Understanding Depression And How to Help
WHAT IS DEPRESSION
Depression is a type of mood disorder. This is where you have a long period of low mood and joyfulness, which negatively impacts your daily life.
It also means severe despondency and dejection, accompanied by feelings of hopelessness and inadequacy and is a condition of mental disturbance, typically with lack of energy and difficulty in maintaining concentration or interest in life.
There are different forms of depression such as clinical, psychotic, dysthymia, post-natal, manic and SAD (seasonal affective disorder).
THE DIFFERENCE between feeling low and clinical depression
Feeling depressed is freely used by people when they are feeling a bit low or unhappy and the term can be used inaccurately.
Depression is a clinical term and to be depressed requires some symptoms to be present for most of the day or over a period of time.
common symptoms of depression
Some of the symptoms of depression include:
Lasting sad, anxious or empty mood, feelings of hopelessness or pessimism, feelings of guilt, worthlessness, or helplessness. Loss of interest or pleasure in activities once enjoyed, including sex. Decreased energy/feelings of fatigue.
Difficulty concentrating, remembering, making decisions. Restlessness or irritability. Sleeping too much, or difficulty in sleeping. Change in appetite and/or weight loss or weight gain. In severe depression, there may be suicidal thoughts.
three possible causes of depression
Biological factors – Depression can sometimes be linked to hormonal changes. Hormones directly affect the brain chemistry that controls emotions and mood.
Women experience depression twice as often as men, and the things that contribute to it are things like the menstrual cycle, pregnancy, miscarriage, post-natal period, pre-menopause and menopause.
There is also a cause of brain function changes, and those suffering from depression are believed to have an imbalance of neurotransmitters.
Social factors– Neighbourhood conflict and poor social networks may mean that a person feels isolated and alone.
Difficulties in our relationships with others can be tremendously stressful and strongly influence our vulnerability to depression.
Historical factors – Things that have happened to us in the past can have an influence on us and vulnerable to depression years later.
For example, people that have had difficult childhood experiences such as physical abuse, sexual abuse, neglect, over-strictness etc., are more prone to depression.
five examples of how depression may affect the individual and their life
Loss of interest in life and things the person used to enjoy – Low mood, low levels of self-motivation and reduced energy often mean that people stop doing the things that they once enjoyed.
Some people say that during their depression they feel numb and incapable of feeling pleasure.
Not doing small duties – Procrastination and neglect of small duties is a sign of depression such as running errands, taking out rubbish, cleaning the house or mowing the grass.
Not doing these chores adds to the personal sense of inadequacy and lack of control over their life and can create friction with others.
Self-neglect – A depressed person may take less care in personal grooming or appearance than usual. In addition exercise is often reduced such as simply walking to the shops.
It also disrupts eating habits and for some this may mean forgetting to eat related to lack of appetite and for others overeating as a means of self-comfort.
Restlessness– Physical changes in depression often include tension, stress and anxiety. People often feel tense and agitated and spend time in restless pacing and worrying.
Avoidance of others – Some people put a lot of effort into hiding their feelings from others. As a consequence other people even those you know may not realise how they are feeling.
Feeling depressed can cause some people to feel unusually anxious about mixing with others, and some feel that they cannot face the world and isolate themselves from others.
how a person’s depression may affect their friends and family
Family and friends can feel helpless when their attempts to help are rejected. Many say they struggle with what to say and what not to say to the person.
Many relatives and friends themselves become despondent at not being able to help the person they care for when a person’s depression gets worse.
If someone does not understand depression and does not understand what the person is going through, they can become angry and frustrated.
Relationships can become strained, sometimes where others actively avoid having anything to do with the person.
daily life that may contribute towards maintaining depression
Community problems and home life – Our communities can either help or worsen or prolong the symptoms of mental distress. Crime, neighbourhood violence etc can contribute to feelings of despair and hopelessness.
Domestic responsibilities and situation – For some, life can seem mundane, and the day-to-day routines of cooking, cleaning and shopping can compound the personal feelings of worthlessness. For others, it is their domestic living conditions that maintain their low mood – a chaotic household, for, eg.
examples of local sources of support that should be available to an individual experiencing depression.
The person’s first point of call is their local GP. They will attempt to rule out any physical illness which may cause symptoms of depression. If they suspect mild depression, they will refer them to some form of talking therapy.
Support groups can play an important role in supporting the person and their carers to obtain information and share experiences.
four treatments that are used to treat depression
Tricyclics (TCAs) are an older antidepressant and more sedative than SSRIs. They have more side-effects such as dry mouth, constipation and blurred vision. However these are effective antidepressants and suit some people well.
Selective Serotonin Reuptake Inhibitors (SSRIs) are a group of drugs that make the feel good chemical serotonin stay around in the brain for longer and these are likely to be chosen by a person’s GP. The best know ones are fluoxetine, citalopram and paroxetine.
There are side-effects such as nausea, headaches and restlessness.
Electroconvulsive therapy (ECT) is usually given to people with severe depression which has not responded to other forms of treatment such as antidepressants. However, it is sometimes used for those with a diagnosis of bipolar disorder or schizophrenia.
Cognitive behavior therapy is the preferred option for most cases of depression. This is a short-term talking treatment which teaches people to change unhelpful aspects of how they think and what they do.
HELP FOR depression
Exercise is believed to increase the release of the brain chemicals (endorphins) that affect our mood and makes us feel happier. It helps us get active and meet new people, stopping us from being isolated and unsupported. Exercise can give us new goals and a sense of purpose.
Relaxation techniques can provide a break from tension, stress and anxiety. Breathing techniques can help relax a person. Some prefer yoga, having a bath or just reading a magazine. A body massage is good for releasing tension.
Avoiding alcohol or drugs can help manage depression, as using them can worsen the symptom. They also make anti-depressants less effective and can cause more side effects.
three factors or characteristics specifically associated with psychotic depression
Psychotic depression is characterised by hallucinations ( seeing, hearing, smelling, or feeling things that are not really there) or delusions (thoughts and fears that are untrue or have no real basis).
Paranoid delusions or delusions of guilt are the most common psychotic symptoms in psychotic depression.
Paranoid delusions are when people often have concerns about paying special attention to them or persecuting them.
People with delusional guilt may believe they are punished for past misdeeds or are responsible for problems they are not responsible for.
Auditory hallucinations – voices or sounds are the most common hallucinations seen psychotic depression.
Psychotic depression is associated with high levels in the blood of a hormone called cortisol. It is an important steroid hormone produced by the adrenal glands.
More cortisol is released during times of stress, and it is believed that psychotic depression is linked to excessive stress levels.
These people have a greater suicide risk than people with non-psychotic depression. Other symptoms include agitation, difficulty falling asleep and frequent waking in the night.
resources and treatment required to manage a person with psychotic depression
Referral to specialist mental health services – crisis resolution and home treatment teams are two specialist mental health services that are intended to support people during a mental health crisis and to prevents matters getting worse.
The person should receive a comprehensive mental health assessment, including a risk assessment.
Medication – Antidepressant and antipsychotic medication may be prescribed. Medication will usually be ordered in combination with a talking therapy.
Hospitalisation– inpatient treatment may be the best option for people that are significant risk of suicide, self-harm or self-neglect. Hospitalisation should be accompanied by high-quality therapy.
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