DEPRESSION

What is depression?

Most people feel ‘low’ for from time to time. Feeling low or sad is a normal reaction to experiences that are stressful, upsetting or difficult to come to terms with. Depression is more than just feeling down – it effects not only how you feel, but also how you think about things, your energy levels, concentration and sleep patterns.

What are the signs of depression?

	Being moody and irritable – easily upset, ‘ratty’ or tearful.
	Becoming withdrawn – avoiding friends family and regular activities.
	Feeling guilty or bad, being self-critical and self-blaming – hating yourself.
	Feeling unhappy, miserable and lonely a lot of the time.
	Feeling anxious and vulnerable.
	Feeling hopeless and wanting to die.
	Difficulty concentrating.
	Not looking after your personal appearance.
	Difficulty getting off to sleep or waking very early.
	Tiredness and lack of energy.
	Lack of motivation and loss of interest in everyday activities.
	Frequent minor health problems such as headaches or stomach-aches.

Effects of depression.

Because depression affects so many aspects of life – your outlook, how you feel, what you are able to do – this can make it hard for you to cope with ordinary daily life as well as usual. For example, depression can cause

	difficulties getting on with friends and family.
	loss of friends.
	loss of confidence, difficulty making decisions.
	loss of self-esteem
	inability to study, work and do well in exams.
	difficulty getting up in the morning and facing the day.
	difficulty doing everyday activities and activities which were previously enjoyable.
	eating problems – turning to food for comfort and eating too much, or just losing interest in food.

Depression changes thinking. When we are depressed, we tend to dwell much more on negative thoughts, experiences and memories. We tend to have distorted, negative views of ourselves (e.g. ‘I’m useless’), of current experience (e.g. ‘nothing I do turns out right’) and the future (‘things will never get better’).

What can help?

Just as there is no one thing that is depression, there is no one ‘treatment’. However there are several things you can do to help.

Activity scheduling.

When you are depressed, you tend to be more passive and less active. Depressed people tend to stop doing pleasurable activities. As a first step towards treating depression it is helpful to increase activity, especially pleasurable activity or those activities that lead to a sense of accomplishment.

It may be useful to track your activities, recording what you do and rating how much you enjoy it. This way you can see how different activities effect your mood. You can then start to schedule in more of the activities you find pleasurable- for example talking to a friend, listening to music, swimming, taking a walk, playing a computer game or watching your favourite TV show.

Evidence suggests that for mild to moderate depression, exercise is beneficial. This is because it produces certain chemicals in the brain, and in addition to this it can give a sense of achievement, which can increase self-esteem. So when scheduling activities, try to include some exercise such as going for a walk, swimming, a game of football or an aerobics class.

Graded tasks.

When you are depressed, it is common to have difficulty concentrating on things. This may make things which before seemed quite simple, a daunting task. In order to maximise your chance of achieving success at such activities; it is useful to break tasks down into small, manageable steps. Think what exactly you have to do to complete the activity.

After each step, give yourself some praise- you are now one step closer to achieving your ultimate goal!

Relaxation.

Often being depressed disrupts sleeping patterns. You may find it difficult to get to sleep, or may wake up easily once you are asleep, and then find yourself even more tired during the day. Lying in bed at night, it is very easy to start thinking about things, thinking negative thoughts and becoming more depressed.

To help you sleep better, it is often helpful to establish an evening routine. For example if you intend to go to bed at 9:30pm, you could have a hot bath at 8:30pm, perhaps with some relaxing aromatherapy oils, then have a hot, milky drink at 9:00pm and listen to some relaxing music. Try to avoid stimulants such as coffee, tea, alcohol etc. for a few hours before your intended bedtime.

You can learn relaxation techniques, which may help you, sleep more easily. A simple relaxation is as follows:

	sit in a comfortable position with your eyes closed. Imagine your body growing heavier and more relaxed.
	breathe in deeply through your nose, filling your lungs completely, and become aware of your breathing as you inhale. As you breathe out, it might be helpful to think of a sound or word you find relaxing, for example the word ‘calm’ or the sound of the sea, or to picture a scene you find relaxing, such as a deserted beach or a quiet country spot.
	don’t worry whether or not you are good at the exercise, simply let go of your tensions and relax at your own pace. Distracting thoughts will probably come into your mind, don’t worry about this or dwell on them, simply return to your mental image or your breathing pattern.
	you can keep this going for as long as it takes to feel relaxed. This might be 2 minutes or 20 minutes- the most important thing is to make sure you feel relaxed at the end of the session. When you have finished, sit with your eyes shut for a few minutes, don’t stand up or begin moving too quickly.

An alternative relaxation technique is to use progressive muscular relaxation.

Getting Help.

If you have tried the suggestions given in the fact sheet and you still feel very depressed, it may be necessary to get help from someone else. Your family doctor or practice nurse may be able to help, or they may suggest that you see someone from the child and adolescent mental health service. This includes child and adolescent psychiatrists, clinical psychologists, social workers and specialist nurses.

DEPRESSION

[information for professionals][information for young people]