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All you Need to Know About Depression

When things go wrong in our lives we are upset and can feel low. Money worries, difficulties at work, health issues, and relationship problems are all distressing scenarios. In these situations it is hard to feel positive. It is, in fact, normal to feel down about such adverse events. An emotional reaction to an upsetting situation is entirely appropriate, but when the adverse events are longstanding, or do not resolve, they drain our mental reserves and can become pathological. We can become depressed.

What about when things are going fine and we still feel down? When our vibrations are low and we feel lethargic and tired all the time. When we cannot see the good in anything and cannot be bothered, when even the things we normally enjoy seem too much effort.

This is a very difficult situation, because on top of feeling down, we say to ourselves “I have nothing to be sad about, I can’t understand why I feel low” and then we feel guilty that we do not feel happy.

Guilt is an extremely destructive emotion. It affirms any negative core beliefs we may be holding of not being good enough; it generates negative thoughts and feelings of hopelessness and can drive negative behaviours such as isolating ourselves and poor communication.

As we know negative thoughts, feelings, and behaviours will all interact leading to a negative spiral that can be overwhelming, leading to depression.

The pandemic has had a detrimental effect on the mental health of the nation. This is reflected in the latest Office for National Statistics (ONS) data[1] which tells us that 21% of adults have experienced symptoms of depression in January to March 2021. This is more than double the rates seen pre-pandemic. Younger adults and those living with a child showed the largest increase compared to before the pandemic from 11% to 29%. However, rates in adults over 70 also rose from 5% to 10%.

Depression is, in fact, the second biggest cause of disability in all ages[2]. This condition can develop insidiously and has lasting effects on the individual, families and communities.

How do you know if you are suffering from depression?

There are 2 core questions to ask yourself:

  1. During the last month have you often been bothered by feeling down, depressed, or hopeless?

  2. Do you have little interest or pleasure in doing things?

If the answer to either of these question is yes for most days for at least 2 weeks, then go through the checklist of associated symptoms (taken from current NICE guidance) below. How many of them do you have?

  • Disturbed sleep (decreased or increased compared to usual)

  • Increased or decreased appetite and/or weight

  • Fatigue/loss of energy

  • Agitation or slowing of movements

  • Poor concentration or indecisiveness

  • Feelings of worthlessness or excessive or inappropriate guilt

  • Suicidal thoughts or acts

Depression also has physical and social symptoms and signs:

The physical symptoms of depression include:

  • Changes in your bowel either diarrhoea or constipation

  • Unexplained aches and pains

  • Low sex drive

  • Changes to your period

The social symptoms of depression include:

  • Avoiding contact with friends and taking part in fewer social activities

  • Neglecting your hobbies and interests

  • Having difficulties in your home, work or family life

  • Poor personal hygiene

How bad the depression is depends on how many of the associated symptoms are present, how severe they are and how they are affecting the person’s daily activities:

Yes to question 1 or 2, but less than 5 associated symptoms from the checklist is below the threshold for a diagnosis of depression, but highlights the need for some psychological work on managing your thoughts, feelings, and behaviours. The NHS Inform self help guide for Depression is a very good resource to help you do this, as is our book ‘How to Rise – A Complete Resilience Manual.’

Yes to question 1 or 2 and more than 5 associated symptoms with minor effects on daily activities is classed as Mild Depression.

Yes to question 1 or 2 and more than 5 associated symptoms with mild, moderate or severe effects on daily life indicates Moderate Depression.

Yes to question 1 or 2 and more than 5 associated symptoms with significant effects on activities of daily living is evidence of Severe Depression.

If you have any of the symptoms discussed above Talk to your GP. They will help you assess what is happening and make a plan to help. This may include counselling, CBT and medication.

If you are drinking more than the recommended 14 units of alcohol per week or using illicit drugs then talk to your local drug and alcohol service for help to stop.

Practicing meditation and mindfulness, increasing your physical activity, journaling (writing down your thoughts and feelings so you can objectively evaluate them), making your reactions and responses conscious, and breathing exercises all help to improve your mental wellbeing and reduce the risk of depression. Our book ‘How to Rise – A Complete Resilience Manual’ has over 60 tools and techniques for you.

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