New ways to beat the blues
Depression is common – it affects about one in seven of us during a lifetime – and it’s a very real medical condition. Your doctor knows only too well how tough it can be, and that tablets aren’t the only solution.
Is there a secret to beating depression?
The first secret to beating depression is to recognise it; the next is to get the help you need. These can both be easier said than done. We all feel stressed from time to time, and symptoms of ‘21st century life’ are very similar to those of depression. But while we all need some stress (or we’d never bother to get anything done), depression stops you working, enjoying life or even functioning as you should.
As a doctor, I use two simple questions to ‘screen’ for depression: ‘In the last 2 weeks, have you been bothered by:
- Lack of interest or pleasure in doing things
- Feeling down, depressed or hopeless?’
If the answer to either or both questions is: ‘Yes, on at least half of days’, I would go on to ask about other symptoms. These include poor sleep; lack of appetite or eating too much; feeling guilty about things that aren’t really your fault; poor concentration; feeling tired; and thoughts you might be better off dead.
These give an idea of how severe the problem might be. In a loved one, being short-tempered, not wanting to socialise or bursting into tears might be clues.
If you think your loved one might be depressed, encourage them to speak to their doctor. Offer to go with them, either into the appointment or to sit outside. Remind them that while they may feel guilty about their mood, that’s part of the illness and their doctor will understand this is a real illness.
Talking as therapy
Since 2010, the government has put major resources into making counselling services more widely available on the NHS. It’s introduced a system called ‘IAPT’ – Improving Access to Psychological Therapies. In many parts of England you can refer yourself, by visiting iapt.nhs.uk/services. You’ll usually be offered an initial assessment by phone, and will agree with the counsellor on the best form of counselling for you – this could be individual sessions with a psychotherapist, graduate mental health worker or psychological-wellbeing-practitioner, or group sessions.
Perhaps the best known form of counselling is cognitive behavioural therapy (CBT). It’s based on the idea that our emotions, our thoughts (particularly our thought patterns), and our behaviour are closely linked and all have an effect on how we react to different situations. For instance, if you were feeling depressed and someone cancelled coffee with you, you might think it was because they didn’t like you. The next ‘negative automatic thought’ might be that nobody liked you, then that you weren’t worthy of being liked – you get the picture. The behaviour that might result could include you cutting yourself off from other friends, which in turn would fuel low self-esteem and more depression. CBT aims to challenge these ‘automatic thoughts’ and help you replace them with more realistic ones. If you can challenge the idea that you’re not likeable, and replace it with the much more likely scenario that your friend really does have a family emergency they can’t get out of, your subsequent behaviour would probably be different. By talking regularly with your counsellor about challenging negative automatic thought cycles and doing similar exercises at home, you can ‘re-programme’ your brain so you subconsciously start to think more positively.
Computerised CBT is becoming ever more popular. It uses the same principles as ‘traditional’ CBT, but uses online exercises to help you work through your thoughts and feelings
Neuro-Linguistic Programming, or NLP, is a form of counselling sometimes described as the ‘study of success’. It’s based on the idea that everything you see is subjective (specific to us) and affected by what you see, hear, smell, taste and touch, and the language you think in. It aims to help you learn or ‘model’ all these senses to manage your mood, behaviour and thoughts more effectively.
If you have a loved one with depression, it’s easy to feel helpless. But just by being there, listening and caring, you can make all the difference in the world.
Antidepressants aren’t addictive and really help some people. When doctors talk about medications being addictive, they’re referring to ever-increasing amounts being needed to get the same effect and craving the medicine if you don’t get it. Neither of these applies to antidepressants, although they can cause side effects (particularly in the short term) in some people. They can also cause unpleasant discontinuation effects if you stop them too quickly - if you get side effects, speak to your doctor rather than stopping. For mild depression, building up your body’s resilience by eating healthily and getting a regular sleep pattern may be enough to resolve the problem. Exercise can boost your body’s natural anti-depressant hormones – start gradually and build up.
With thanks to ‘My Weekly’ magazine where this article was originally published.