A Guide to Depression: Understanding Low Mood

Depression is very common - one in five people become depressed at some point in their lives. Someone is said to be suffering from depression when low feelings don’t go away quickly and become so intrusive they interfere with everyday life.

The word ‘depression’ is sometimes used to describe feelings of low mood which affect us all from time to time. Feeling sad is a normal reaction to experiences that are upsetting, stressful or difficult; these feelings will usually pass.

However, depression is an illness with intense feelings of persistent sadness, helplessness and hopelessness that are accompanied by physical effects such as sleeplessness, loss of energy and other symptoms (see below). These feelings last for an extended period of time and negatively affect a person’s quality of life. Sometimes people may not realise how depressed they are, especially if they have been feeling this way for a long time. Feeling low may have become normalised.

Low moods associated with depression can be mild, moderate or severe, and last for weeks or months, rather than days. Persistent depressive disorder, also called dysthymia, is a continuous long-term and chronic form of depression.

People of all ages suffer from depression, and experience symptoms of depression, including children, teens and young adults. Older adults can feel depressed because of life changes that happen as we get older, which sometimes cause feelings of unease, loneliness, loss and sadness.

People with a family history of depression are more likely to experience depression themselves. Depression is an illness with real consequences and risk to wellbeing and is not a form of weakness or failure. Many famous leaders are known to have suffered from depression including Winston Churchill, the American president, Abraham Lincoln, and Mahatma Gandhi.

Depression is not something you can ‘snap out of’. Anyone can experience depression and if you’ve been diagnosed with depression, you may wonder what is happening to you. You may be concerned that the depressive feelings and mood changes will never end. You may notice that depression has affected many different areas of your life. Depression may impact on family relationships, your performance at work, your physical health and in how you view yourself and the world. You may experience social isolation, despair, stress, sadness and a lack of energy and interest. You may experience a loss of hope or severe anxiety. You may feel that you are not coping well.

The first step in fighting depression is to understand what it is, how it affects you and what may be causing it. There are several approaches and techniques an experienced therapist might employ to help you understand and alleviate depression.

Everyone’s experience of depression is different. However, several specific types of depression have been identified:

Reactive depression

This type of depression is triggered by a traumatic, difficult or stressful event, and because of this event, a person experiences low, depressive feelings and sometimes anxiety. In other words, reactive depression is depression that is usually the result of some difficult personal experience, like the death of a loved one, the loss of a job, financial problems, health issues or other factors; all of which may trigger depression. This type of depression is sometimes easier to understand as the origin of the low feelings is usually known.

Endogenous depression

Endogenous depression is not always triggered by an upsetting or stressful event. Those affected by this common form of depression may experience physical symptoms such as weight change, fatigue, sleeping problems and low mood as well as poor concentration and low self-esteem. With this type of depression, people cannot always identify any obvious cause of their symptoms and this can be worrying. In simple terms, this type of depression is depression where the cause is not clearly apparent and this can feel confusing.

Bipolar disorder (previously called Manic Depression)

People with bipolar disorder experience mood swings with ‘highs’ of excessive energy and elation, and ‘lows’ of utter despair and lethargy. At its worst, delusions or hallucinations can occur. Most people with this condition usually have their first episode in their late teens or early twenties. This type of depression is less common than many others.

Seasonal Affective Disorder (SAD)

This type of depression generally coincides with the approach of autumn or winter. It is often linked to shortening of daylight hours and lack of sunlight. Symptoms of Seasonal Affective Disorder may include wanting to sleep excessively and cravings for carbohydrates or sweet foods. Special lights that mimic sunlight can sometimes be used to treat this kind of depression.

Postnatal depression

Some women become depressed after having a baby. There may be an obvious reason for these feelings but often there is not. This type of depression can be particularly distressing when a mother is depressed at a time when she feels she should be enjoying the arrival of her new baby. This can lead to feelings of guilt and a sense of not coping with motherhood. Around one in every ten women experiences postnatal depression after giving birth.

Depression and women

Women are more likely than men to have received treatment for a mental health problem such as depression. Approximately 29 percent of women will suffer from a mental health problem in comparison with 17 percent of men. It has also been found that about 1 in 4 women will suffer from depression compared to 1 in 10 men. Various reasons have been suggested for this difference. One thought is that men are less likely to report the symptoms of depression. Another belief is that various social and biological factors predispose women to depression and related mental health disorders. Some experts believe that men experience depression more often than statistics indicate, and the discrepancy is mostly due to depression being under-diagnosed in men. Women are also twice as likely to suffer from anxiety as men and when anxiety is present alongside depression, treatment can be a more complicated.

Depression and men

It has been suggested that clinical depression in men may not get a diagnosis because men present different symptoms to their GP’s. Men are often less likely than women to acknowledge or talk about difficult emotions. Men sometimes turn to alcohol or aggression to mask depressive feelings altogether, which can worsen depression. Though depression in men is less common than in women, suicide in men is several times greater than that in women. British men are three times more likely than British women to die by suicide and suicide remains the most common cause of death in men under the age of 35.

Common symptoms of depression include:

  • Loss of energy
  • Persistent sadness
  • Loss of self-confidence or self esteem
  • Difficulty concentrating or making decisions
  • Being unable to enjoy things that are normally pleasurable or interesting
  • Undue feelings of guilt or worthlessness
  • Feelings of helplessness
  • Sleeping problems – too much sleep or too little
  • Avoiding people / distancing oneself from others / social isolation
  • Loss of appetite
  • Self harm or risk of self harm
  • Using more alcohol or drugs than usual
  • Crying, sometimes inexplicably
  • Losing interest in life / feeling unmotivated
  • Not coping with things that used to be manageable
  • Feeling restless or impatient / a general sense of boredom
  • Being preoccupied with negative thoughts
  • Having a bleak, pessimistic view of the future / a feeling of pointlessness
  • Losing interest in sex or intimacy or in other people
  • Loss of hope
  • Thinking about death or suicide

Treatment of depression

Depression, whether mild or more severe depression, is a treatable illness and is normally managed in one of two ways: through talking through difficult feelings and experiences with a professional counsellor or psychotherapist, and through medication. Depending on the diagnosis, your doctor can help you decide which treatment options may be most suitable to your personal circumstances. Some people prefer both treatments simultaneously – counselling in conjunction with anti-depressant medications.

If depression is interfering with your quality of life, or if you have had feelings of pointlessness or thoughts of harming yourself, seek advice and support and speak to your doctor or a mental health professional, or make an appointment with a qualified counsellor or psychotherapist. Discussions in counselling are confidential and speaking to someone could be the first step towards getting beyond the grip of depression. Most therapists have a great deal of experience in helping people with depression and can offer a confidential form of treatment and support.

Self help

There are many things people can do to help themselves alleviate episodes of depression. These techniques for coping with depression should be seen as complementary to professional help rather than as an alternative to it. For example, there are self-help videos and books that may offer some advice to overcome depression and mental disorders, however they may not give you the full support, information or treatment that you really need, especially if you have major depression or clinical depression.

Share your experiences

Depression can often be alleviated by talking to other people who may have had similar experiences. Sharing difficult feelings with close friends or family members can sometimes help unburden a person suffering from depressive feelings and friends and family can offer emotional support to improve wellness. Having a talk with friends and those you trust can also give you the support you need to seek professional help and treatment. Sharing your feelings with an unbiased , trained therapist provides a healing outlet for depression.

Inform yourself

Knowledge is power and the more you know about depression, the better chance you will have to understand the thoughts and feelings that you may be experiencing. Being well-informed can reduce misconceptions, guilt and fear associated with depression. There is a wealth of information and resources about depression available online, from your doctor and from relevant charities and mental health organisations.

Exercise

Physical activity releases chemicals into the bloodstream that can help in the fight against depression, unhappiness and low mood. Completion of an exercise programme can result in a sense of personal achievement and self-care, both of which counteract some of the negative feelings associated with sadness and depression.

Regular exercise can also boost your mood if you have depression. The National Institute for Health and Care Excellence (NICE) recommends that people with mild to moderate depression take part in around three exercise sessions a week, lasting from 45 minutes to 1 hour, over 10 to 14 weeks. There are different types of activities that you can enjoy and do regularly, so find the right exercise for you so that you will keep to it. A regular exercise routine requires discipline and commitment and these may help reduce the scope and severity of depressive feelings.

Relax

Depression is often associated with stress and anxiety. Depression-related sleep problems can add to an overall sense of fatigue and weariness. Find ways to relax and improve wellness that work for you: yoga, meditation, walking, reading and listening to your favourite music are some suggestions.

Change your diet

Depression can affect appetite, both in the quantity and type of food consumed. Avoid high salt, high sugar and high fat foods. Concentrate on fruits and vegetables and reduce your intake of alcohol and highly sugared beverages. Fruit juice is a good alternative to these drinks. Some people choose to avoid caffeine and many people feel that omega-3 (found in fish oils) can be helpful in treating depression.

Contact us

We hope that this Depression Guide has given you useful information. For an appointment to discuss problems with depression, please use our booking form.

Sources

The Royal College of Psychiatrists, www.rcpsych.ac.uk/metalhealthinformation (2010)

Better or Worse: A Longitudinal Study of the Mental Health of Adults in Great Britain, National Statistics (2003)

Samaritans Information Resource Pack (2004)

The National Service Framework for Mental Health, Department of Health (2005)

www.depressionalliance.org

www.mind.org.uk

Word Health Organization (Accessed 23/06/2021)

The National Institute for Health and Care Excellence (NICE) (Accessed 23/06/2021)

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