23/04/2012 10:04

A guide to depression

This week is Depression Awareness Week and Dr Rosemary Leonard offers advice on what signs to look out for and what you can do to get help.


A depressed woman (© Getty Images)

Everyone feels sad or down at times - it's part and parcel of leading a normal varied life. But if you constantly feel a bit miserable and you find it difficult to enjoy anything, it could be a sign that you are depressed.

Other symptoms can include feeling constantly tired, losing interest in hobbies, your family and friends, and your sex life, feeling tearful, or crying for no good reason, and disturbed sleep - either sleeping too much, or tending to wake early in the morning. Many people with depression have low self-esteem, find it difficult to concentrate or remember things, and have a change in appetite - either eating more than usual, or eating much less. Physical symptoms are common too - vague aches and pains, and worse symptoms from any problems you may already have, such as arthritis or an irritable bowel.

Depression is a genuine illness, and it's not a sign of weakness or that you should just 'pull yourself together'. It known to be linked to a change in levels of the chemicals in the brain, such as serotonin and noradrenaline, that control mood. In some cases there is an identifiable cause, such as bereavement, or a series of stressful life events. It can also be triggered by coping with a long-term illness, or after giving birth. But in many cases it just occurs for no reason at all. This is especially common in people who have a family history of the condition. Trying to cope by drinking alcohol tends to make it worse.

If you think you may be suffering from depression, or someone has mentioned to you that they are worried you are depressed, then see your GP as soon as possible. Be open and honest about how you are feeling - it will help your doctor make an accurate diagnosis. Your doctor may also ask you to fill in a questionnaire about how you have been feeling for the past two weeks - this helps them to judge the severity of your mood change.

Mild depression can often be tackled successfully by lifestyle changes - making sure you get a little more sleep, eating sensibly, cutting down on booze, and most importantly, taking regular exercise.

Mild to moderate depression can also be helped with the herbal remedy St Johns Wort If you decide to give this a try, make sure you buy a registered herbal product, which should come in a packet with a full information leaflet. It is important you read this to check if it is suitable for you, or will interact with any medicines you are already taking.

Treatment available from your doctor for moderate to severe depression includes anti-depressant medication or talking therapy, or a combination of both. Anti-depressant drugs help to boost levels of the chemicals in the brain that control mood. The most common type used are Selective Serotonin Uptake inhibitors, or SSRIs, such as citalopram or fluoxetine. They do not cause an instant change in mood, and usually take at least a week - often longer - to take effect. They are not addictive - you do not get used to them and need an increase in dose, and there is no compulsion to take any extra dose either.

Once you are started on antidepressants you should reckon on needing to take them for at least six months, sometimes longer. It is usually best to stop them gradually, to avoid slight dizziness which can occur if they are stopped suddenly.

There are various different types of talking therapy which can be helpful. Counselling allows you to chat through and obtain advice on coping with any problems that may be troubling you, but if you have a rather negative outlook on life then you may benefit from more structured cognitive behaviour therapy (CBT). Your GP will be able to advise on the type of treatment that is most suitable for you.

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All content within Her is provided for general information purposes only. The content should not be treated as a substitute for the medical advice of your own doctor or any other qualified health care professional and should not be used as the basis for diagnosis or choice of treatment. This content is provided to Microsoft by Dr Rosemary Leonard and Microsoft is not able to verify the accuracy or reliability of this information. Microsoft shall not be responsible or liable for any diagnosis made or treatment chosen by any user based on the content. [Microsoft does not endorse any third party websites listed or health product or service mentioned or recommended in the content and shall not be liable for them.] Always consult your GP if you have any concerns about your health.

39Comments
23/04/2012 18:55
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I had a total mental breakdown in 2009 and was initially prescribed Citalopram but all that did was cause me to hallucinate.  So my doctor changed it to Sertraline with the advice of a Psychiatrist and I  had the dose increased twice.  I refused to take any sedatives as I didn't want to complicate my recovery further.  It took me 3 months to be able to communicate just how I felt and understand just what had happened to me and then I went for Cognitive Behavioural Therapy.  It is the best thing I have ever done.  60 sessions gave me a new lease of life - I feel totally liberated and so much more in control of my life and able to challenge those negative feelings when they occur.  I don't think there was a single thing left in my life that had not been examined in my sessions - I was able to shed so many many negative feelings that were buried so deep and having faced up to everything that had happened I now know that these same feelings cannot hurt me again.  I'm now coming off the tabs which at least numbed me so that my poor brain could recover.  Just remember this Depression is NOT a state of mind it IS a chemical imbalance and therefore a physical thing.  I'm happy to shout "I'VE HAD A MENTAL HEALTH PROBLEM AND IT HAS BEEN THE MAKING OF ME".
23/04/2012 14:50
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Depression can also be an indicator of some other underlying psychological conditions too. It's not always obvious that you might be suffering from Aspergers Syndrome, *for instance*, as conditions like this can get passed off as simple behavioural traits BUT they do cause greater instances of depression & anxiety among their possible syptoms.

 

This MSN article is DANGEROUS in that it makes taking SSRIs, like Citalapram, seem like a wonderfully simple cure-all fix. They are not, and I say that both from personal experience and that of friends. SSRIs are known to cause you to feel very lethargic, heavy headed, be unable to concentrate, have poor attention to detail, motivation & drive issues, dietary problems and pose potential fertility risks for both sexes in the medium to long term. It doesn't help that a lot of GPs really still are of the opinion that 'we' are whingers, and dole the drugs out like Smarties to shut us up, instead of providing positive, targetted councelling that can allow people the chance to develop their own mechanisms for coping... and as a patient you're not always aware of, or in a position to insist on, appropriate methods of treatment unless they are suggested - which often they are not.

 

There is no simple fix, it is different for everyone... If it was simply more sleep, less drink, less stress then it wouldn't be a recognized & medically accepted condition.

 

Personally, the best thing I ever did was throw the medication away, learn to recognize & understand my condition & it's effects - including the positives of being Aspergers, such as heightened specific skills & talents - and becoming a father, to the loveliest little chap in the World - who provides me with all the reasons I could ever want to keep on trying.

23/04/2012 17:53
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I am now 6 weeks into treatment on Citalopram, after failing to take enough sleeping tablets and vodka to not wake up again. Unfortunately the side effects are a general lack of interest in life or what tomorrow will bring.  As that is what got me to the low-point of attempting suicide, I wonder what the point of the drug is! Having said that, the 'lows' are less frequent and I would urge anyone with suicidal thoughts to see their GP. Suicide is not the answer, it just leaves a lot of hurt and confused people behind. Good luck all.
23/04/2012 14:08
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Indviduals can contact their local branch of Mind for help and support.  The Oxfordshire branch has a dedicated team of over 100 staff working right across the county. 

 

 

23/04/2012 16:25
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My doctor told me to exercise more to release the natural chemicals in your body that stop you feeling depressed.  I also tried St Johns Wort, but every now and again seem to make me feel overly aggressive. It's a minefield - I think that there's no one answer for everyone.  Depression can be caused by many things and we're all different to begin with and therefore we're affected in different ways.  I think maybe you've just got to be open minded - keep going til you find something that works :o)
23/04/2012 20:12
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Sunny Day

 I was diagnosed with Bi-polar approx. 4yrs ago having suffered off and on with depression most of my life .I tried to" treat" myself feeling ashamed that i couldnt seem to pull myself together as friends and work colleges told me.My CPN says there isnt a stigma attached to depression/bipolar but its surprising how many people ive known who suddenly become very busy or just stop phoning or asking you out for coffee.

I count myself lucky that i have a very good consultant who understands my out bursts and is always at the end of a phone should i need him.As for medication i had two chioces either try what was recommended or just let the" monster" inside me take over.Im glad i made the  chioce i did tablets are not my idea of fun but at least i nolonger sleep all day not wanting to get washed or dressed or speak to anyone.

I know how good i am when i can look outside the window and recognise the sun shining,maybe life isnt as bad after all. 

23/04/2012 21:24
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Hi,

 

I'm 20 and I have recently been diagnosed with depression. I never knew I had it. I would be on the bus traveling to work and if another person looks at me i think they want to hurt me and I would get anxious and move away from them. If the bus goes under a bridge I would think that the top of the bus would hit the bridge. I work in under a train track bridge and everything a train goes overhead the roof would shake and I always thought the roof would cave in and make excuses to my employers to go home. I would shake and my breathing would go wild.  I looked up anxiety on Google, I experienced every sympton shown. I kept this from my family for a long time then it got worse and I became aggitated an my attitude got worse so I decided to speak to my parents about the smallest problems I feel. They advised to go doctors which I did the following day and I cried as soon as I started talking about it. From there I realised I had a problem.  He conducted a questionnaire which is a simple circle some numbers which they then count and speak with you about treatment based on your score. Mine was a simple talk with him every week and my employers. My employers othered support and spoke with my everyday and kept my enthusiam and spirits up. Speak with your employers and family as they will be able to help you through everything. It's hard at first as you feel, I'm not a child I should grow up and stop being silly but depression is not something that you will be able to handle by your self. It's important to speak to someone as soon as you experience any symptoms. I hope this helps. Stacey

23/04/2012 21:28
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My Son has severe depression he has disowned all his family lost the love of his life  but will not get help his depression affects all of us  it is breaking my heart but Ican not help him and he will not be helped  it is a terrible illness.
23/04/2012 17:44
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The best thing I ever did was see the doctor about my depression.  I have had it nearly all my life.  I tried so hard not to take anti-depressants, but it was the only thing which helped me.  Before then I was taking supplements like DLPA or St. John's Wort, but they eventually stopped working or my depression was so bad it couldn't be controlled with them any more.  I am on Citalopram.   Talking helps a little, but that in itself is not a cure.  Talking is okay when you are doing it, but then you discover you still have the depression and the things that caused the depression are still there.  They don't disappear through talking.  Citalopram helps me cope.  It is not 100% effective though.  Nothing is.
23/04/2012 19:09
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Depression is one of the symptoms of HYPOTHYROIDISM. In fact, the symptoms of depression ape the symptoms of hypothyroidism and therefore the two are regularly, FAR TOO REGULARLY confused and the thyroid missed as a probable cause, and left untreated!

Hypothyroidism, untreated, is a killer, and on the way to that is a living death!

If you have been suffering  with depression for more than a couple of months, or indeed if you have to go to the GP for symptoms of depression at all, please insist on a thyroid test! (Having said this, that doesn't necessarily get you totally out of the woods re diagnosis, as the 'normal range' of levels is very wide, and some GPs will not try you on thyroxine  even if you are on the cusp of those levels.)

 Be aware however, that nowadays they are allowed to, (different from in the early nineties), so don't take a 'normal' but low result as written in stone, and ask if your GP would consider trying you on Thyroxine as a test.

If you have a low reading, and your Dr. won’t, - keep an eye on your list of symptoms, write them down, and if they worsen or get added to, go back and ask for another test, or get another Doctor, someone who will listen!    Please note, don’t go to the Doctor when you feel quite well, as any test will come back ok, (even when you are hypothyroid, levels fluctuate immensely and could confuse matters. Doing this is part of the reason  the thyroid link is missed, and the hell goes on for countless people.)

Hypothyroidism is a physical disease and is SOOOO easily treated, (tablets the size of saccharine tabs), of thyroxine, and in the UK this is automatically free from charges.

As a generality, (of the properly diagnosed population) Hypothyroidism affects 1:50 female, to 1:1000 male, but is noted widely that this is probably a conservative estimate, and can happen at any age.

 I have tried to add a few links to the bottom of this post just to get you started, however it is being stopped because they are being misread as poss spam, (but Google, Hypothyroidism symptoms). PLEASE read them ALL up. IF your depression is caused by hypothyroidism it could save your life, and indeed make life worth living again.

 

God Bless.

 

23/04/2012 22:02
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i have suffered from depression for 20 years now,,it is one of the worst things that anyone can go through,i take medacation,been to councilers,been in a treatment place at different times,,most of my family have suffered depression at some stage in there lifes,
thats makes it so much easier when other people know what your going through
for people who have never had depression,its very hard for them to understand,,its not a illness that can be seen,,its an illness that people can hide,,
my god in thisday and age,it should be written on walls for everyone to see,and try to understand, i do believe that i will have to life with this for the rest of my life and never
get up in the mornings and have that feeling of happiness,,no fear,the worry about how im going to get through the day
i feel so deeply for everyone that suffers from depression,,and wish there  was a cure for it like so many other illnesses xxxxCrying 

23/04/2012 21:24
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if so many people are suffering from psychological conditions it would point to a problem within society rather than individuals.so rather than having half the nation doped up on happy pills maybe we should change the way society is structured.or maybe it is a reflection of our image/consumer/money orientated lifestyles propagandised to the people by those at the top  
23/04/2012 22:25
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i was diagnosed with depression over four years ago and like others probably had quite a while before that,i have had real lows in which i felt so worthless that for everyones sake and mine i'd be better off out of the picture,but it was the thought of my kids that stopped me doing anything stupid,i have very little self esteem and find it hard to concentrate and focus on even the most trivial things everything seems to be an effort,i don't sleep very well and am always tired it's a struggle to get through the day,another thing is when i'm depressed i get quite aggressive and am horrible to the people around me but i can't see it,it's people around me that let me know and that in turn makes the situation worse,i'd find myself crying for very little reason or no reason at all,some mornings on the way to work i'd cry then put a front on to work mates as if nothing was wrong but they now know about me and are very supportive as are my bosses who accomodate me with work that i can cope with which is a big help,i've been on citalopram and was on it for about three years but even with the dosage increased it stopped working for me so then i was put on flouxetine which helped a bit and has now been increased but feel quite drained all the time and find it hard to concentrate and have very little energy,i've tried a few times to come off them but then hit rock bottom and wanting the easy way out so was put back on them,it's very frustrating trying to explain how you feel and i think unless you've suffered depression you can't quite understand what people go through with it and it makes me so angry when you get someone telling you to just snap out of it,if i could snap out of it i would'nt be depressed - it's an illness FACT i hate being like it but the medication does help,hopefully i'll get some counselling,i used to hate admitting i had depression because of the stigma you get from it but now i find it's best to come clean and try to explain to people how i feel

23/04/2012 19:44
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hi, my mum is depressed, but all our family and friends tell her to go to the doctors but all she says is "im not depressed!!" she can't see that she is depressed, i am 14 and the last mother and daughter thing we did was 1 year ago, my dad does all the cooking and we are allways rouwing because of the strain on everyone, she does not contact her best friend anymore, and mum and dad do not do anything together, she is worried what people think of what she looks like, she hardly ever goes out the house, so she is overweight, all her clothes are to small for her but she says i dont want to go to get some clothes. Everyone is really worriede about her, if anyone can help please email me at chloegemmahiett @hotmail.co.uk   i will be very grateful of any help xx
23/04/2012 14:44
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VALIUM-IS HIGHLY ADDICTIVE!!! So are NOT more effective. Anti-depressants help, but they are not the only solution. Going to your G.P, or MIND is the best action you can take if feeling depressed.
23/04/2012 20:42
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to Chloe Gemma - this is the hardest part of depression, to get the person to admit they need help.  i dont have the answer i am afraid but you could ask your own doctor he might know how to get your mum the help she needs.  good luck x

23/04/2012 17:32
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Just to let you know I was Bi polar (prob still am) but i saw a specialist and that helped most, I had been taking anti depressants but almost cost me my dream job as alot of companies (eg health care) dont like employees taking anti depressants, so be careful.
23/04/2012 20:21
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Unlike every day understandable mood changes or transient sadness , clinical Depressive Illness is  serious but thankfully treatable in vast majority of cases. One needs to understand the characteristic biological symptoms and seek help from GP if  troublesome symptoms continue unabated for 2 weeks or more. delaying only can make suffering worse and make it more resistant to treatment,

RECONGNIZE THESE BIOLOGICAL SYPMTOMS IF PRESENT - SEEK GP'S HELP SOON. 

Poor sleep with broken sleep & early waking.

Feeling worse in mornings improving somewhat as the day goes.

Poor appetite generally.

Weight loss 5% or more in last 2 weeks.

Loss of energy, initiative and libido.

poor concentration

Bodyaches and headaches ( vague but like heaviness, constriction , heart beat awareness , tummy ache ).

Talking therapy may not help in severe cases and anti depressants can transform  lives, return  it to normal daily living and joys. So NEVER dalay seeking help as GP's are getting better at recognizing & getting the right help from specialists if needed.

 

23/04/2012 18:36
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Ive been on citalopram form almost 2 months now and as lovely as it sounds, it doesnt fix how your feeling, waking up in the morning is just as much of a struggle, and you start to rely on the meds as a cure but, honestly depression can only be cured if your willing to change, it sounds easy but its very difficult i see two therapist and my GP there very good at what they do, but if your after a solution to your problems they are not gonna give it to you. My advice is it sucks, and is very time consuming but attempt a mood map, could help you realise whats causing your poblems, every hour write down how your a feeling score it out of 10 and elaborate why. type "Mood Maping" into google, could help?
23/04/2012 23:08
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To all of you who have said that medication shouldn't be used/taken, I can only assume that none of you have ever suffered from depression in the true sense. It's a lot different than someone saying they are feeling depressed!  I suffered with deperession for years before I got diagnosed and had medication + counselling . I now feel great. There is a sign on the wall at my sessions with the pychiatrist ' Many people in the UK suffer from depression but many more have a problem with this.'
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