Treatment for Depression

Everyone feels low or down from time to time; it’s a normal part of life and does not always mean something is wrong. Feeling low is expected following distressing events or major life changes; however, sometimes periods of low mood can happen for no obvious reason, often passing after a couple of days or weeks. When emotions such as despair and hopelessness won’t go away, you may have depression.

Depression is classified as a mood disorder. More than a response to life’s struggles, depression can change how you feel, think and function in daily life. It can interfere with your ability to work, eat, sleep, study and enjoy life. You may feel tired, lacking in confidence, anxious, frustrated and angry. It can also affect relationships and certain health conditions.

People experience different feelings of depression, ranging from impending doom, emptiness and lifelessness to restlessness and anger. Left untreated, anger can become a serious health problem. In the mildest form, depression can be a low mood, making everyday activities seem harder, but does not stop you leading your normal life. At its most severe, depression can lead to suicidal thoughts, making the disorder life threatening.

Try to remember that feelings of helplessness and hopelessness are symptoms of depression and not the reality of your situation. By identifying the cause of your depression, recognising the symptoms and understanding the types of depression, you can take the first steps to overcoming the problem.

Signs and Symptoms of Depression

The symptoms of depression can be complex and differ widely between people. Depression can cause a variety of symptoms that affect your mood and your body. Symptoms can be constant, or they may come and go.

There are many symptoms of depression and you are unlikely to have all of them at any one time. The psychological symptoms of depression can make you feel:

Low, sad or anxious
Impatient, restless or irritable
Guilty, insignificant and incompetent
Empty and numb
Angry, restless and aggressive
Lonely and isolated
Lack of interest in things you usually enjoy
Lack of self-confidence or self-esteem
Hopeless and miserable
Suicidal or wanting to harm yourself

Physical symptoms of depression include:

Moving or talking more slowly than usual
Difficulty concentrating
Changes in appetite or weight (usually decreased, but sometimes increased)
Constipation
Unexplained aches and pains and headaches
Decreased energy and greater fatigue
Reduced sex drive (loss of libido)
Changes to your menstrual cycle, increased cramps
Difficulty sleeping, trouble sleeping through the night, waking up early or sleeping too much

The social symptoms of depression include:

Avoiding friends, family and social gatherings
Abandoning your hobbies and interests
Having problems at home, work or in family life
Drinking excessively, taking drugs, taking part in high-risk activities

Causes of Depression

Whilst many illnesses have a specific medical cause, making direct treatment easy, depression is far more complicated. Life affects everyone differently and we can all experience negative emotions that can be a healthy reaction to the difficulties we encounter. However, for many people, negativity can develop and become more serious, with as many as 1 in 4 of us experiencing a mental health condition each year.

Despite common belief, depression is not just the result of a chemical imbalance in the brain, which can be simply cured with medication. Biological, social and psychological factors undoubtedly play a role in depression. There is no single reason for depression. It has a variety of triggers. Factors that affect our mental health include:

Upbringing, environment and early childhood trauma

Early life events such as abuse and bullying can affect the way your body reacts to fear and tense situations, making you more susceptible to a number of health conditions in later life, including depression.

Genes and personality

You may be at a greater risk of depression if you have certain personality traits such as low self-esteem or being overly self-critical. This may be due to genes you inherited from your parents, early life experiences or a combination of the both.

Traumatic or stressful life events

For some people, major life changes, such as mourning, divorce, redundancy, and financial problems can cause increased levels of stress. When these tense events occur, it is important to surround yourself with strong and supportive relationships to maintain good mental health. Difficult, unhappy or abusive relationships can have a negative effect and increase your risk of depression.

Chronic illness and certain medications

Unmanaged pain or being diagnosed with a serious illness such as heart disease, diabetes or cancer can all trigger negative emotions and possibly lead to depression. Certain medications such as Corticosteroids, Benzodiazepines, Anticonvulsants, opioid pain killers and specific blood pressure medication can also result in symptoms of depression in some people.

Family history

You are at a greater risk of developing depression if someone in your family such as a parent or sibling has previously struggled with depression, or another mood disorder. However, there is no single ‘depression’ gene and just because a relative suffers from depression, it does not mean you will.

Loneliness

There is a strong connection between loneliness and depression. A lack of social support can increase your risk of developing depression. Having depression can also cause you to withdraw from others, intensifying feelings of isolation. Having a support network of close friends and family can help you maintain perspective on your issues.

Alcohol and substance abuse

Drinking too much alcohol or taking drugs can result in a spiral of depression. Many people use alcohol or drugs as a coping mechanism for stress and difficult emotions. If you are already at a higher risk of depression, substance and alcohol abuse may push you over the edge. Alcohol affects the chemistry of the brain, increasing the risk of depression with approximately 21% of people with a substance abuse problem experiencing depression.

Giving birth

Some women are particularly vulnerable to depression following pregnancy. The physical and hormonal changes, as well as the extra responsibility of a baby can result in postnatal depression.

Many factors influence how we think about and react to challenges and opportunities in life. There are many situations and events in life that can affect us and trigger depression. It can be everyday experiences, a one off event or several things building up over time. Even typically positive experiences can sometimes be difficult to handle. How we feel is a completely natural reaction to life challenges. In some cases, these feelings can become more difficult to manage, particularly if they do not go away.

Common Types of Depression

Major Depressive Disorder (MDD)

When someone uses the term clinical depression, they are typically referring to major depressive disorder. Major depression is characterised by an all-consuming dark mood and a loss of interest in activities, even ones that you usually find enjoyable. Your doctor may diagnose you with major depression if you have 5 or more symptoms for a period of 2 weeks or longer.

Persistent Depressive Disorder

Persistent depressive disorder refers to a type of chronic depression present for most days for a period of at least 2 years. You may experience short-term periods of not feeling depressed; however, this relief of symptoms generally lasts for less than 2 months. Although the symptoms are not as extreme as major depressive disorder, they can be mild, moderate, or severe. If you have persistent depressive disorder you may struggle to be upbeat, you may lose interest in daily activities and have low self-esteem. These feelings can last for years and may significantly affect your relationships, school, work and daily activities.

Bipolar Disorder

Bipolar disorder is also referred to as manic depression. An individual with bipolar disorder will suffer from mood swings that range from extreme highs to extreme lows. In some cases, bipolar disorder can affect a person’s sense of reality and may require hospitalisation. When you are in the low period, you will experience symptoms of major depression. Medication can help control your mood swings.

Postnatal Depression

Pregnancy can cause hormonal shifts that can often affect a woman’s mood. Depression can start during pregnancy or following the birth of a child. Mood swings, anxiety and irritability are not uncommon after labour and typically last up to 2 weeks. Postnatal depression symptoms are more severe and generally longer-lasting. In rare cases, an extreme mood disorder called postpartum psychosis may develop after childbirth.

Premenstrual Dysphoric Disorder (PMDD)

Women with PMDD experience depression and other symptoms at the start of their period. Among the most common symptoms are irritability, exhaustion, anxiety, grumpiness, bloating, increased appetite, food cravings, aches, and breast sensitivity. The main thing that sets apart premenstrual syndrome (PMS) related depression from other forms of depression is the timing of symptoms.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is a form of depression that comes and goes in a seasonal pattern. Symptoms include sleepiness and weight gain that typically occur during the winter months.

Atypical Depression

If you experience signs of depression such as fatigue, increased appetite or extreme sensitivity, but find your mood improving temporarily in the face of a positive event, you may be experiencing atypical depression. It is common for people who have atypical depression to experience depression at an early age and despite its name, is not uncommon or unusual.

Diagnosing Depression

If you are worried that you may be experiencing symptoms of depression, it is essential that you reach out to a medical or mental health professional. Sometimes, when struggling with depression, it is hard to accept that treatment can actually help. However, the sooner you seek treatment, the sooner your depression will improve. Depression is a serious mental health illness with the potential for complications, so it is important not to ignore the symptoms.

There are no physical tests to diagnose depression; however, your doctor may carry out urine or blood tests to rule out other conditions that have similar symptoms such as an underactive thyroid.

The most effective method for diagnosing depression is by answering questions about your general health and talking through the way you are feeling mentally and physically. It is important to be as honest as possible when describing your symptoms and how they are affecting you; this will help your doctor determine whether you have depression and how severe it is. In most cases, they will ask a series of questions about your:

Appetite or lack of
Moods
Sleeping pattern
Activity levels
Thoughts and feelings

Prior to your doctor’s appointment, write down a list of any worries you may have about depression and specific symptoms you are experiencing. It is also helpful to get an in-depth family history from relatives prior to meeting with your doctor.

Many people put off seeking treatment for depression, but it is best not to delay. The sooner you speak to a healthcare professional the sooner you will be on your way to recovery.

Living with depression can be challenging, but there are treatment options that can help improve your quality of life. You may successfully manage your symptoms with one treatment technique, or you may find that a combination of treatments is the best route for you. Treatment options include:

Medication

Your doctor will discuss the different medication options with you as most people finds different medications can help. You may have to try out different types of medication before you find the one that works best for you. In most cases, if you suffer from moderate to severe depression, antidepressants may be beneficial.

Antidepressants work to treat the symptoms of depression and there are many different types of antidepressants available. They all work similarly to each other, however side effects vary between individuals.

When you start taking antidepressants, you should ensure you see your doctor every couple of weeks to evaluate their effectiveness. If they are working, you will need to continue taking them for at least 4 months, at the same dose after your symptoms have improved.

If you have had previous episodes of depression, you may need to continue to take antidepressants for up to 5 years, or in some cases, longer. Your doctor may recommend you take a course of antidepressants alongside talking therapies, particularly if your depression is quite severe.

If you are experiencing depression with psychotic symptoms, your doctor may prescribe antipsychotic medication as part of your treatment plan. It is common to combine medical treatments and other types of therapies, including the following:

Psychotherapy

Psychotherapy involves speaking with a trained therapist, either on a one-to-one basis, in a group or with a relative or partner. It can help you learn skills to cope with negative feelings by looking deeper into your worries and problems and deal with difficult habits.

Light Therapy

Light therapy is a form of treatment where you are exposed to an artificial light source. The exposure to white light can help control your mood and improve symptoms of depression. Light therapy is primarily used to treat major depressive disorder with seasonal patterns (commonly known as seasonal affective disorder or SAD). Light can also be used to treat other conditions such as sleep disorders and other forms of depression.

Cognitive Behavioural Therapy

Cognitive behaviour therapy (CBT) is based on the notion that your thoughts, feeling and actions are all connected. CBT recognises that events throughout your past may have shaped you, but concentrates mainly on present thoughts, feelings and behaviours. CBT aims to help you deal with problems in a more positive way. You are shown how to change negative patterns, overcome negative thoughts and look for practical ways to improve your state of mind and the way you feel on a daily basis.

Alternative Therapies

It is important to talk with your doctor before taking a supplement with prescription medication as in some cases they can reduce the effectiveness of your medication, or even worsen your symptoms. There are several types of supplements that are thought to have some positive effects on depression symptoms including:

St. John’s Wort

Studies are mixed, but this natural treatment is used as an antidepressant medication. St. John’s Wort is a natural, herbal supplement that does not require a prescription and can be purchased over the counter at a health food stores. It is believed that St. John’s Wort works in a similar way to a standard antidepressant, used to treat mild to moderate depression and sometimes mild anxiety, sleep problems and major depressive disorder with seasonal patterns (SAD).

S-adenosyl-L-methionine (SAMe)

S-adenosyl-L-methionine (SAMe) is a compound found naturally in the body that has been found to ease symptoms of depression. The results were best seen in people taking selective serotonin reuptake inhibitors (SSRIs), a form of traditional antidepressant.

5-hydroxytryptophan (5-HTP)

5-HTP is an amino acid that your body naturally produces which may raise serotonin levels, a chemical messenger that sends signals between your nerve cells that may potentially ease symptoms. Low serotonin levels are associated with depression, weight gain, sleep disorders, anxiety and other health problems. Raising your body’s production of serotonin may have numerous benefits.

Self-Care

You can improve symptoms of depression by taking care of yourself, getting enough sleep, eating a healthy, balanced diet, avoiding negative people, and participating in enjoyable activities.

Avoiding alcohol and drugs

Abusing alcohol and/or drugs is a short-term fix for negative emotions. Long-term substance abuse can make depression and anxiety symptoms worse.

Exercise

Exercise increases your body’s production of endorphins (hormones that improve your mood). Aiming to exercise for 30 minutes 3-5 days a week is recommended for a healthy body and a healthy mind.

Different treatments work for different people. If a particular medication or treatment technique does not work for you, you should be offered an alternative. It is important to remember that recovery is a journey and is not always straightforward. You may find that it is more helpful to concentrate on learning more about yourself and developing ways to deal with trigger situations, as opposed to trying to get rid of all symptoms of depression.

Outlook

Depression can be temporary, or it can be a long-term challenge. Treatment does not always make your depression go away completely and without treatment, depression can become worse.

Treatment often makes symptoms of depression more manageable and can prevent it from recurring. Managing symptoms of depression involves finding the right combination of medications and therapies. If one treatment does not work, discuss things with your doctor and they can help you find a different treatment technique that may help you manage your condition better.