4 Feb 2015

Depression

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What is depression?

Depression is a mental health condition that affects over 350 million people worldwide, and there are many people that will suffer in silence. To understand more about depression we need to know how to recognise it and what the main characteristics are.

Depression can be typically characterised by low mood, difficulty concentrating or remembering things, feeling of gulit/self-blame, no pleasure or interest in things that were once enjoyed, feeling helpless, feeling agitated or restless, negative thinking and bleak thoughts about the future, changes in sleep patterns (either difficulty sleeping or sleeping more than usual), change in appetite (eating less than usual, eating more than usual), thoughts about suicide.

An important point to remember is that we all feel down sometimes, and might have the odd “off day”, but when the low mood and characteristics described above become consistent or reoccurring and interfere with daily living then it is a cause for concern and help should be sought.

What causes depression?

This is a common question we are often asked, but it can be difficult to pinpoint a single cause. There can be many causes of depression and below we have highlighted some of these:

  • Past and present life events – This may include a traumatic events and major life events such as the loss of a loved one, going through a divorce, moving house, changing jobs or reaching retirement. Such events require adjustment.
  • Other health problems – Having other health problems in particular long term conditions such as diabetes and chronic pain are linked with low mood and depression.
  • Poor diet and exercise – A poor diet and general lack of fitness can contribute to depression. Foods that are broken into glucose more slowly are better at providing a steady stream of energy throughout the day. Exercise can increase serotonin levels as well as provide a number of other health benefits.
  • Alcohol – People may turn to unhealthy behaviors to help cope with depression such as drinking alcohol, however alcohol is a depressant, and will tend to make you feel worse overall.
  • Genetics – There is some evidence that suggests there maybe a genetic link for severe and recurrent depression. However more research is needed in this area.
  • A chemical imbalance in the brain – Serotonin is the chemical that effects emotions and behavior and low levels of serotonin is linked to the cause of mild to severe depression. There are specific medications that can help increase the amount of serotonin in the brain.
What are the different types of depression and what are the symptoms?

When you visit your GP with depression they will look for key signs and symptoms. They may ask you specific questions and/or ask you to complete a questionnaire. They will be looking for symptoms that have been present continuously for at least a two week period. These symptoms can include:

  • Decreased interest or pleasure
  • Depressed mood
  • Sleep problems – more or less
  • Changes in weight – gain or loss
  • Feelings of worthlessness
  • Fatigue or loss of energy
  • Poor concentration
  • Recurrent thoughts of death, suicide or attempts
  • Agitation or retardation

Based on this information you will be classified as mildly, moderately or severely depressed and treated in accordance. There are generally two types of depression, the first where people will have consistent low mood, the second where people fluctuate between low mood and manic phases (heightened mood) – known as bipolar depression.

Depression in the South Asian community

Communication about depression can be a barrier within the South Asian culture because there are no specific words for depression therefore it can be difficult for those that speak little or no English to communicate this with their healthcare professional, family and friends. Sometimes people may refer to depression as ‘sinking of the heart’ or describe alternative physical symptoms, such as unexplained pain. Therefore depression may not always be identified by the healthcare professional. At times when depression has been diagnosed, the available treatments and interventions are not always relevant to this community as they may not meet cultural and religious needs.

There is still some degree of stigma associated with being depressed in the South Asian community, although this is starting to become more recognised. Prevalence of type 2 diabetes is high in this population, which has been associated with high levels of depression too. Other health conditions have also been studied, for example, south Asians in the UK are reported to be five times more likely to be severely depressed if they have a cancer diagnosis compared to white British people.

What can you do if you are suffering from depression or you know someone who might be?

It is important to remember that recognition of the signs and symptoms is the first step in the right direction. It’s always good to talk to someone you trust, that could be a family member, a friend or your GP.

Treatment

Your health care practitioner will be able to direct you to the most appropriate treatment dependent on your diagnosis of depression. For mild depression, patients can be treated without medication whereas for moderate to server depression they may be prescribed medication in combination with talking therapies.

Psychological approaches including ‘talking therapies’ are being made more accessible through the Improving Access to Psychological Therapies (IAPT) programme.

Psychologists are able to offer cognitive behaviour therapy (CBT) an approach that looks at helping individuals identify thoughts and feeling affecting their behaviour and then looking to change these.

More recently mindfulness based therapy has become popular for general health and wellbeing as well as for those suffering from depression. Mindfulness focuses on the here and now and helps individuals become more aware of their thoughts and feelings, rather than being bombarded and overwhelmed with thoughts that are not particularly significant at that moment in time.

Exercise is also recommended as a treatment for depression. So try and keep active because it helps to lift mood levels and give you the feel good factor.

What services are available?

The following are just some of the places you can get help with depression: