Depression –

Generally, a mood state characterized by a sense of inadequacy, a feeling of despondency, a decrease in activity or reactivity, pessismism, sadness and related symptoms’ Reber and Reber (Psychology Dictionary).

Depression gets thrown around as a word a lot, however I believe it can mean different things to different people.  I think there is still quite the connotation with the word depression – weakness, inability, being limited, failing, being flawed, being challenged, struggling – the list could go on.  I get frustrated by fly away comments that you hear, ’How depressing! There are no matcha lattes anywhere?!’ I mean everyone’s difficulties are different, however, using the word depressing can really upset someone that really struggles.  Language is powerful and thought should be put into the words chosen before you give yourself a self or GP diagnosis of depression.

The reason I have put the shhh in the title is that people who struggle with feeling this crap are often not talking about it, they are quite, isolated, removed themselves from friendship groups.  Depression can be a silent killer, hence how suicide can take people by surprise, you may never have known how awful someone feels, then all of a sudden they may be gone.

Depression requires strength

What is interesting when I work with people with depression and see it outside of work is the strength needed to ask for help.  You should not have to wait until the worst moments and when things are unmanageable to ask for help, however many do wait to access help.

One of the most ironic things about depression is that even if you feel like things are at an all time low, the things that help the most, can be daily activities that give you meaning and a sense of feel good.

Common things to lift mood are:

  1. Exercise
  2. Eating well
  3. Rest from work
  4. Socialise
  5. Volunteering/doing something that is meaningful to you.
  6. Reaching out to talk to a friend

Sadly, these can be the most challenging things to do when you feel really crap.

Signs that you may be depressed –

Being demotivated and apathetic

Struggling to find the positives at all in a day

Isolating yourself

Not being able find the energy to do things that make you feel better (exercise, eating well, having a relaxing bath)

Poor sleep

Anxiety is high as well as mood feeling low.

Biology of depression –

Depression is seen to be related to a chemical imbalance in the brain (serotonin predominantly), but also related to difficult times in life.

Feelings of anxiety can tip over into feeling depressed because the energy used feeling anxious can be overwhelming and then exhaust you to feeling absolutely nothing.

Trauma can lead to low mood, particularly if you experience flashbacks or dissociations.  These frightening experiences can lead to emotional dysregulation where you might flip from feeling anxious about how these make you feel to not knowing what to do and isolating yourself to avoid thinking about it.

What can help if you’re feeling low

The above list is a starting place, but may not be ‘all’ you need.  Depression when it strikes is really obvious to medical and mental health professionals.  Meeting someone as a mental health nurse who thinks they have depression vs seeing someone who really has depression is a clear distinction.  The affect of someone with depression is significantly different to that of someone who has low mood, but in the context of life stressors, difficult situations, feeling overwhelmed and anxious.  ‘Self help’ strategies could be all you need.  Find your exercise (PT, yoga, classes, walking, running).  Look out for what makes you feel good.  Find your friends that listen to you and seek them out.

If the above strategies feel beyond you – you  need to see a GP.  Is that to get medication? No.  No antidepressant should be prescribed without a talking therapy.

A GP should be referring you for talking therapy if they are prescribing you medication.  If they are not, ask them for it.

What to do if it does feel too much

  1. Try to act before this.
  2. Get to the GP asap.
  3. A&E in any hospital has a mental health team – they are a place of safety and specialist support is available.
  4.  https://www.samaritans.org
  5. https://www.giveusashout.org
  6. https://www.pandasfoundation.org.uk
  7. https://nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines