Three in five people in the UK have depression at some point in their lives, and for one in five women and one in 10 men it is severe enough to have a major impact on life. But there is help - you just have to ask.
What are the common signs of depression?
If I'm assessing depression, I ask two simple questions; in the last month, have you often been bothered by:
1) Feeling down depressed or hopeless
2) Having little interest or pleasure in things you usually enjoy?
If the answer to either questions is 'yes' on more days than not, you may be depressed. Other symptoms to look out for include change in appetite (either being off your food or being more hungry); problems with concentration; sleeping difficulty (problems getting to sleep, waking in the night, waking early or sleeping too much); feeling you're a failure, or have let others down; feeling unduly tired; or thoughts that you would be better off dead.
Of course, depression comes in a whole spectrum of severity, ranging from the sort that make life a bit less enjoyable to the overwhelming. Most doctors use a well-proven questionnaire called the PHQ9 to get an idea of how severe your depression is. But remember, this is only a starting point - your GP will want to ask lots more questions to get a more personal idea of the impact your symptoms are having on your life.
Break free of the stigma
Very sadly, lots of my patients put off coming to see me about depression because they're ashamed it's 'their fault', or they ought to be able to 'snap out of it. Neither belief has any truth at all.
Depression is every bit as much of a 'real' medical problem as asthma or a broken leg. If you had a stomach ulcer, you wouldn't dream of putting up with the pain without treatment, especially when there was a risk you might end up in hospital with a perforated ulcer. The same applies to depression - your doctor certainly won't tell you to 'pull yourself together'. But you can't get help unless you ask. It's natural to feel sad sometimes - depression is more than this. It stops you enjoying even positive parts of life. Anxiety becomes a medical problem if you can't control it, or if you know logically there's nothing to worry about but just can't stop it.
What do you do if you are depressed?
If you have mild or moderate depression, it's very unlikely you'll be offered tablets. However, in more severe depression they can be very effective. Antidepressants can cause side effects, like all medicines. Common side effects include feeling sick, diarrhoea or constipation, dry mouth and feeling anxious. But these side effects often settle within a few weeks. They take a few weeks to work, so do stick with them. You need to take them for at least six months after you start to feel better, to reduce the chance of the depression returning when you stop them.
Antidepressants aren't 'addictive' in the way Valium® or alcohol are. They don't get 'used' to them, needing more and more as time goes on. You never 'crave' them if you miss a dose. Having said that, many people do get withdrawal effects, especially if they stop taking their medication suddenly. For some people, these effects (particularly anxiety, dizziness and vivid dreams) can be very distressing. Once you're taking antidepressant tablets, always work with your doctor to taper your dose rather than coming off them at once.
In recent years, the government has put much more emphasis on providing talking therapy services for patients with depression. Admittedly, it's still not ideal, with a bit of a 'postcode lottery' where counselling is concerned. But it's much easier than it was to access help. For instance, all counselling on the NHS is now available through a single service called IAPT (Improving Access to Psychological Therapies). You can find services near you and refer yourself via this website, or your GP may have a local number.
You'll usually be offered a telephone assessment first, and your counsellor will decide with you what talking therapy would work best for you. Cognitive Behavioural Therapy (CBT) is probably best known, but not the only kind. CBT works on the principle that if you're depressed or anxious, your mind will automatically think of the worst case scenario in any situation (eg if a friend cancels coffee for a hospital appointment, you wonder if they've made up the appointment to get out of seeing you). This in turn affects the way we act. CBT aims to help you challenge these unhelpful thoughts so you can change your thoughts and your behaviour. It can help for depression, anxiety and more. It's often more effective than medicines, and helps even if you need medicine too.
If you're depressed, you may feel tired and lacking motivation, so exercise might seem impossible. But exercise boosts natural 'feel-good' hormones - so do take that first step.
With thanks to 'My Weekly' magazine where this article was originally published.
Looking for even more information about depression? Visit our new depression health hub.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.