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Understanding Depression

Depression, Anxiety and Stress were the main reasons that 11 million people in the UK took time off work last year. You may have a colleague or a loved one who struggles with Depression, you may be experiencing it yourself, perhaps unknowingly but...

What exactly is Depression?

Depression is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself and the way you view things. A depressive disorder is not a sign of personal weakness or a condition that can be wished away. People who are depressed cannot merely "pull themselves together" and get better.

Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from Depression. The symptoms may vary from person to person, they also depend on the severity. Depression causes changes in thinking, feeling, behaviour and physical well-being.

What causes Depression?
There is no single cause of Depression, it can occur for a variety of reasons and it has many different triggers. Some of the most common causes include a stressful event eg. bereavement, redundancy, relationship breakup, financial worries. Some other causes of depression are loneliness, family history, illness, giving birth, addictions and if you have low self-esteem.

Signs and Symptoms of Depression

• Sadness or 'empty' feelings.
• Anxiety.
• Decreased energy, fatigue, being 'slowed down'.
• Loss of interest or pleasure in activities that were once enjoyed, hobbies, sex and intimacy etc.
• Insomnia, oversleeping or waking much earlier than usual.
• Loss of weight or appetite, or overeating and weight gain.
• Feelings of hopelessness and pessimism.
• Feelings of helplessness, guilt and worthlessness.
• Thoughts of death or suicide or suicide attempts.
• Difficulty concentrating, making decisions or remembering.
• Restlessness, irritability or excessive crying.
• Chronic aches and pains or physical problems that do not respond to treatment.

Depressed people may often have thoughts like:
• 'I am a failure'
• 'I can't do anything right'
• 'I will never accomplish my goal'
• 'No one cares about me'
• 'This situation will never end'
• 'Things will never be right for me'

Depression isn't always visible, at times you may:
• Make jokes so others feel the joy you're unable to feel.
• Text "I'm fine" while your eyes are full of tears.
• Give motivational speeches to others yet you feel totally lost in the world.
• Go to work and fulfil your obligations but fall apart when you get back home.
• Be the life of the party even though you feel empty inside.
• Keep conversations surface level because anything deeper could lead to you breaking down.
• Look over old photos and grieve for the "life that was" before Depression.
• Neglect hygiene for days or even weeks at a time e.g. showering, changing clothes etc.
• Practice saying "I'm ok" and faking a smile in front of a mirror before a social event.
• Leave the TV on all night to drown out any negative thoughts that surface.
• Put on extra makeup on your "bad days" to almost kid yourself and others that things are ok.
• Work late nights to distract yourself from your suffering.
• Sleeping a lot to pass time.
• Dread facing the day because you do not have the motivation to be productive.
• Fear the night because your thoughts of inadequacy will keep you awake.
• Wait until your neighbours are not in sight because you lack energy to have small talk and don't want to be "seen".
• Be genuinely happy for your loved ones, who are excelling and making the most of life, but you feel a void and emptiness each time you attend a wedding or hear about a birth, a promotion or proposal.

10 reasons to open up about your Depression
1. So you can receive the support you deserve.
2. To hear a voice you trust when you feel consumed by negative thoughts.
3. So you can release bottled up emotions that need to be moved through.
4. To feel less alone in your battle with Depression.
5. To minimise conflict and guilt - for example, instead of others thinking that you socially withdraw because you don't care about them (which may make you feel guilty, even though it's not your fault), they can recognise it's to actually cope with your symptoms.
6. To deepen your connection with others by being vulnerable and showing more of yourself.
7. To decrease the shame and stigma surrounding depression and inspire others to open up.
8. To get a friend, family member or professional perspective on your struggle (someone you can trust)
9. Because you wouldn't want your loved ones to suffer in silence either, you'd want to be there for them.
10. To help distract you from painful intrusive thoughts.

How can I support someone who suffers from Depression?

It can be very hard to watch someone you love and care for experience the struggles of Depression. Knowing what to do and say can be a task as we don't want to upset them or make symptoms worse. The following tips may help add a bit of light to a Depression sufferer's darkest moments.

10 Tips for supporting someone with Depression
1. When they seem distant, don't take this personally. It doesn't mean they've "checked out" or they've stopped caring, it might mean their symptoms have taken over during this period.
2. Remind them how much you love and care for them regularly. Living with Depression is like living with a bully in your mind that constantly tells you you're worthless and a burden. Reassurance can help decrease one's attachment to these negative thoughts.
3. Don't force arranging activities or meeting up when their symptoms have set in. Often, when Depression strikes, being in a "controlled" or "safe" environment is essential. Most often this is one's own home.
4. Be patient with them. Depression doesn't disappear overnight, just because one has "good days" doesn't mean it has disappeared.
5. Ask and learn about their triggers. This can be challenging but once you know them you'll be more able to work together against the triggers.
6. If they break down over something that you think is "small", acknowledge that it may be big to them. Consider that they may also be "Depression tired". This isn't just being physically tired but also mentally, emotionally and spiritually tired. Fighting Depression drains you of your energy.
7. Don't try to "fix" them. Supporting them is great but healing is complex and takes time. When appropriate encourage seeing a counsellor or therapist but don't take on this role yourself.
8. Recognise that “numbness" is a key symptom of Depression, this means they may struggle to engage with things, be unresponsive at times and unable to get joy out of things. So if they don't appear uplifted by a gift you've given them this doesn't mean they don't appreciate it, it just means Depression is making it difficult to feel in that moment
9. Research Depression - the more you understand the symptoms of Depression the less it will come between you.
10. Look after yourself. You may find that the worry and concern for your loved one get you down. Try and practice good self-care. Your needs matter too. It's ok for you to get help as well. Support is something that we can all benefit from.

8 beautiful things to say to someone who has Depression
1. I care for you so much, even on your darkest days. I am so grateful to have you in my life.
2. You don't have to be the "happy" and "fun" one all the time.
3. You are enough as you are. 
4. It can't be easy fighting through the painful symptoms of depression. I'm proud of you. 
5. I may not know how you are feeling but I'm here to support you in any way I can.
6. Please never think you are a burden to me, you are so far from it.
7. Don't think you have to try and be anything else for me. It's ok to not be ok. 
8. You have helped me so much over the years, please don't feel guilty for receiving the same support during this difficult period.

Minimising someone's Depression invalidates their experience and makes them feel ashamed for struggling more than what you perceive to be appropriate. Stigma hurts, consideration helps and compassion heals.

8 things we should not say to someone who has Depression
1. We all get sad from time to time.
2. It's just a phase you're going through, it's no big deal.
3. You just need to get out more, that will fix your problems.
4. If you could just be grateful you wouldn't be depressed.
5. It's all in your head.
6. You just need to be positive.
7. You don't have a real reason to be depressed.
8. You are overreacting, things can't be that bad, you make stuff up.

Mental Health Stigma v Compassion

Stigma: "They are so lazy for not getting out of bed."
Compassion: "I may not personally understand Depression as I've only experienced sadness, but I've heard it's complex and affects everything. They may already feel worthless for having this struggle so I'll be careful not to put them down."

Stigma: "They are so rude for cancelling plans last minute, they clearly don't care about me at all."
Compassion: "While this is frustrating, I recognise that the symptoms of anxiety can feel crippling. They probably haven't made this decision lightly and they could even be trying to protect me from their struggle. I won't rush to judgment and will clarify any concerns when they feel better."

Suicidal thoughts
Stigma: "They don't have it that bad, they're just attention-seeking."
Compassion: "I may not be able to resonate with their struggle, but their suicidal thoughts are very real to them so I must take this seriously."

Depression is a common reason that people seek Counselling

Treatment for Depression includes Counselling and Anti-depressant medicines, they can take time to work but have a good chance of success. Some people have recurring episodes of depression and require long-term treatment to keep symptoms away. An in-depth form of Counselling in the form of Psychotherapy is a helpful form of treatment, in fact, it appears to be just as effective as Anti-depressant medications.

A common Psychotherapeutic approach used to combat Depression is Cognitive Behaviour Therapy (also referred to as CBT). Cognitive Behavioural Therapy is a combination of two kinds of Therapy: Cognitive and Behavioural.

Cognitive Therapy focuses on thoughts, assumptions and beliefs. Clients can learn to recognise unhelpful beliefs and patterns of thinking. Cognitive Therapy is not about "positive thinking" in the sense that you must always be geared towards thinking happy thoughts. It's a way to gain control over racing, repetitive thoughts which often feed or trigger Anxiety.

With the use of Behavioural Therapy, clients can learn how to change their behaviour. There are some common Behavioural techniques used in the treatment of Anxiety disorders, such as desensitisation, relaxation and breathing exercises. They all form part of Behavioural Therapy. Cognitive and Behavioural Therapy (CBT) is often used together because they're beneficial to each other. CBT focuses on the clinical observation that the depressed mood often results from negative patterns of thinking and behaviour. These thoughts can feel powerful and compelling, but usually do not tell a balanced, reasonable story.

Therapy Sessions allow the client and Therapist to work together to determine what types of negative thinking is problematic for the depressed client. Also, the types of coping or balanced thoughts that can be used to provide a better perspective, to lift the client's mood and help him or her function better. Cognitive Behaviour Therapy has a focus on helping the depressed client increase his or her activity level and develop more gratifying activities.

During sessions, the client can express their thoughts and feelings. The Therapist takes an active approach to teach here-and-now coping strategies to help clients understand and change cognitions and behaviours that contribute to their depressed mood. This is an active problem-solving form of Therapy. Practising new skills outside of sessions is a central part of treatment. A key goal of Therapy for Depression is to provide you with tools that you can use to work on your depressive symptoms, it also aims to prevent future episodes. 

Get help for Depression

If you're depressed or manic you may not experience all of the symptoms, some people have many; others will have just a few. The severity can be different for each person and even vary over time. No one is predestined to develop Depression. However, it is very important to be aware of risk factors so that those of us who may be vulnerable can educate ourselves, be attentive to warning signs, as well as, take steps towards recognising and preventing Depression.

To learn more about Depression, choose your free Ebook. If you're experiencing any symptoms and require help, you can have a Counselling session with one of our qualified Counsellors and Mental Health professionals. We provide Therapy for Depression via Email, Instant Messenger, Skype or WhatsApp Calling and Telephone. We would be happy to support you.