Dealing with depression in Essex

What is depression?

Depression is more than feeling sad or low.

We all experience feelings of sadness, anger, frustration, low self-esteem and worry in response to events in our lives. However, these usually lift after a few days or weeks at most. A low mood that persists longer than this can be a sign of clinical depression.

Clinical depression is a real illness with real symptoms – it is not something you can just “snap out of”. In its mildest form, long-term depression is general low spirits, that make it difficult for you to take a lot of joy or fulfilment out of experiences. In severe cases, depression can make you lose the will to live, making it a potentially life-threatening condition.

Dealing with depression can be a real struggle without the right support around you, and the longer it persists, the more difficult it is to break away from. There are several specific types of depression outside of a general feeling of sadness and low self-worth. These include: 

• Seasonal Affective Disorder (SAD) – a change in mood related to changes in season (low mood typically occurs during winter, but not in all cases)
• Dysthymia – also referred to as persistent depressive disorder or chronic depression, dysthymia is continuous mild depression lasting two years or longer
• Prenatal Depression – depression that takes place during pregnancy
• Postnatal Depression (PND) – depression that occurs in the weeks and months of becoming a parent

If you are struggling to cope with any of the specific types listed above, it is important to seek help for depression from your loved ones, GP or another qualified professional as soon as possible.

What does depression feel like?

Depression impacts people in different ways, so there is no hard and fast answer to what it feels like. For some, dealing with depression feels like battling an emptiness inside them,  finding it almost impossible to be filled with happiness or positivity. For others depression is more visceral and painful, linking to other conditions such as high stress or anxiety.

Many incorrectly assume that depression presents itself through crying, frowning or wearing dark clothing. In fact, severe depression is typically a state of emotional numbness and exhaustion. Depression is very much a real illness, but it’s not always visible. What appears to be a brave or smiling face could be someone who has lost themselves to uncontrollable negative feelings. 

If you would like to figure out more what depression feels like and if it relates to you, PSYCOM offers 10 slides of quotes from people living with depression on what it feels like to them. They could help you recognise if you are experiencing similar feelings.

There’s also an insightful video created by the World Health Organization entitled “I had a black dog, his name was depression”. This presents depression as a big black dog that follows us around wherever we go, making it challenging to find any enjoyment in life and our struggles to hide it from the world around us. Our therapists have used this to help those with severe depression understand the impact depression has on peoples’ lives.

How many people suffer from depression?

In the Office of National Statistics’ (ONS) study measuring national well-being (last published September 2018), approximately one in five people in the UK demonstrated evidence of having depression or anxiety. However, this number could be greater, as people don’t always make their feelings of depression known.

Globally, the WHO estimates that 300 million people are affected by depression, making it the leading cause of disability worldwide. Also, it noted that more women are affected by depression than men. Of course, everyone experiences depression differently, so it is important treatment is built around an individual’s specific feelings.

What is depression caused by?

There is no single cause for depression, and where it stems from varies from person to person. For some the cause is a single traumatic event, others a combination of several reasons, and in certain cases there presents no clear reason at all.

Many refer to depression as a “downward spiral”, where one sad event leads to another, combining to turn a low mood into sustained depression. But, as mentioned previously, there doesn’t necessarily need to be a clear cause for depression. Some of the most common causes include:

• Childhood Experiences
  Difficult experiences like abuse (physical, sexual or emotional), neglect, a frantic family environment, loss of a loved one or other traumatic events can lead to people becoming more vulnerable to depression in later life.
• Traumatic Life Events
  An unpleasant or unforeseen event, like a bereavement, the end of a relationship, loss of a job, being bullied/abused, or physical/sexual assault can trigger depression. Giving birth and early life as parents are also prevalent causes of depression.
• Other Mental Health Problems
  Depression is closely linked to other mental health difficulties, such as anxiety, stress and eating disorders. Having these pre-existing conditions can make you more likely to suffer depression.
• Chronic Illness/Pain
  Suffering from a chronic or life-threating illness can cause depression, as these might prove difficult to manage or stay positive through.
• Physical Conditions
  Numerous physiological conditions are linked to low mood and a greater likelihood of depression, including hormonal problems, menopause, low blood sugar and sleep problems.
• Genetics
  Although no clear genes for depression have been identified, research suggests that if a parent or close family member suffers from depression, you are more likely to deal with depression during your lifetime.
• Personality
  Different personality types are more likely to encounter depression, including those who have low self-esteem and those who are more introverted.
• Drugs, Alcohol & Medication
  Although they might initially mask the struggles caused by depression, drugs and alcohol can make you feel worse overall. The side effects of certain prescribed medicines can also cause depression.
• Poor Diet and Exercise
  An unbalanced diet, lack of exercise and poor sleep schedule can all impact your mood and ability to cope with difficult circumstances, resulting in a greater likelihood of depression.

As part of our courses for dealing with depression, determining the cause(s) of your depression is critical in developing techniques to manage feelings related to that source.

How to tell if you have depression

Like the causes, the symptoms of depression also vary from person to person. As a general rule, you would have a generally low mood, a feeling of hopelessness, and a lack of interest in the things that used to make you happy. It also depends on the severity of the depression – in milder cases, symptoms will be less frequent and impactful on everyday life, while severe depression can make it nearly impossible to do anything meaningful.

Below we’ve provided a list of common signs of depression, which may help you determine if you’re suffering with the condition. It’s unlikely you’ll have all these symptoms at one time.

What are the signs of depression?

• Do you feel down most days? Has this persisted for an extended period of time (2+ weeks)?
• Are you finding it hard to get any enjoyment out of things that used to make you happy?
• Do you feel socially awkward or isolated, particularly around friends or loved ones?
• Do you feel helpless or lacking hope?
• Do you feel useless or inadequate? Are you talking down to yourself?
• Have you lost confidence?
• Do you feel empty or numb?
• Do you often feel tired or without energy?
• Is it a struggle to concentrate on everyday things like watching TV?
• Are you often restless, agitated or irritable?
• Do you have a sense of unreality?
• Are you having difficulties sleeping (too little or too much)? Do you struggle to find motivation to get out of bed?
• Are you finding it hard to function at school/work/home?
• Have you lost interest in sex?
• Have you experienced any changes in your menstrual cycle?
• Are you suffering from constipation?
• Do you find it difficult to think or speak clearly?
• Are you moving or speaking more slowly than usual?
• Are you comfort eating or lacking any appetite?
• Are you using more tobacco, alcohol or drugs than usual?
• Have you experienced any physical aches or pains without an obvious cause?
• Have you experienced any delusions or hallucinations?
• Are you having suicidal thoughts or thoughts of harming yourself?

If you notice you demonstrate some or many of these signs, it is recommended to speak to your GP or a qualified therapist to discuss your symptoms and receive help for your depression.

Why does depression make you tired?

As depression can make you feel drained of all energy, it is a significant cause of day-to-day fatigue. Depression is also linked to other symptoms that result in tiredness, including sleep problems, restlessness, high stress levels and poor diet.

How long can depression last?

Depending on your lifestyle choices and whether you seek treatment or alternative support, depression can last for weeks, months, or even years at a time. Depressive episodes can be a reoccurring factor in a person’s life for several years, especially if they do not pursue self-help, therapy, medication or another form of professional support.

For some, depression isn’t something that doesn’t ever go away, but is something they learn to manage and cope with, whether it is through beneficial techniques, medication or speaking to someone. Living with depression is nothing to be ashamed of, and by taking the right approaches, it can be managed effectively to minimise the hold it has on your life.

How to combat depression

At its worst, depression can make it impossible to find joy in anything that used to make you happy, and cause you to lose sense of what makes life worth living. If and when this happens, there are several things you can do to help manage the symptoms of depression, minimising the impact it has on your everyday routine.

Realistically, “combatting depression” is probably the wrong term to use here. Supressing or fighting the thoughts and emotions behind your depression can be unconstructive, and actually give them a stronger hold over your emotional well-being.

Of course, if you feel unable to cope with these negative feelings, or are struggling to understand the causes behind how you’re feeling, seeking therapy for depression is an effective solution. We will cover this more in the “How to treat depression” section. For now, we’ve listed five immediate steps you can take to try and lessen how much depression impacts your life:

Stay Social
Isolation leaves you alone with depressive thoughts, making it difficult to take your mind off them. Staying connected with your family and close friends helps with depression, and gives you someone to talk to when you’re at your lowest. You don’t necessarily need to talk about your feelings (although in most cases this does help), but just having a general conversation and interacting can help take your mind off your negative feelings.

Healthy Diet
Some lose their appetite completely when they are depressed, while others find comfort in eating. Both result in an unhealthy diet, which allows depression to survive and thrive. To help reduce the impact of these feelings, a balanced consistent diet is incredibly useful.

In particular, the following six foods are tipped to help improve symptoms of depression:

• Turkey – due to its tryptophan levels, turkey helps boost serotonin production, a chemical that naturally helps your body feel better
• Walnuts – one of the richest sources of Omega-3, walnuts support your brain’s health
• Tuna – speaking of Omega-3 acids, tuna and other fatty fishes offer the same support to the mind and body
• Yogurt – as a food rich in calcium, protein and Vitamin D, yogurt and other low-fat dairy products can induce a sense of well-being and relaxation
• Green tea – the theanine found in tea leaves (as well as certain mushrooms) provides anti-stress benefits to drinkers, helping to combat depression
• Dark chocolate – in moderated doses, dark chocolate also releases serotonin to make your body feel happier (and it’s a nice occasional treat!)

Please consult with your doctor or dietician about potential improvements to your diet that can have a positive impact on your mood.

Light Exercise
Does exercise help with depression? Or is it just something people say?

Exercise can be an effective treatment in itself for depression. This is outlined by NICE (The National Institution for Health and Care Excellence) in their recommended treatments for mild and moderate depression. To prove effective, this exercise needs to be intense and regular, but with this dedication, exercise can prove as effective as medication.

Aim for a minimum of 150 minutes of activity a week in whatever form suits you and your lifestyle best. Outdoors or indoors, in a team or individually, establish a pattern that suits you and stick to it as best you can.

Improve Your Sleep
When people are coping with depression or generally feeling low, it is easy to fall into bad sleeping habits, most notably staying up late and sleeping during the day. If this is a struggle for you, try to pick the same time at night to get in bed and to wake up in the morning, as this routine will help you feel more energized during the day. In addition, avoid spending too much time in and around your bed – establish that it is there for sleep.

Face Your Fears
Feeling low or depressed can result in avoiding situations that cause feelings of anxiousness, such as social situations. If you notice this happening to you, facing up to these situations early ensures you avoid falling into repeated bad habits, and gives you a welcome sense of accomplishment at a difficult time.

Try the NHS’s tips on overcoming fears for more information to help you manage depression.

How to deal with depression alone

Dealing with depression alone is not easy, and might mean you don’t get that push towards specialist support from your loved ones. But, you might not feel comfortable speaking to someone yet about the problems you are facing.

Before seeking professional help with depression in the form of therapy or medication, you might want to attempt a few self-help techniques. If you are persistently feeling low and depressed, it’s important to engage external support as soon as possible. However, with mild or moderate depression, self-help tips can make a noticeable difference to your mood.

Establish a Routine
Our first self-help tip for depression is to work on establishing a routine. Not having regular patterns for eating, sleeping or doing important tasks can leave you feeling disorganised and stressed, which could cause further depression. By simply writing to-do lists or creating a weekly calendar, you make every day more manageable and set times for self-care and relaxation.

Keep a Mood Diary
Tracking how your mood changes and evolves over time can help you determine if your depression is getting better or worse, as well as at what times and in what situations you struggle most. Collecting this data helps you deal with depression by giving you guidance on your unique triggers, and a platform to start challenging unhelpful thoughts.

Read Books or Listen to Music
Depression can result in a noticeable drop in concentration levels. By devoting time to read or listening to music, you can improve your concentration through the words and sounds, as well as improve your mood.

Set Realistic Goals
Completing achievable goals on a regular basis can help you feel more accomplished and fulfilled, rather than focusing on negatives in your life. These don’t have to be huge tasks, it can be as straightforward as having a shower, calling a friend or cooking a meal. Reaching these small goals can give you little boosts of self-confidence and happiness, motivating you onto bigger challenges.

Be Kind to Yourself
Remember that nobody is perfect, and if you miss one of your goals or make a mistake, it isn’t the end of the world. Being kind and fair to yourself is at the heart of much self-help for depression. Treat yourself as you’d treat a friend, focus on things that help make you happy, and reward yourself when you do something positive (while avoiding beating yourself up if you don’t).

Join a Peer Group
When you’re dealing with depression alone, it can be an isolating experience. You might feel you’re the only person in the world that feels this down. Joining a peer support group introduces you to others that are going through similar issues, allowing you to share tips and stories to support how you manage your depression.

How to help someone with depression

The support of loved ones can play a big role in a person’s recovery from depression. Just having someone understanding to talk to can do the world of good when dealing with depression. And, even if your friend, family member or other acquaintance does not want to discuss their problems yet, if you notice them displaying symptoms, there are ways to help them cope with depression without drawing attention to it.

Ways to help someone with depression

• Let them know you’re there to listen whenever they have something on their mind, even if they don’t feel like talking right now. Remember to stay open-minded and non-judgmental.
• Make the extra effort to stay in touch with them, as they may not have the energy or motivation to keep in contact with you.
• Gently encourage them to try some self-help techniques to manage their depression, and even join them if possible to keep them company.
• Don’t be critical over their condition, as this can put them under too much pressure to change immediately, or feel guilty for how they’re affecting others.
• Don’t act like there’s a deadline for depression or that you need to be responsible for finding the solution – they will feel better with the right support in time.
• Be sure to take care of yourself as well, as supporting another person could put significant strain on your own well-being.
• Finally, get information about the professional services that are available to treat their depression, such as therapy, support groups or medication.

How to treat depression

There are numerous different treatments for depression that can help manage your conditions. What treatment is best for you will depend on how severely symptoms are affecting you and your own personal preferences. But with a range of options available, you will almost certainly be able to find an effective treatment for your depression.

Depression Therapy
One of the most common and effective treatments for depression is therapy. This is where you speak to a doctor or qualified therapist about the various problems and feelings you have been experiencing in a secure, confidential environment. Our team at Therapy For You work with many people suffering from depression to different degrees, using therapy to develop techniques to face their problems and manage their mood.

Depression therapy can take several forms:

Cognitive Behavioural Therapy (CBT)
CBT helps you overcome depression by approaching your thoughts and feelings and determine the effects they’re having on you. The main focus of these sessions is to change thought patterns and introduce methods to alter your thinking and behaviours for the better.

Computerised CBT (CCBT)
Rather than working one-on-one with a qualified therapist, this form of CBT for depression is completed with a computer.

Counselling
Best for mild or short-term bouts of depression, counselling offers practical advice and support for steps to improve your condition and tackle the issues you are facing in your life. There are a number of different types of counselling therapies recommended for depression:

• Interpersonal Therapy (IPT)
  Interpersonal Therapy is an acute and a maintenance therapy, delivered over as few as eight sessions. It has psychodynamic origins, meaning the study of the psychological forces that underlie human behavior, feelings, and emotions, but is explicitly biopsychosocial approach to treating depression. This considers the biological, psychological and social factors in causing depression. IPT is evidence-based and is recommended as a first-line intervention in the NICE guidance.

• Dynamic Interpersonal Therapy (DIT)
  Dynamic Interpersonal Therapy is a brief form of psychodynamic psychotherapy developed for the treatment of mood disorders, spread over around 16 sessions on average. This provides a safe space for people to talk about difficult past experiences that they may not remember consciously, but are causing the negative feelings associated with depression and other disorders.

  Currently DIT will be rolled out within IAPT (Improving Access to Psychological Therapies) services as the psychodynamic model to treat depression. While IAPT follows NICE guidelines, DIT itself isn’t part of NICE at this moment in time. However, it is currently undergoing evaluation to be included in the NICE guidelines.

Counselling for Depression
Counselling for depression is a manualised form of psychological therapy recommended by NICE to treat depression. It best fits for people that have minor depressive symptoms or mild/moderate chronic depression, offering support over 6-10 sessions across a period of 8-12 weeks.

This form of counselling targets the emotional problems behind a person’s depression as well as the internal thoughts that often maintain this mood (e.g. self-criticism). This helps patients approach and understand their underlying feelings and reflect on the new meanings that emerge.

These types of counselling are delivered appropriately by our trained team at Therapy For You.

Medication for Depression
Alongside therapy for depression, medication is another common treatment for this condition. Typically, medication for depression takes the form of antidepressants, which you might be offered separately or in conjunction with talking therapies.

If you’d like to learn about the different kinds of medication for depression, Mind has created an A-Z list of antidepressants that are licensed in the UK. Remember to consult with your GP about whether they feel medication is the right course of action for you.

Alternative Depression Treatments
While therapy and medication are the most common treatments for dealing with depression, should these prove ineffective, there are a number of lesser-used alternatives:

• Watchful Waiting – keeping a close eye on your mood, and waiting to see if this changes after a couple of weeks.
• Guided Self-Help – working with professionals to apply techniques on your own time.
• Physical Activity – using exercise and other activities to treat depression.
• St John’s Wort – a herbal treatment has been noted to help in cases of mild or moderate depression (please seek advice from your GP before taking anything).
• Mindfulness – being mindful of your various thoughts and feelings.
• Peer Support – speaking about your problems with others facing similar difficulties.

GPs will usually only prescribe these alternatives if your depression hasn’t responded to therapy or medication.

Specialist Depression Treatments
If neither talking therapies, medication nor alternatives help alleviate the symptoms of your depression, your GP might refer you to a mental health specialist, most likely a member of your community mental health team (CMHT) also known as Recovery and Wellbeing Teams.

The specialists you talk to may include:

• Psychiatrists
• Clinical Psychologists
• Occupational Therapists
• Community Psychiatric Nurses
• Social Workers

These individuals will reassess your condition, speak to you about the causes of your depression and devise a treatment plan to manage your symptoms.

Your GP will be able to give you guidance on what treatment makes most sense to you and refer you to the relevant professionals.  Or you will be able to discuss this with your therapist at the point of assessment.

Suicidal Thoughts & Self-Harm
If your feelings of depression have led to suicidal thoughts or self-harm, visit our crisis page or contact your GP for an emergency appointment, or contact several other organisations that can give you quick support and treatment.

• Samaritans – 116 123
• NHS – 111
• Contact your local crisis team (CHRT)

How to get help with depression

Once you realise you are dealing with depression, it is important to seek help straight away. Often the earlier you seek support, the easier it is to prevent these feelings from becoming too severe and having a significant impact on your life and the lives of those around you.

Hopefully, this page has provided insight into the causes and symptoms of depression, as well as various tips and treatments that can help you overcome this condition. We all suffer from low mood and sadness in our lives, but if they sustain, they can prove life-altering and, in some cases, life-threatening.

At Therapy For You, our CBT and online psychoeducational courses have helped many suffering from depression and other mental health concerns in Essex. These can help you understand the unique causes and triggers behind your depression, and develop a personal plan of action to managing and reducing the impact this has on your happiness and overall well-being.

To find out more about our depression courses, get in touch to book a telephone assessment with one of our qualified therapists.