What is depression?
Depression is a persistent low mood that lasts for a long period of time, affecting your everyday life.
The symptoms range from mild to severe. In its mildest form, depression can simply mean feeling persistently low in spirit which can make everyday tasks seem harder and less worthwhile. Severe depression can be life-threatening as it can make you feel suicidal, that life is no longer worth living.
If you have been diagnosed with depression, you may be told that you have mild, moderate or severe depression. This is dependent on the impact your symptoms currently have on you and affects the type of treatment you may be offered. It is possible to experience mild to severe depression during one episode or across different episodes of depression.
Types of depression
There are some specific types of depression:
- Seasonal affective disorder (SAD) – this type of low mood occurs at a certain time of year, or during a certain season.
- Dysthymia/Persistent depressive disorder/Chronic depression – continuous mild depression that lasts for two years or more.
- Prenatal/Antenatal depression – a depressive episode that occurs during pregnancy.
- Postnatal depression (PND) – a depressive episode that occurs in the weeks and months after becoming a parent. PND can affect both men and women.
The good news is that with the right treatment and support, most people with depression can make a full recovery.
What are the symptoms?
The signs and symptoms of depression can be complex, and everyone’s experience will vary.
Some common symptoms include:
- feeling down, upset or tearful
- feeling restless, agitated or irritable
- feelings of guilt, worthlessness and putting yourself down
- feeling empty and numb
- feeling isolated and unable to relate to other people
- not getting any enjoyment out of life
- having no motivation or interest in things
- having no self-confidence or self-esteem
- feeling hopeless
- having suicidal thoughts, or thoughts of harming yourself
Physical and social symptoms
- avoiding social events and neglecting your hobbies and interests
- self-harming or suicidal behaviour
- difficulty speaking, thinking clearly or making decisions
- low sex drive
- difficulty remembering or concentrating on things
- using more tobacco, alcohol or other drugs than usual
- difficulty sleeping or sleeping too much
- feeling tired all the time
- changes in appetite or weight
- unexplained physical aches and pains
- moving or speaking more slowly than usual, or being restless and agitated
What are the causes of depression?
There is no single cause as it can occur for a variety of reasons and it has many different triggers. Some possible causes include:
Childhood experiences – evidence shows that difficult experiences during your childhood can increase the vulnerability to depression later in life. Certain experiences could be emotional, physical or sexual abuse, neglect, grief, a traumatic event or an unstable family environment.
Life events – such as bereavement, unemployment, abuse, sexual assault or major life changes.
Other mental health problems: coping with the symptoms of an existing mental health problem can trigger depression. You may experience depression if you experience anxiety, PTSD or an eating disorder.
Physical health problems: you may have a higher risk of depression if you have a chronic, life-threatening illness such as cancer or heart disease. A severe head injury can trigger mood swings and emotional health problems. Other health problems that can increase your risk of depression include hormonal problems, low blood sugar, sleep problems and symptoms relating to your menstrual cycle.
Genetic inheritance: if someone in your family has had depression, such as a parent or sibling, research shows that it’s more likely that you may also develop it.
Medication, recreational drugs and alcohol: low mood can be a side effect of certain medications. Alcohol and recreational drugs can make you initially feel better, but they can make you feel worse overall.
Sleep, diet and exercise: A poor diet and lack of sleep and exercise can make it harder for you to cope with difficult things going on in your life as it can affect your overall mood.
Treatment for mild to moderate depression
Treatment varies depending on how severe the depressive episode is. Sometimes it can be managed through self-care. However, often during a depressive episode help from a professional in invaluable. Seeing a GP can help provide you with options such as referrals for talking therapies and medication to help you cope with depression.
Coping with depression can be difficult, but there are steps that can help you. Here are some self-care suggestions for you to consider:
- Talking through your feelings can be helpful
- Try peer support such as self-help groups for people with depression
- Try mindfulness- there are apps such as Headspace and Calm that can guide you
- Look after your physical health and keep active
- Practise self-care, take time to look after yourself and do things that you enjoy
- Spend more time in nature
- Keep a mood diary to see if there’s a pattern
If you have mild to moderate depression that is not improving, you may find a talking therapy helpful. Different types of talking therapies include cognitive behavioural therapy (CBT), interpersonal therapy (ITP) and counselling.
A GP can refer you for talking treatment, or you can refer yourself directly to a psychological therapies service.
If you have moderate to severe depression, the following treatments may be recommended:
- Anti-depressant medication- for example, selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). You can talk to your doctor about your options. Different people find different medications most helpful.
- Combination therapy may be recommended, which involves taking a course of antidepressants plus talking therapy. This combination usually works better than having just one of these treatments.
- Mental health teams- you may be referred to a mental health team if you’re depression is severe. Such a team is made up of psychologists, psychiatrists, specialist nurses and occupational therapists who provide intensive specialist talking treatments as well as prescribed medicine.
Treatment for severe depression
In the case of severe depression where you are battling suicidal thought and/or self-harm, our GP or psychiatrist may recommend a different course of treatment. These can provide short-term relief and help in your long-term recovery.
Treatment for severe and complex depression can include:
- Medication for psychotic symptoms
- Crisis resolution services
- Hospital admission
- Electroconvulsive therapy (ECT)
- Repetitive transcranial magnetic stimulation (rTMS)
- Transcranial direct current stimulation (tDCS)
It’s important to remember that recovery is a journey, which isn’t always straightforward. You may find it useful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of each symptom.
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Further reading and support
Reviewed by Dr Daniel Fenton, Clinical Director at The Doctors Clinic Group
Published: May 2020 | Review date: May 2023