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Depression
Am I depressed - or is it something else?
So, what is depression?
Why do people get depressed?
Changing behaviour
Changing negative thoughts
Where to seek help
Am I depressed or is it something else?
Our mood naturally varies over time and from day to day and everyone gets down sometimes. We may say that we are 'down', 'fed up', or 'feeling under the weather'; we may get disheartened about something that happens or when things don't go the way we would have liked. Although people often say 'I'm depressed' to mean these things, this would not usually be what is called clinical depression and is simply part of the normal ups and downs of life. Some people naturally experience frequent mood changes, while others have a relatively stable equilibrium.
Similarly, if we suffer a major loss, we readily understand that it is normal to grieve. Although some of the emotions we feel when we are bereaved appear similar to depression, grieving is a natural and ultimately healing process. Sometimes, though, past losses which were not fully mourned at the time may later resurface and present as depression much later.
So, what is depression?
Put simply, the distinction between feeling 'down' and being depressed is one of both degree and duration; i.e. low mood becomes problematic when it is frequent, persistent and begins to affect our work, relationships, social activities and self-esteem. Depression includes a persistent low mood and loss of interest or pleasure in life - it also commonly involves:
• a change in eating, weight and/or sleep patterns
• reduced energy levels and reduced physical activity
• impaired concentration
• negative thoughts and beliefs about self, others and the world
• avoiding other people and withdrawing into one's room
• feelings of worthlessness or hopelessness
• loss of interest, enthusiasm and enjoyment
• reduced sex drive
• feeling irritable and short-tempered, or tearful
• being unable to continue as usual with work and interests, maybe because you feel listless, or 'can't be bothered', or things feel pointless
• the future may seem bleak or hopeless, or feel that it just not worth going on, or think about suicide.
Please note that we may feel some of the above for reasons other than depression, or even several together for a brief while , without this being of major concern. Someone who is depressed will experience a number of these changes persisting for quite some time.
Nonetheless, depression is very common - it affects people of all ages and backgrounds and is one of the most common reasons for people seeking help from counsellors or doctors.
Why do people get depressed?
Often depression is a response to events or circumstances that are felt to be deeply troublesome or distressing, or which seem to threaten our personal identity. Usually these circumstances seem too hard or even impossible to change. There can be a sense of powerlessness, hopelessness and an all-pervasive gloom.
However, sometimes people seem to get depressed for no obvious reason. In these cases, it may be that something that hurt deeply some time ago (even years ago) begins to surface now. Although this is perplexing and just as distressing, this process is not uncommon. Sometimes, though, the onset of depression seems to be caused by nothing in particular and can be the result of chemical or hormonal changes affecting our body.
It is understandable to feel down for a while after something upsetting has happened, like the end of a relationship or feeling disappointed that you have not done as well as you would have liked. Usually this disappointment passes with time, and people find that they can come to terms with what has happened and start to look forward to the future in a more positive way. However, if the low mood is frequent or persists, or seems so severe that it affects your ability to function normally, it is time to seek out some help.
How to help yourself
There are some things you can try which have been shown to help lift a depressed mood. These involve changing your behaviour and challenging your negative thoughts .
Changing behaviour
People who are depressed often stop doing pleasurable activities which would make them feel better in the short term, for example they may stop going out, opt out of regular sporting activity, or stop going to see friends or to lectures. Encourage yourself to start doing things again - activity can lift your mood and you may well find that you can do things better than you imagine. If you usually enjoy going to the cinema or swimming, for example, try these things to start with. Any activity will be helpful, but enjoyable activities and physical exercise/sport are particularly effective. [The Counselling Service can arrange special membership of Fenners Fitness Suite with appropriate support from staff there to help you get started.]
• Break tasks down into steps or manageable 'chunks' and tackle these one at a time. Although it may not seem so to you, you will probably be able to do things just as well as when you are not depressed
• Start with easier tasks and then progress to more difficult ones: this will help you to regain your confidence
• Be realistic and allow yourself more time to do fewer things
• Allow yourself to feel pleasure at what you have achieved and reward yourself for each achievement
• It is very important to spend time with people who are supportive. Isolating yourself increases depression, while social support helps lift a low mood
• Find people with whom you can be honest about how you are feeling, and with whom you do not have to put on any pretence - but don't take up all their time.
Changing negative thoughts
There is a link between negative thoughts and emotional disturbance which can make us vulnerable to depression.
If you are not aware of any specific negative thoughts and are confused about why you are depressed, you may find it helpful to talk with someone. A trained counsellor can help you understand the depression and find the most effective and appropriate ways of dealing with what you are experiencing. There are different ways of challenging your thoughts. One way is to use a structured cognitive behavioural approach (such as described briefly here) which involves:
• becoming more aware of your negative thoughts
• recognising that your appraisal of situations may be biased or distorted due to depression
• learning how to challenge your own negative thoughts and beliefs so that they become more balanced.
Some examples are given below:
Situation: Getting critical feedback for an essay.
Negative thoughts: I am stupid.
Other explanations: I didn't have much time to do this essay - the workload has been very heavy recently. I chose to do other things as well. The work is supposed to be challenging. Constructive criticism helps me to improve. I've done well in the past - which shows I can do well.
Situation: My partner does not want to see me tonight.
Negative thoughts: They don't care about me any more.
Other explanations: They said they had to work tonight - this is most likely true. We saw each other at the weekend and had a good time. They said some nice things to me lately and seemed caring the last time we met.
Do not automatically believe your negative thoughts no matter how strong they feel at the time. By considering other explanations, your 'worst possible' conclusion will be seen as only one of a number of possible explanations for your situation. This allows you to consider each explanation and see which is most likely to be true, or to try to collect 'evidence' which will help you test the different explanations.
If you feel it is appropriate, try talking to other people to help you get a balanced perspective on which are the most likely explanations.
Where to seek help
- Talk to your doctor who can discuss the range of treatments available to you, including medication. Telephone Bailrigg Health Centre on 94130 to make an appointment.
- Come to the University Counselling Service to talk to one of the counsellors.
- If you feel really desperate and despairing out of normal working hours, telephone Cumbria Health on Call (the out-of-hours emergency service) on 0845 0524999.
- Telephone the Samaritans (local: 01524 61666 or national 0345 909090).
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