What is depression?

We all feel down or sad sometimes, but these feelings don't usually last and are a normal response to problems or difficulties in our lives. However, when they don't go away or are more than we can cope with and affect our ability to go on with our daily lives, it may be depression.

The World Health Organisation (WHO) states that depression is the leading cause of disability worldwide, affecting around 350 million people. Northern Ireland has an exceptionally high rate of depression compared with the rest of the UK, with figures showing a 25% higher rate of mental ill-health than England. Reasons for this include relatively high rates of social deprivation and the legacy of ‘The Troubles’.

What are the symptoms of depression?

Look out for the following signs. If you've had at least two of these core symptoms and some of the other symptoms listed below for at least two weeks, you should talk to your GP.

Core symptoms

• An unusually sad mood that doesn't go away.
• Loss of enjoyment or interest in activities that used to be enjoyable.
• Tiredness and lack of energy despite appropriate rest.

As well as these, you may also experience one or more of the following:

• Loss of confidence in yourself or poor self-esteem.
• Feelings of guilt when you're not really at fault.
• Wishing that you were dead.
• Difficulty making decisions and concentrating.
• Moving more slowly or becoming agitated and unable to settle.
• Difficulty sleeping or sleeping too much.
• Loss of interest in food or eating more than usual, leading to weight loss or gain.

Not every person who has depression will have all of these symptoms.

Some other terms you might hear are:

Recurrent depression

When someone experiences more than one episode of the illness. It is pretty common, although episodes can vary in severity, and individuals may have periods where they are well between episodes.

Reactive depression

If your doctor thinks that your depression has been triggered by difficult events in your life, such as divorce or money worries, they may say that it is reactive.

Dysthymia

Continuous mild depression that lasts for two years or more. Also called persistent depressive disorder or chronic depression.

How is depression diagnosed?

If you have been experiencing any of the symptoms listed above for over two weeks, you should book a visit to see your GP.

Depending on the number and severity of symptoms, your GP may diagnose you with mild, moderate or severe depression. The vast majority of cases will be diagnosed and treated by your GP.

Treatment

Treatment for depression may involve self-help, talking therapies and medication. Once a diagnosis has been made, your GP will talk you through the different options that might work for you. Some of these include:

Self-help

It is important to remember that many people can recover from depression through self-help alone. However, this may be initially difficult as you may lack the energy and motivation to do things that may help. Accordingly, your GP may discuss some self-help options with you that are appropriate to your circumstances and embark on a period of 'watchful waiting'. During this time, they will monitor your progress regularly.

Talking Therapies

If your GP feels that it may be helpful, they may refer you for appropriate one-to-one talking therapy. Talking therapies involve talking to a trained professional or therapist over a series of sessions. Some types of talking therapies are:

• Cognitive behavioural therapy (CBT) has been proven to be very effective for mild/moderate depression and in preventing relapse. It works on the basis that if we change our unhelpful thinking patterns and behaviour, it will improve how we feel mentally and physically. The Living Life to The Full programme delivered by AWARE NI is based on CBT principles - click here for more information.
• Counselling involves talking to a trained counsellor about the problems you are experiencing. It can be effective where there appears to be some underlying reasons or circumstances which may have contributed to the onset of depression or is prolonging the illness. To find a list of Counsellors in your area, you can check out the website www.counselling-directory.org.uk.

Medication

Antidepressants are the most commonly prescribed and evidence-based medication for treating moderate/severe depression. They work by boosting certain brain chemicals that affect mood. It is essential to take them exactly as prescribed and only stop taking them when advised by your GP. You may need to try a few different types before finding one that works for you.

You should tell your GP as soon as possible if you experience side effects from antidepressants, even if they disappear or are tolerable. Antidepressants can also react with other medications, but your GP will talk you through this. A standard course of antidepressant medication can last for at least six months after recovery.

*Medication is vital in the treatment of bipolar. If affected, you may be prescribed several types of medicines, including a mood stabiliser, antidepressant medication and anti-psychotic medication if required.*