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Depression


What is Depression?

While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood – it's a serious condition that affects your physical and mental health...


Signs & Symptoms of Depression

You may be depressed if, for more than two weeks, you've felt sad, down or miserable most of the time, or have lost interest or pleasure in usual activities, and have also experienced several of the signs and symptoms across at least three of the categories below.


It’s important to remember that we all experience some of these symptoms from time to time, and it may not necessarily mean you're depressed. Equally, not everyone who is experiencing depression will have all of these symptoms.


Behaviour

Not going out anymore

Not getting things done at work/school

Withdrawing from close family and friends

Relying on alcohol and sedatives

Not doing usual enjoyable activities

Unable to concentrate


Feelings

Overwhelmed

Guilty

Irritable

Frustrated

Lacking in confidence

Unhappy

Indecisive

Disappointed

Miserable

Sad


Thoughts

I’m a failure

It’s my fault

Nothing good ever happens to me

I’m worthless

Life’s not worth living

People would be better off without me


Physical

Tired all the time

Sick and run down

Headaches and muscle pains

Churning gut

Sleep problems

Loss or change of appetite

Significant weight loss or gain


What causes Depression?

While we don’t know exactly what causes depression, a number of things are often linked to its development. Depression usually results from a combination of recent events and other longer-term or personal factors, rather than one immediate issue or event.


Life Events

Research suggests that continuing difficulties – long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, prolonged work stress – are more likely to cause depression than recent life stresses. However, recent events (such as losing your job) or a combination of events can ‘trigger' depression if you’re already at risk because of previous bad experiences or personal factors.


Personal Factors

Family History-Depression can run in families and some people will be at an increased genetic risk. However, having a parent or close relative with depression doesn’t mean you’ll automatically have the same experience. Life circumstances and other personal factors are still likely to have an important influence.


Personality– Some people may be more at risk of depression because of their personality, particularly if they have a tendency to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.


Serious medical illness–The stress and worry of coping with a serious illness can lead to depression, especially if you’re dealing with long-term management and/or chronic pain.


Drug and alchohol use–Drug and alcohol use can both lead to and result from depression. Many people with depression also have drug and alcohol problems. Over 900,000 Indians will experience depression and a substance use disorder at the same time, at some point in their lives.


Changes in the brain

Although there’s been a lot of research in this complex area, there’s still much we don’t know. Depression is not simply the result of a ‘chemical imbalance’, for example because you have too much or not enough of a particular brain chemical. It’s complicated, and there are multiple causes of major depression. Factors such as genetic vulnerability, severe life stressors, substances you may take (some medications, drugs and alcohol) and medical conditions can affect the way your brain regulates your moods.


Most modern antidepressants have an effect on your brain’s chemical transmitters (serotonin and noradrenaline), which relay messages between brain cells – this is thought to be how medications work for more severe depression. Psychological treatment can also help you to regulate your moods.


Effective treatment can stimulate the growth of new nerve cells in circuits that regulate your mood, which is thought to play a critical part in recovering from the most severe episodes of depression.


Types of Depression?

There are different types of depressive disorders. Symptoms can range from relatively minor (but still disabling) through to very severe, so it's helpful to be aware of the range of conditions and their specific symptoms.


Major depression:-

Major Depression is sometimes called major depressive disorder, clinical depression, unipolar depression or simply 'depression'. It involves low mood and/or loss of interest and pleasure in usual activities, as well as other symptoms. The symptoms are experienced most days and last for at least two weeks. Symptoms of depression interfere with all areas of a person's life, including work and social relationships. Depression can be described as mild, moderate or severe; melancholic or psychotic (see below).


Melancholia:-

This is the term used to describe a severe form of depression where many of the physical symptoms of depression are present. One of the major changes is that the person starts to move more slowly. They're also more likely to have a depressed mood that is characterised by complete loss of pleasure in everything, or almost everything.


Psychotic depression:-

Sometimes people with a depressive disorder can lose touch with reality and experience psychosis. This can involve hallucinations (seeing or hearing things that aren't there) or delusions (false beliefs that aren't shared by others), such as believing they are bad or evil, or that they're being watched or followed. They can also be paranoid, feeling as though everyone is against them or that they are the cause of illness or bad events occurring around them.


Antenatal and postnatal depression:-

Women are at an increased risk of depression during pregnancy (known as the antenatal or prenatal period) and in the year following childbirth (known as the postnatal period). You may also come across the term 'perinatal', which describes the period covered by pregnancy and the first year after the baby's birth..


The causes of depression at this time can be complex and are often the result of a combination of factors. In the days immediately following birth, many women experience the 'baby blues' which is a common condition related to hormonal changes and affects up to 80 per cent of women. The 'baby blues', or general stress adjusting to pregnancy and/or a new baby, are common experiences, but are different from depression. Depression is longer lasting and can affect not only the mother, but her relationship with her baby, the child's development, the mother's relationship with her partner and with other members of the family..


Bipolar Disorder:-

Bipolar disorder used to be known as 'manic depression' because the person experiences periods of depression and periods of mania, with periods of normal mood in between..


Mania is like the opposite of depression and can vary in intensity – symptoms include feeling great, having lots of energy, having racing thoughts and little need for sleep, talking quickly, having difficulty focusing on tasks, and feeling frustrated and irritable. This is not just a fleeting experience. Sometimes the person loses touch with reality and has episodes of psychosis. Experiencing psychosis involves hallucinations (seeing or hearing something that is not there) or having delusions (e.g. the person believing he or she has superpowers).


Bipolar disorder seems to be most closely linked to family history. Stress and conflict can trigger episodes for people with this condition and it's not uncommon for bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse, attention deficit hyperactivity disorder (ADHD) or schizophrenia.


Diagnosis depends on the person having had an episode of mania and, unless observed, this can be hard to pick. It is not uncommon for people to go for years before receiving an accurate diagnosis of bipolar disorder. If you're experiencing highs and lows, it's helpful to make this clear to your doctor or treating health professional. Bipolar disorder affects approximately 2 per cent of the population.


Cyclothymic disorder:-

Cyclothymic disorder is often described as a milder form of bipolar disorder. The person experiences chronic fluctuating moods over at least two years, involving periods of hypomania (a mild to moderate level of mania) and periods of depressive symptoms, with very short periods (no more than two months) of normality between. The duration of the symptoms are shorter, less severe and not as regular, and therefore don't fit the criteria of bipolar disorder or major depression.


Dysthymic disorder:-

The symptoms of dysthymia are similar to those of major depression but are less severe. However, in the case of dysthymia, symptoms last longer. A person has to have this milder depression for more than two years to be diagnosed with dysthymia..


Seasonal affective disorder (SAD):-

SAD is a mood disorder that has a seasonal pattern. The cause of the disorder is unclear, but it's thought to be related to the variation in light exposure in different seasons. It's characterised by mood disturbances (either periods of depression or mania) that begin and end in a particular season. Depression which starts in winter and subsides when the season ends is the most common. It's usually diagnosed after the person has had the same symptoms during winter for a couple of years. People with SAD depression are more likely to experience a lack of energy, sleep too much, overeat, gain weight and crave for carbohydrates. SAD is very rare in Australia and more likely to be found in countries with shorter days and longer periods of darkness, such as in the cold climate areas of the Northern Hemisphere..


Treatments for Depression?

There are also plenty of things you can do for yourself to recover and stay well. The important thing is finding the right treatment and the right health professional for your needs.


Psychological treatments for depression:-

Psychological treatments (also known as talking therapies) can help you change your thinking patterns and improve your coping skills so you're better equipped to deal with life's stresses and conflicts. As well as supporting your recovery, psychological therapies can also help you stay well by identifying and changing unhelpful thoughts and behaviour...


There are several types of effective psychological treatments for depression, as well as different delivery options. Some people prefer to work one on one with a professional, while others get more out of a group environment. A growing number of online programs, or e-therapies, are also available..


Interpersonal therapy (IPT):-

IPT is a structured psychological therapy that focuses on problems in personal relationships and the skills needed to deal with these. IPT is based on the idea that relationship problems can have a significant effect on someone experiencing depression, and can even contribute to the cause.


IPT helps you recognise patterns in your relationships that make you more vulnerable to depression. Identifying these patterns means you can focus on improving relationships, coping with grief and finding new ways to get along with others..


Mindfulness-based cognitive therapy (MBCT):-

MBCT is generally delivered in groups and involves a type of meditation called 'mindfulness meditation'. This teaches you to focus on the present moment – just noticing whatever you’re experiencing, whether it's pleasant or unpleasant – without trying to change it. At first, this approach is used to focus on physical sensations (like breathing), but then moves on to feelings and thoughts.


MBCT can help to stop your mind wandering off into thoughts about the future or the past, and avoid unpleasant thoughts and feelings. This is thought to be helpful in preventing depression from returning because it encourages you to notice feelings of sadness and negative thinking patterns early on, before they become fixed. As a result, you’re able to deal with warning signs earlier and more effectively..


Cognitive behaviour therapy (CBT):-

CBT is a structured psychological treatment which recognises that the way we think (cognition) and act (behaviour) affects the way we feel. CBT is one of the most effective treatments for depression, and has been found to be useful for a wide range of ages, including children, adolescents, adults and older people. .


CBT involves working with a professional (therapist) to identify thought and behaviour patterns that are either making you more likely to become depressed, or stopping you from getting better when you’re experiencing depression. I


It works to change your thoughts and behaviour by teaching you to think rationally about common difficulties, helping you to shift negative or unhelpful thought patterns and reactions to a more realistic, positive and problem-solving approach.


CBT is also well-suited to being delivered electronically (often called e-therapies)..


Behaviour therapy:-

While behaviour therapy is a major component of cognitive behaviour therapy (CBT), unlike CBT it doesn’t attempt to change beliefs and attitudes. Instead it focuses on encouraging activities that are rewarding, pleasant or satisfying, aiming to reverse the patterns of avoidance, withdrawal and inactivity that make depression worse.


Recovering from a Mental Health Condition?

Recovery can take time and is different for everyone. As well as getting treatment underway, you'll need to find new ways to manage and live with the changes and challenges of anxiety and/or depression.


While psychological and/or medical treatment can help with your recovery, there are many other ways you can help yourself to get better and stay well..


Stages of recovery:-

Recovery is a unique and individual process that everyone goes through differently. However, there are some common emotions that many people may experience.


1.Shock at having to deal with something difficult and scary that you have no prior experience of.


2.Denial or difficulty in accepting having a health problem, particularly one that many people find hard to understand.


3.Despair and anger at having to deal with the condition and its related difficulties.


4.Acceptance of having a condition and the changes it brings, and accepting how others see you and how you see yourself.


5.Coping by finding new ways to live with and tackle these changes and challenges.


6.Recovery goes beyond focusing on managing distressing symptoms but about having choices and being able to create a meaningful and contributing life.


Available Support:-

There are proven ways that people recover from anxiety or depression, and it’s different for everybody. However, there are a range of effective treatments and health professionals and other support people who can help you on the road to recovery. There are also many things you can do to help yourself to recover and stay well. The important thing is finding the right treatments and the right health professionals and support team that works for you.


Different types of anxiety or depression require different types of treatment. This may include lifestyle changes such as regular physical activity, healthy eating and adequate sleep, family and peer support, and psychological therapy for mild-moderate anxiety and depression, through to more specialised psychological and medical treatments for severe depression and/or anxiety provided by a team of health and mental health professionals.


What’s important is getting the treatment and support that’s right for your condition and situation.


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