How do you know if you have depression?

Low mood is common.  Covid lifestyle and lockdowns mean that low mood is much more likely in more people, because we are limited in what we can do, how we can do it and our normal strategies of keeping busy, being engaged in life have been stopped.  Feeling low and flat is really not uncommon, even if it’s just for a portion of a day.

Do not panic if you feel low or flat and this is unlike you.  It is ok.  Low and flat feelings are part of your emotional landscape, some people may just avoid these feelings or not experience them as intensely as others.  Pretending everything is fine and wonderful is equally not a particularly healthy way to live life.  But a balance of emotions is key.

Nice guidelines outline clearly what are the main symptoms of depression:

https://www.nice.org.uk/guidance/cg90/chapter/Appendix-assessing-depression-and-its-severity/

What helps to manage depression?

Common tool ‘Do’s:

Exercise, socialising, engaging in a hobby, working towards small goals, working, having meaningful activity every day, therapy, get good sleep.

Common tool ‘Do not’s:

Drink alcohol at all or excessively, ignore thoughts and feelings, isolate yourself, tell yourself your feelings do not deserve help.


Many people function with depression, no medication and practicing ‘wellbeing’ techniques to manage their mood.  This is great for some people.  These things take effort, energy and a little bit of desire to feel ok.  These things are great if you already have an understanding of what works for you to feel good.

Management tools take time to learn what works for you and but as this article explains – one thing doesn’t work for everyone.  https://www.mind.org.uk/information-support/your-stories/the-myths-of-exercise-and-depression/ As an exerciser a personal trainer and a clinical nurse specialist, I can assure you that most of my patients benefit from fresh air and a walk, no matter what, but a full on gym session is not something to push for if someone is feeling really crappy and can’t get out of bed.

What helps if you don’t know what helps?

The hardest part about feeling low, flat, depressed, is that you often feel so despondent, the thought of getting up for a walk or going to the gym is completely off your radar.  The most annoying thing someone could tell you (me) when you feel really rubbish is ‘get up and get out’, ‘get some exercise’, talk to a friend’.  But seriously.  These are the last things you may want to do, but they work!  These things help.

https://www.nhs.uk/conditions/stress-anxiety-depression/exercise-for-depression/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/

https://www.mentalhealth.org.uk/publications/how-to-using-exercise

Some of the key take homes from these links (there are many more), is it’s not necessarily the intensity of exercise done, or the length of conversation, it is more the action, motivation and distraction involved that can level out or lift mood.

Exercise is probably one of the easiest ways to make a daily change as you don’t need to look to anyone else to get out for a walk or sign up to a fitness class.

Talking to someone can be really difficult, but advice like this:

https://www.helpguide.org/articles/depression/helping-someone-with-depression.htm

Could change the way you try and communicate with your nearest and dearest.  Sending out a link to a friend like this, could highlight to them that you need some help and maybe they need some tips on how to help you.

https://www.headstogether.org.uk/10-things-to-say-to-someone-with-depression/ If you need to hear phrases like these in this link, tell your friends.  Sometimes, people really struggle to know what to say and even the most experienced mental health professionals say the wrong thing at the wrong time, because no one is a mind reader!

Professional help –

There are plenty of ways to engage in meaningful activity each day and you will know the things that you like.  Drawing, reading, music, walking, talking, knitting, it doesn’t matter what it is, you can find ways to get you through the day.

What do you say to your GP to get professional help?  Well, the best thing to do is be honest.

  1. Tell the GP how you feel.  Flat, low, depressed, anxious, worried, no energy.
  2. How long have you been feeling this way?
  3. Has something happened to make you start feeling this way?
  4. Are you doing less than you normally would?  Eating patterns changed?
  5. Are you struggling to sleep?
  6. Are you having intrusive thoughts about how useless/rubbish/not worthy you are that you struggle to manage?
  7. Have you thought about or actively self harmed/suicide?

It is likely the GP will tell you to try what I have advised above, engage in activity, try new things, get moving, keep routine, get good sleep.  But if you have tried these things already, the GP is more likely to offer you help with medication or therapy sooner.

Types of professional help for depression –

I have written blogs already about what different therapies are and why someone might need a different sort of thing at a different point in time:

https://powex.co.uk/why-talk-and-where-to-find-it/

https://powex.co.uk/mental-health-emergency/

There is no 1 answer but medication can help –

Medication works well for some long term.  But Nice Guidelines advise that no medication should be started with a therapeutic treatment plan alongside.  So if the GP fobs you off with ‘take these’, do not accept this.  You should be asking for therapy, advice around therapy and you should be having regular check ins with the GP (or a psychiatrist) to monitor how you feel on medication.

Some people take medication to get them back on their feet, engaging in their useful management tools and then they come off meds (with Dr’s advice – don’t do this yourself).

Some people skirt around using wellness techniques for a long time and avoid medication.  But there is nothing wrong with using medication to help you.  Would you refuse antibiotics if you had an infection that required them?  Unlikely if you were in physical pain.  Emotional pain can need meds too.  Its ok!