personality traits are inherited from your parents or the result of life experiences, they can impact your risk of depression. For example, you may be at a greater risk if you tend to worry excessively, have a negative outlook on life, are highly self-critical, or suffer from low self-esteem.

Early childhood trauma or abuse. 

Early life stresses such as childhood trauma, abuse, or bullying can make you more susceptible to a number of future health conditions, including depression.

Alcohol or drug abuse. 

Substance abuse can often co-occur with depression. Many people use alcohol or drugs as a means of self-medicating their moods or cope with stress or difficult emotions. If you are already at risk for depression, abusing alcohol or drugs may push you over the edge. There is also evidence that those who abuse opioid painkillers are at greater risk for depression.

When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilise your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.

Reach out to other people. 

Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. They just need to be a good listener—someone who’ll listen attentively without being distracted or judging you.

Get moving. 

When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.

Eat a mood boosting diet. 

Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.

Find ways to engage again with the world. 

Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.

If support from family and friends and positive lifestyle changes aren’t enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:

Effective treatment for depression often includes consulting a therapist who can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent depression from coming back.

It may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision.

When looking for a therapist, seek out mental health professionals who specialise in the treatment of depression. You can ask your doctor or other trauma survivors for a referral, call a local mental health clinic, psychiatric hospital, or counseling center.

Beyond credentials and experience, it’s important to find a therapist who makes you feel comfortable and safe. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel comfortable and understood.