Hello there guys! I can’t believe we’ll soon be coming to the end of April. Where has the time gone?! I can appreciate that these days, for some people, time could not move quickly enough.
I meant to put out this post in March but the corona virus was becoming a serious reality globally and I did not want to put a downer on everyone. At the time, I was concerned that a post on depression might not be what people need. However, in retrospect, especially given how events have unfolded, I think we need articles like this now, more than ever. Most of us have never experienced anything with such huge implications, financially, socially and physically, not only for us but all around the world. It is natural to be sad about the upheaval it has caused to our lives, our livelihoods and for some people, grief over loved ones who have died. It is understandable that we may feel hopeless, unable to predict when this will come an end and indeed what the consequences will be.

My goal here is to provide some information on depression. Obviously, every single detail cannot be covered but I will try to provide an overview and provide some links to some websites which you can visit for more information if you want.
Disclaimer: I am NOT a psychiatrist. The information I am providing is based on my (limited) knowledge and experience. This is not a substitute for seeing a doctor if you are experiencing symptoms of depression.
It goes without saying that everybody gets sad at some point in their life. Sometimes, that can be caused by a terrible life event like losing your job, someone you love dies or a relationship ends. There are so many things that can trigger a feeling of sadness and to some degree that is part of life. However, with depression, (and with mental health in general,) what is more important is the impact that it’s having on you and how often you have these experiences. In the next paragraph I will attempt to define depression. However, it is worth noting that there isn’t a definition as such, rather there is diagnostic criteria by DSM V* or ICD-10**.
Depression is a state of persistent low mood and loss of pleasure or interest in most activities and/or low energy levels which can be accompanied by a variety of other symptoms. The symptoms should be experienced for most of the day, for most days of the week for at least two weeks to be diagnosed as depression.

I’ll classify the symptoms into emotions, thoughts, behaviours and physical symptoms. Some common emotional symptoms are feeling low, sad, angry, guilty, overwhelmed, flat, hopeless and worthless. Common thoughts are thoughts of death, thoughts to end one’s life or harm oneself, thoughts of guilt, etc. These might be manifested behaviourally by stopping hobbies or previously enjoyed activities, isolating oneself, increased intake (or dependence) on alcohol, illicit drugs, poor concentration and motivation, etc. Physical symptoms include poor energy levels, poor (or too much) sleep, poor (or increased) appetite, weight loss (or gain), constipation, lethargy.
It’s interesting to know that depression is the most common psychiatric disorder and globally the WHO ranks it as the leading cause of disability. It’s also worth noting that a lot of patients who have chronic conditions such as hypertension, diabetes, heart problems, also tend to have depression as a secondary diagnosis partly because of the stress and all the emotions that come with dealing with a chronic condition. Being female is a risk factor for depression. This means it is more common in women but has no bearing on the resilience or strength of women or indeed people who struggle with their mental health.
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There are many theories on why people become depressed (this reminds me of my A Level Psychology days, fun times!). The biological theory examines how our genes, the chemicals in our body as well our brain structure and function might cause someone to have depression. The behavioural theory suggests that depression occurs as a result of a person’s interaction with their environment. For example, negative reinforcement associated with certain behaviours or the removal of positive reinforcement of behaviour such as the satisfaction of working when someone loses their job might lead to depression.

The cognitive approach looks at how people’s thoughts, feeling and behaviours interact. Thus suggests that depression occurs when people have negative thoughts, a problem with how they process information and negative self-beliefs. In reality, the cause of depression (as with many things) is multifactorial. It is not just one isolated cause, they all play a role to some degree and that degree may vary for reach person.
Now that we know what depression is, its symptoms and why people might develop it, you might be wondering what can be done about it. Well, there’s loads that can be done. I think the first thing to remember is that you’re not alone. There are many people across the world, in your local area, in your church, school, office who have depression (whether diagnosed or not). Just because we cannot measure depression in an objective, linear method like a temperature reading does not mean it is not important or that it is made up. Before being diagnosed with depression it is important to ensure there is no physical health condition that is causing the symptoms one may have by carrying out investigations as required. For example, people with low levels of thyroid hormone (hypothyroidism) may have symptoms similar to depression. In such cases, it is important to treat these conditions first and then reevaluate things.
There are two main types of treatment for mental health conditions: talking therapies and medication.

Talking therapies are the first-line treatment option for depression. This involves talking to a therapist individually or in a group about your experiences and learning skills to cope and manage the symptoms you experience. This can be done face-to-face or virtually. Cognitive behavioural therapy (CBT) explores your thoughts and feelings and how they manifest through your behaviour. Psychodynamic therapy explores how your subconscious impacts on your experiences. This might include talking about your formative years, your past experiences and your views of yourself. Therapy is not the “simple” option. It can be very tasking mentally and may dredge up many unpleasant memories. As such it is important to be mentally prepared and have a good social support system.
Medication (pharmacotherapy) is other main treatment option. The medications used are antidepressants. There are many drug classes and they work in slightly different ways to balance the chemicals in the brain. They may be used alone or with talking therapies. They are not a magic bullet that works straightaway. They can take up to two to four weeks for people to experience a benefit and sometimes you feel worse before you feel better. You might have a good effect with the first one you try but sometimes people have to try different medications to find one that works best for them.

I know this is a lot of information to take in all at once but there you have it. You can send me a message about any questions you have. I can’t promise I’ll be able to answer them all, but I’ll try to point you in the right direction if I can’t. At some point in the near future, I’ll write a post about a personal experience.
I will leave you with a reminder that healing is not always linear. For example, just because you have had a sore throat which healed does not mean you will not have it ever again. It’s similar with mental health. It’s a journey but there is hope because it gets better. I have had consultations with a few patients where we agreed to stop their antidepressants because they were feeling much better. There is hope!
*DSM V – Diagnostic and Statistical Manual of Mental Disorders (DSM–5) – an American diagnostic guide (of sorts) for mental health conditions.
**ICD-10 – 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It’s a diagnostic guide for physical and mental health conditions.
Helpful websites for you
Mood assessment – https://www.nhs.uk/conditions/stress-anxiety-depression/mood-self-assessment/
Support + Information + apps – https://www.nhs.uk/oneyou/every-mind-matters/
General Information – https://www.nhs.uk/conditions/clinical-depression/
General Information – https://www.uptodate.com/contents/depression-the-basics
Resources I used
https://patient.info/doctor/depression-pro
What is Depression?
https://depression.curing.center/tag/symptoms-of-depression/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748674/
https://www.simplypsychology.org/depression.html
https://adaa.org/resources-professionals/practice-guidelines-mdd