Research has found that changes in brain systems or the chemical balance of the brain may be at the root of depression. These changes can be triggered by stressful events in life such as a bereavement, the breakdown of a relationship or losing your job. But for some people, the illness occurs for no apparent reason.

People with a family history of depression are more at risk of developing the illness, but not everyone in this situation will develop depression.

Some people are prone to suffering from depression at particular times in their lives. For example, some women may be particularly vulnerable to episodes of depression in relation to childbirth. Depressive symptoms are also a part of bipolar disorder.

Most people with depression do get better with the right treatment and support, but it can come and go.

Depression affects everyone differently, but there are some common symptoms:

• Feeling sad or low for long periods of time n Feeling hopeless or helpless
• Feelings of guilt
• Being anxious or worried a lot
• Feeling irritable
• Feeling tired all the time and having no energy
• Having no motivation or being unable to concentrate
• Losing interest in things that you normally enjoy
• Losing interest in sex
• Changes in your appetite – eating too much or too little
• Having trouble sleeping, or needing to sleep more than usual
• Moving or speaking more slowly than usual
• Thoughts of suicide or hurting yourself
• In severe cases, a person with depression might experience symptoms of psychosis (e.g. hallucinations, such as hearing voices).

It’s important to note that a person with depression might not experience all of these symptoms – for example, someone can be suffering from depression without feeling particularly sad.

Getting help

If you or someone close to you has been experiencing low mood for a period of two weeks or more, speak to a GP or other health professional.

At first they may suggest some lifestyle changes and monitoring your mood for a short period in case it improves on its own. If this doesn’t happen, you may need to discuss other treatment options.

Treatments for depression

People with mild depression sometimes get better without any treatment, but in more severe cases they may need lots of help.

Lifestyle changes are usually the first method of treatment to try. Getting more exercise, eating healthily and sleeping well can all have a powerful effect our  moods.

Self-help websites can also be useful, such as Living Life To The Full (llttf.com) and MoodGym (moodgym.anu.edu.au). These sites are recommended by medical professionals as a good source of information and practical advice on coping with depression.

Talking therapies such as counseling and cognitive behavioral therapy (CBT) are the next step. Group therapy, couples therapy or bereavement counseling can also be helpful depending on the root cause of a person’s depression. CBT is a treatment that helps change the way a person thinks and behaves. It identifies unhelpful ways of thinking and can help to break the cycle of negative thoughts.

In moderate to severe cases, antidepressant medication may be required. These medicines work by balancing the chemicals in the brain that control our moods. Many people find them effective, but they can have drawbacks. Some people experience unpleasant side effects, and they can take several weeks to work.

A combination of lifestyle changes, talking therapies and medication is often the most effective way to treat depression.

Tips for people with depression

• Talking to people you trust about how you feel can be helpful, and may make it easier for you to talk to your GP.
• Depression might feel like it will never go away, but in most cases it does get better with the right help.
• Make an effort to stay connected to the people you care about. Keeping in touch with friends and family can help you to get perspective and avoid feelings of isolation.
• Depression can become a cycle – you become depressed, then feel more depressed about being depressed. Remember that it is a real illness, and not your fault.
• Keep occupied and do things that you like. Whether you enjoy gardening, writing, making music or sports, doing something helps take your mind off depressive thoughts.
• Avoid using alcohol or drugs to get you through hard times Alcohol is a depressant, and can stop medication from
  doing it’s job, and while it may seem to make you feel better temporarily, it will eventually make things worse.
• Get plenty of exercise – even a 20-30 minute walk every day can make a difference. It releases chemicals called endorphins into your body, which are a natural antidepressant. Eating well and getting enough sleep can also help.
• If something in particular has triggered your depression, try to tackle the cause if you can.
• Remember that treatment can take a few weeks to work – try to be patient and allow enough time for it to take effect.

Tips for partners, families and carers

• One of the best ways to help a person with depression is to listen to their problems. This can help with tackling the root of their depression or just remind them that people do care about them.
• If someone you care about is depressed, encourage them to get help rather than dealing with it by themselves. Don’t make them feel bad about taking medication or seeing a therapist.
• Telling someone with depression to ‘snap out of it’ or
  ‘pull themselves together’ is likely to make things worse. Remember that depression is not just being unhappy, it’s an illness.
• Remember that people don’t need to be depressed ‘about’ anything in particular. It can affect anyone, regardless of their situation.
• If someone you care about is depressed, it can help just to talk to them or spend time with them. It will make them feel cared about and help take their mind off their depression.
• People who are depressed can sometimes be irritable or difficult to deal with. Try to be patient with them.
• Look after yourself – if someone close to you is depressed it can be very hard on you too. It’s easy to fall into the same trap and become depressed yourself.
• If someone with depression talks about hurting themselves or not wanting to live anymore take it seriously. Encourage them to tell their doctor how they feel.

Useful websites

NCMH

This website has a dedicated depression section, including details on research, suggested reading and links to medication information.
ncmh.info/depression

Mind

Information and support along with downloadable leaflets and real people’s stories. Search ‘depression’ from the homepage. mind.org.uk

Journeys

This Wales-based organization offers information and self help resources for depression, and runs support groups for people suffering with the illness.
journeysonline.org.uk

Samaritans

Available 24 hours a day to provide confidential emotional support for people experiencing feelings of distress, despair or suicidal thoughts.
samaritans.org