Depression is a mood disorder. Often a PHQ 9 questionnaire is used to help diagnose depression. People can experience depression over a few weeks or months, over a few years or all their life. They may have one episode or repeating episodes throughout their life. Depression is more than a feeling of ‘fed up’ or ‘miserable’ for a few days as this is a very normal experience for most people to have short periods of low mood. To be diagnosed as clinical depression these feelings of persistent and lasting sadness, hopelessness and unhappiness have to last for weeks or more and are bad enough to significantly disrupt normal functions of your work, social life and family life (doctors sometimes categorise it with mild, moderate and severe labels).
One big question often asked regarding the causes is Genetic/Physical or Life Experience? It is a difficult question to answer. Brain chemistry of depression involving the role of neurotransmitters and chemicals like serotonin and norepinephrine, hormones such as thyroxine can be involved. Some research has shown people with depression have slight physical difference in their brain structure as well. Often people who have family members with depression are more prone to depression, but psychologists and scientists are not sure if this is nature (genetics) or nurture (watching and mimicking someone as you grow up).
Some people like to separate depression into types, you may have heard of SAD or Seasonal affective disorder a type of depression that occurs at a particular time of year – usually autumn/winter. Dysthymia a continuous mild depression lasting for two years or more (sometimes called persistent depressive disorder). Prenatal depression (during pregnancy) and Postnatal depression (first year or so after giving birth). Some people class grief as a type of depression, I personally see them as different yet having some similarities based on my experiences having worked as a bereavement specialist, and with people who are depressed.
Depression can be a part of other mental health problems, such as bipolar disorder, borderline personality disorder, other personality disorders and schizoaffective disorder to name a few.
Symptoms of depression include feeling unhappy or hopeless, low self-esteem and finding no pleasure in things you usually enjoy. Depression can have psychological, physical and social symptoms continuous low mood or sadness. These include feeling (not an exhaustive list):
• hopeless, pessimistic or helpless
• low self-esteem
• guilt-ridden or worthless
• irritable and intolerant of others cranky and restless
• having no motivation or interest in things
• finding it difficult to make decisions
• not getting any enjoyment or pleasure out of things you normally would
• anxious or worried
• suicidal thoughts or self-harming
• struggling to focus or remember
• moving or speaking more slowly or more quickly than usual
• changes in appetite (eating more or less) or weight (gain or loss)
• unexplained aches and pains
• lack of energy
• low sex drive
• changes to your menstrual cycle
• disturbed sleep – difficulty falling asleep at night or waking up very early, trouble staying asleep
• tired or lacking energy
• avoiding contact with friends and taking part in fewer social activities
• neglecting your hobbies and interests
• having difficulties in your home, work or family life
• digestive problems
• “empty” feelings
• a sense of unreality
• using more tobacco, alcohol or other drugs than usual
• delusions, such as paranoia
• hallucinations, such as hearing voices.
There is no single or unique agreed cause of depression. It is believed depression can occur for a variety of reasons and it has many potential and different triggers. It can be one event or a collection of events, it may even be linked to an illness. Some of these ‘causes’ can include:
• Personality /Family history – certain personality traits may make people more vulnerable to feeling depression, possibly due to genetics, or your early life experiences, or both.
• Giving birth – hormonal and physical changes, as well as new responsibility could possibly trigger pre/postnatal depression.
• Loneliness – sometimes caused by feeling low and stressful events/occurrences leading us to isolate from friends and family perpetrating the depression.
• Alcohol and drugs – drugs such as cannabis can trigger depression, particularly in teenagers, while alcohol affects the chemistry of the brain, which increases the risk of depression (please see previous blog posts about drugs and alcohol).
• Illness – evidence shows there is a potential higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease, cancer, underactive thyroid (hypothyroidism), or damaged pituitary gland, or if you suffer a head injury they can sometimes trigger mood swings and emotional problems. A chemical imbalance or hormone issue, conditions affecting the brain and nervous system, menstrual cycle or the menopause, low blood sugar.
• Childhood experiences – physical, sexual or emotional abuse, neglect, bereavement, traumatic events, an unstable family situation, bullying
• Low self-esteem – how you learned to cope with difficult emotions and situations can make you feel less able to cope with life’s ups and downs and lead to failing coping mechanisms.
• Life events – such as losing your job or unemployment; the end of a relationship; bereavement; major life changes, like changing job, moving house or getting married; being physically or sexually assaulted; being bullied or abused; trauma; illness. It takes time for people to come to terms with events, such as these. If these happen consecutively some people may feel they spiral into depression.
• Sleep problems, a poor diet, lack of exercise can also lead to depression and altered body chemistry.
• Other mental health problems and illness such as anxiety; eating problems; PTSD; bi-polar; personality disorders.
Treatment for depression usually involves a combination of lifestyle changes, talking therapies and medicines such as SSRI commonly known as anti-depressants (please see earlier blog post about medications for more information). A good place to start would be your doctor or speaking to a therapist.
If you are struggling with depression or would like support with mental health issues or you’d like video, telephone or face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at firstname.lastname@example.org or on 07598810304