Depression

What is Depression?

Changes in mood are a normal part of life. Depression is therefore not simply defined by the presence of a particular emotion. Instead, it refers to a complex illness in which the individual feels their emotional state is beyond their control. Depression has been stigmatised and trivialised in the past, however, public knowledge about the disease is slowly improving. This is a complex and disabling condition characterised by a spectrum of symptoms that one cannot just ‘snap out of.’ Recent estimates suggest as many as 1 in 5 people will suffer from depression during their life. Fortunately there are various treatment pathways; if you think you may be affected by depression, help is at hand.

What causes Depression?

The cause of depression has been a major question in psychiatry, psychology and neuroscience. Furthermore, it has been the subject of immense research in the hope of identifying therapeutic avenues and preventative measures. There is still no definitive answer, though several possible mechanisms have been proposed. There is no single risk factor that can predict with 100% certainty the development of depression. Instead, it is likely that certain environmental stressors interact with a genetic predisposition to decide the development of mood disorder.

No single gene has been identified that causes depression. However, depression does, to an extent, ‘run in families,’ and it is likely that several genes working in combination may leave an individual vulnerable to depression. At the level of the brain, there are a multitude of theories exploring how depression may develop, particularly chemical imbalance (for example in serotonin).

What are the symptoms of Depression?

Depression is characterised by a spectrum of symptoms including a persistent low mood, sadness, or numbness, a loss of interest in life, an inability to enjoy things or life (anhedonia), exhaustion and fatigue, restlessness, changes in sleep, loss of appetite, loss of libido, thoughts of self-harm or suicide.

Diagnosis of the disorder is clinically based on a set of criteria (DSM or ICD), with doctors acknowledging the severity of the condition.

How is Depression treated?

Treatment of depression is split into antidepressant drugs, cognitive behavioural therapy (psychological treatment) and other less common treatments such as ECT and TMS. The treatment pathway depends on the individual and their symptoms.

Medication using antidepressants are useful in a proportion, but not all patients. It is important to appreciate that they do not work immediately, instead taking 3 or more weeks to come into effect. Importantly, these drugs do have side effects which your GP or psychiatrist will consult you about. These vary amongst individuals, but include indigestion, nausea and changes in sexual function. The drugs are not usually addictive, though some patients do experience withdrawal symptoms when they come off their medication.

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage mental illness. CBT addresses seemingly overwhelming problems by breaking them into smaller parts. Typically, sessions focus on a scenario, and the thoughts, feelings and behaviours that follow that scenario. CBT is also used in anxiety and other mental illnesses.

If you are worried that you are suffering from depression, consulting a GP or psychiatrist is useful, especially if you are feeling overwhelmed. Consultations are confidential and private and the doctor is there to help you. Even if you are not ready to see a doctor, telling a friend how you feel can be helpful. Making a note of what you think may be triggering your feelings of depression can be useful. Following this, trying to eat properly and stay active is a positive effort. Avoid alcohol where possible as it often makes depression worse.