Mental Illness Fellowship Victoria. (n.d.). Factsheet – Understanding depression. http://www.mifellowship.org/sites/default/files/styles/Fact%20Sheets/UDepression.pdf
Most people experience lows throughout their life. However, we are talking here about a depression that is not just a low mood but a persistent low mood with physical and psychological symptoms.
The expression ‘clinical depression’ describes a group of illnesses that are characterised by an excessive or long-term depressed mood that affects the person’s life. Depression is often associated with anxiety.
Depression is often not recognised and, as a consequence, left untreated.
Depression has been described medically in many ways over time. Recent explanations of reactive (triggered by a stressful event) and endogenous (not seen to have any obvious trigger) are less popular at the moment. It is now more commonly described in terms of severity or degree - a judgment made on a number, type and severity of symptoms present.
Mild depression – decreases interest in things that were once pleasurable, reduces motivation, and increases irritability. Work or usual life activity is not necessarily interrupted and the depression often goes undiagnosed because it does not cause a crisis which must be attended. People experiencing this degree of depression will often reduce stressful issues in their life to relieve the depression. If ignored however, mild depression may develop further.
Moderate depression – decreases pleasure in life even further, hence the impact on life is greater. Motivation becomes a real issue and important aspects of life and relationships may be neglected causing further problems and isolation. Untreated at this point, depression can exacerbate into severe depression.
Severe or major depression – severely interferes with life. A person with this severity of depression will experience low self esteem, distress, feelings of uselessness, sleep disturbance, appetite change, suicidality, and loss of libido as well as other unique features. In some cases, major depression may develop psychotic features.
Often there are many interrelated factors associated with depression including inherited disposition, a chemical imbalance in the brain, life stresses, past bad experiences and personality. Medical illness, drugs and alcohol can also play a part.
People experiencing feelings of sadness which have persisted for a long time should firstly contact their family doctor or community health centre. Treatment depends on each person’s symptoms. The options may include:
- psychological interventions and general supportive talking therapies so that the person can understand their thoughts and behaviours and sort out practical problems and conflicts
- anti-depressant medications to relieve depressed feelings, restore normal sleep patterns and appetite and reduce anxiety
- hospitalisation, where safety of the person, monitoring of psychotic symptoms, monitoring of any physical illnesses and substance use issues and monitoring of medications can be carried out
- for some severe forms of depression, electroconvulsive therapy (ECT) is a safe and effective treatment. It may be life saving for people at a high risk of suicide or who, because of the severity of their illness, have stopped eating and drinking and will die as a result.
The recovery phase involves responding to the broader range of issues that impact on people who are susceptible to depression, including examining actual stress levels and the person’s ability to deal with stress. Cognitive Behavioural Therapy (CBT) is the talking therapy of choice for recovery from depression. Being involved in experiences that create a sense of achievement is another important aspect to recovery. Learning new communication techniques can create a sense of achievement and improve relationships. Sometimes medication will need to be ongoing and there may be maintenance doses of ECT administered.
Insight into the Experience of Depression
Symptom | Associated behaviour Remember, these behaviours are out of keeping with the person’s normal value system | Helpful interventions |
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Depressed mood, loss of interest or pleasure in nearly all activities |
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Inability to concentrate |
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Suicidal ideation |
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Decreased energy, tiredness and fatigue |
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Sense of worthlessness or guilt |
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Changes in appetite |
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Reduction in libido |
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In addition to the specific interventions previously mentioned, there are many things friends and family can do to help.
Always remember that depression is a medical condition that requires medical treatment. Just as you cannot stop a person’s leg bleeding by talking to them, you cannot stop depression without medical intervention. Treatment is effective.
Find out as much about the condition as you can. Knowledge is power and gives you a much better chance of developing good coping strategies.
Be patient. People experiencing depression need to come to some insight regarding their illness. This is not always easy and takes time.
Know what to expect of the mental health system and be prepared to be assertive in seeking appropriate care.
Link in with community organisations that offer supports and services that complement the mental health service system. They often provide educational programs, counselling and local support groups.
Remember to stay healthy yourself. Do not underestimate the impact of the illness on you. Depression often involves trauma and grief and has an impact on whole families. Be prepared to seek support to develop strategies that keep you well.
Depressionet
www.depressionet.com.au
Mental Illness Fellowship Victoria www.mifellowship.org
Mental Health Services Website (Vic)
www.health.vic.gov.au/mentalhealth
National Alliance of the Mentally Ill (NAMI) (USA)
www.nami.org
Mental Health Council of Australia
www.mhca.com.au
SANE Australia
www.sane.org
Beyond Blue
www.beyondblue.org.au