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Depression is characterised by feelings of unhappiness and sadness. However, it is far more than simply feeling unhappy or fed up for a few days. Everyone has times when they feel down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days.

Depression is a real illness with real symptoms, and it’s not a sign of weakness or something you can “snap out of” by “pulling yourself together”. Those people who think that depression is trivial and not a genuine health condition are wrong. The good news is that with the right treatment and support, most people can make a full recovery.

It’s important to seek help from your GP if you think you may be depressed, and if you’ve been feeling low for more than a few days. Many people wait a long time before seeking help for depression, but it is best not to delay. The sooner you get some help, the sooner you can be on the way to recovery.

Sometimes there is a trigger for depression. Life-changing events, such as bereavement, losing your job or even having a baby, can bring it on. People with a family history of depression are also more likely to experience it themselves.

But you can also become depressed for no obvious reason.

How common is depression?

Depression is quite common and affects about one in 10 of us at some point. It affects men and women, young and old. Depression can also affect children. Studies have shown that about 4% of children aged five to 16 in the UK are affected by depression.

Symptoms of Depression

The most widely recognised symptom of depression is a feeling of sadness, feeling hopeless and losing interest in things that you use to enjoy. The symptoms persist for weeks or months and are bad enough to interfere with your work, social life and family life.

However there are also many other symptoms of depression, listed below. You are unlikely to have every symptom listed, and the experience of depression can vary widely between different people.

If you experience some of these symptoms for most of the day, every day for more than two weeks, then it is likely that you have depression and it is possible to get help in order to start feeling better.

Physical Symptoms

  • moving or speaking more slowly than usual
  • change in appetite or weight (usually decreased, but sometimes increased)
  • constipation
  • unexplained aches and pains
  • lack of energy or lack of interest in sex (loss of libido)
  • changes to your menstrual cycle
  • disturbed sleep (for example, finding it hard to fall asleep at night or waking up very early in the morning)

Behaviours

  • Eating more or less
  • Sleeping too much or too little
  • Isolating yourself from others
  • Crying more
  • Wanting to cry but are unable to

Depression can come on gradually, so it can be difficult to notice something is wrong. Many people continue to try to cope with their symptoms without realising they are ill or that there is anything that can help. Sometimes it is a friend or family member who notices that something is wrong.

The experience of depression varies widely, and is usually described as more or less serious depending on the type of impact it has on your day to day life.

  • mild depression has some impact on your daily life
  • moderate depression has a significant impact on your daily life
  • severe depression makes it almost impossible to get through daily life – a few people with severe depression may also have psychotic symptoms

Other Types of depression

There are different types of depression, and some conditions where depression may be one of the symptoms. These include:

  • Postnatal depression: Some women develop depression after having a baby. Postnatal depression is treated in similar ways to other forms of depression, with talking therapies and antidepressant medicines.
  • Bipolar disorder: this is also known as “manic depression”. It’s where there are spells of depression and excessively high mood (mania). The depression symptoms are similar to clinical depression, but the mania can include harmful behaviour such as gambling, going on spending sprees and having unsafe sex.
  • Seasonal affective disorder (SAD): This is also known as “winter depression”, SAD is a type of depression that has a seasonal pattern usually related to winter when there is less daylight.

Causes of Depression

There is no single cause of depression. You can develop it for different reasons and it has many different triggers.

For some, an upsetting or stressful life event (e.g. bereavement, divorce, illness, redundancy and job or money worries) can be the cause, or it may be a combination of a number of significant events.

People often talk about a “downward spiral” of events that leads to depression. For example, if your relationship with your partner breaks down, you’re likely to feel low, so you stop seeing friends and family and you may start drinking more. All of this can make you feel even worse and trigger depression.

Some studies have also suggested you’re more likely to get depression as you get older, and that it’s more common if you live in difficult social and economic circumstances.

Sometimes depression develops and there is no obvious cause at all.

Stressful events

Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events happen, you have a higher risk of becoming depressed if you stop seeing your friends and family and you try to deal with your problems on your own.

Illness

You may have a higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease or cancer. Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems. Some people may have an underactive thyroid (hypothyroidism) due to problems with their immune system. This can cause a number of symptoms, such as extreme tiredness and a loss of interest in sex, which can in turn lead to depression.

Personality

You may be more vulnerable to depression if you have certain personality traits, such as low self-esteem or being overly self-critical. This may be due to the genes you’ve inherited from your parents, or because of your personality or early life experiences.

Family history

If someone else in your family has suffered from depression in the past, such as a parent or sister or brother, then it’s more likely you will too.

Giving birth

Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as added responsibility of a new life, can lead to postnatal depression.

Loneliness

Becoming cut off from your family and friends can increase your risk of depression.

Alcohol and drugs

Some people try to cope when life is getting them down by drinking too much alcohol or taking drugs. This can result in a spiral of depression. Cannabis may help you relax, but there is evidence that it can bring on depression, especially in teenagers. Alcohol can also be seen as something that initially makes you feel better and helps you manage difficult emotions and feelings, but alcohol is categorised as a “strong depressant” and actually makes depression worse.

Treatment

Treatment for depression usually involves a combination of medicines, talking therapies and self-help.

The kind of treatment that your GP recommends will be based on the type of depression you have.

Talking Therapy

Talking therapies, such as counselling or psychological therapies (e.g. CBT), have been shown to be very helpful for depression. Together with a counsellor or therapist you can express your feelings, learn to understand your depression better, perhaps how it developed, and how it is being maintained, or getting worse. This will then lead you to find ways that you can make changes that will help your mood and symptoms of depression to improve.

Medication

Antidepressants are tablets that treat the symptoms of depression. There are many different kinds of antidepressant and they have to be prescribed by a doctor, usually for depression that is moderate or severe.

Antidepressants can work very well in combination with a talking therapy, often better than either treatment alone for more severe depression.