Most people, children as well as adults, feel low or ‘blue’ occasionally. Feeling sad is a normal reaction to experiences that are stressful or upsetting. However, when these feelings go on and on, take over your usual self and interfere with your whole life, it can become an illness. This illness is called ‘depression’.
Around 1 in 10 people will experience clinical depression in their lifetime but the vast number of these sufferers will not receive treatment, either due to limited understanding that they may have depression or due to the stigma of being labelled with such a condition. The difference with depression is that those feelings persist and have no signs of going away on their own. If those feelings continue over the course of a few months then it is worth seeking professional support for this, reminding yourself that it is not a sign of weakness, just that circumstances may have become so overwhelming that resolving them on your own seems like too much of a mountain to climb.
The symptoms of depression, remembering that they should persist for a significant period of time, vary across age ranges but key signs to look out for in young people would be;
Some young people may also feel helpless or hopeless or may even have suicidal thoughts or possibly may be engaging in self-harming behaviour.
There is a very large evidence base that reflects the efficacy of Cognitive Behavioural Therapy (CBT) for the treatment of depression (NICE, UK) and that there certainly is help out there to reduce these symptoms and get you back onto the road of recovery.
CBT is a structured talking therapy that helps people to adjust their thinking styles and behaviour, altering the way they think about themselves, their life and their future, so that they feel like they are back to their normal selves. The evidence for CBT treatment depicts that there are some very useful strategies to improve your mood and reduce your symptoms. In CBT this is called Behavioural Activation (BA).
BA is about supporting someone to keep busy, distract themselves through activities and make sure that they are filling their time with more positive things. Not only does this help to stop those negative and intrusive thoughts from ruminating around your mind, but also helps you to engage and interact with others.
The research shows that many people with low mood or depression prefer to spend time on their own. Evidence shows that this is something that may maintain your depression, as changing that negative cycle of thoughts and behaviours is crucial to reducing your symptoms. So, spend less time on your own, get out of the house, engage in social activities, do some of the things you used to enjoy doing, exercise and plan some breathing exercises for when you are ready to go to sleep (most people with depression will encounter disturbed sleeping habits) and speak to a family member or close friend about how you’re feeling.
If you notice that your mood doesn’t change or that your symptoms persist, it is highly recommended that you seek professional help to overcome this.
In some circumstances, it may be recommended that you start a course of medication. This can be discussed with you by a prescribing clinician and you will have an opportunity to talk through any questions that you may have. Read more about how Camali Clinic deals with prescribing anti-depressants.
Generally speaking, medication would not be considered a first line treatment for depression and your doctor might recommend a therapy such as CBT in the first instance. In many cases, this may be enough to reduce your symptoms and overcome this difficult period, however, in severe depression your doctor may recommend medication alongside therapy.
If you are prescribed medication and not offered therapy with this, I would strongly recommend that you ask to be referred to a qualified therapist for this. All of the research show that therapy alongside medication for those severe cases is much more beneficial than just medication.
In many cases of depression, there is a high rate of comorbidity with anxiety. They often feed into each other and some people may experience the anxiety before any symptoms of depression, but then the depression appears to take over. It would be important to understand which condition came first and your therapist would be able to explore this with you.
Anxiety can be described as a difficulty in coping with life’s stresses and worries to the point that it all becomes too much and you feel unable to cope. You may experience symptoms of excessive worrying, fears and uncertainties about the future and present with the physical symptoms that come with anxiety; stomach pains, sweating, increased heart rate, shallow breathing, shakiness, dizziness, palpitations or fear that you may faint or pass out.
Often with anxiety, people feel that they have reduced coping skills and question why they are not able to deal with these difficulties, which can affect their self esteem and confidence, particularly over a prolonged period of time,and cause them to develop low mood or depression through negative thoughts about themselves and their ability to cope.
In cases such as this, seeking professional support is highly recommended and visiting your GP or a mental health clinic is a brave and courageous starting point.