Depression

---

Depression is often a numb feeling rather than sadness. Clinical depression is an illness, a medical condition. It significantly affects the way someone feels, causing a persistent lowering of mood. Every year, around 6% of all adult Australians are affected by a depressive illness.

Depression is often accompanied by a range of other physical and psychological symptoms that can interfere with the way a person is able to function in their everyday life. The symptoms of depression generally react positively to treatment. Children and teenagers can also become depressed and this can show itself in different ways to depression in adults.

Thoughts, Feelings and Behaviour

A person may be depressed if for more than two weeks they have:

• Felt low, sad, down or miserable most of the time OR
• Lost interest or withdrawn from previously engaged activities that was pleasurable and rewarding previously 
• Experienced symptoms in at least three of the following four categories:

Thoughts

• “I’m a failure”
• "I am hopeless"
• “It’ is my fault”
• “Nothing good ever happens to me”
• “I’m worthless”
• “Life is not worth living”
• "It's always me"
• "Why bother"
• "I am not good enough"

Feelings

• Low and depressed
• Irritated and frustrated
• Overwhelmed
• Guilty and worthless
• Unhappy
• Indecisive
• Disappointed
• Miserable
• Sad
• Sense of loneliness 
• Tearful
• Cannot be bothered
• Feeling tired all the time
• Feeling flat and numb
• Feeling restless and fidgety
• Feeling every thing is an effort
• Feeling one has let themselves or their family down

Behaviour

• Withdrawn from previously engaged activities 
• Stopped socialising 
• Falling behind in daily chores
• Withdrawn from family and friends
• Relying on alcohol and drugs
• Inability to concentrate 
• Loss of interest and motivation
• Loss of sexual interest

Physical

• Lethargic 
• Sick and feeling drained
• Headaches and muscle pains
• Churning gut/sick in the belly
• Irregular sleep (sleeping too much or too less)
• Poor appetite/weight loss
• Over eating

 There is no single cause of depression. It likely develops due to a combination of factors, including life events (such as experiencing violence or losing someone close to you) and biological factors (genetics or hormones).  Depression can be described as mild, moderate or severe. 

People affected by depression often experience negative thinking patterns and may stop doing their regular activities, which can make their symptoms worse. Depression is about withdrawing from previously engaged behaviour .

 In simple terms, depression becomes a bit of a cycle: you feel low, sad down, you withdraw from previously engaged activities, before you enjoyed going out, now you don't, you stop engaging in daily chores, you practice avoidance and withdrawal. This feeds back into your thoughts, I am a failure", I am worthless', I am hopeless", and this feeds back into being tired, sad, demotivated, and increasing further avoidance and withdrawal. 

Although there has been a lot of research in this complex area, there is still much that we do not know. Depression is not simply the result of a chemical imbalance, for example because a person has too much or not enough of a particular brain chemical. 

However, disturbances in normal chemical messaging processes between nerve cells in the brain are believed to contribute to depression. 

Some factors that can lead to faulty mood regulation in the brain include:

• genetic vulnerability
• severe life stressors
• taking some medications, drugs and alcohol
• some medical conditions

Types of depression

There are different types of depression. The symptoms for each can range from relatively minor through to severe. 

Major depression

Major depression, or major depressive disorder is the technical term used by health professionals and researchers to describe the most common type of depression. Other terms sometimes used include unipolar depression or clinical depression. 

Depression can be described as mild, moderate or severe.

Melancholia

Melancholia is an older term for depression and is still sometimes used to describe a more severe form of depression with a strong biological basis, where many of the physical symptoms of depression are particularly evident. For example, one of the major changes is that the person can be observed to move more slowly, or to be experiencing significant changes to their sleep pattern and appetite. 

A person with melancholia is also more likely to have a depressed mood that is characterised by complete loss of pleasure in everything or almost everything.

Dysthymia

The symptoms of dysthymia (sometimes called Persistent Depressive Disorder) are similar to those of major depression, but are less severe and more persistent. A person has to have this milder depression for more than two years to be diagnosed with dysthymia.

Psychotic depression

Sometimes, people with a depressive condition can lose touch with reality. This can involve hallucinations (seeing or hearing things that are not there) or delusions (false beliefs that are not shared by others), such as believing they are bad or evil, or that they are being watched or followed or that everyone is against them. This is known as psychotic depression.

Antenatal and postnatal depression

Women are at an increased risk of depression during pregnancy (known as the antenatal or prenatal period) and in the year following childbirth (known as the postnatal period). This time frame (the period covered by pregnancy and the first year after the baby’s birth) may also be referred to as the perinatal period.

The causes of depression at this time can be complex and are often the result of a combination of factors. In the days immediately following birth, many women experience the ‘baby blues’, which is a common condition related to hormonal changes, affecting up to 80 per cent of women who have given birth. 

The ‘baby blues’, or the general stress of adjusting to pregnancy or a new baby, are common experiences, but are different from depression. 

Depression is longer lasting and can affect not only the mother, but her relationship with her baby, the child’s development, the mother’s relationship with her partner and with other members of the family.

Up to one in 10 women will experience depression during pregnancy. This increases to 16 per cent in the first three months after having a baby.

Bipolar disorder

Bipolar disorder used to be known as ‘manic depression’ because the person experiences periods of depression and periods of mania with periods of normal mood in between. The symptoms of mania are opposite to the symptoms of depression and can vary in intensity. They include:

• feeling great
• having plenty of energy
• racing thoughts
• little need for sleep
• talking fast
• having difficulty focusing on tasks
• feeling frustrated and irritable. 

This is not just a fleeting experience. Sometimes, the person loses touch with reality and experiences hallucinations or delusions, particularly about their ideas, abilities or importance. A family history of bipolar disorder can increase a person’s risk of experiencing bipolar disorder. 

Because bipolar disorder includes periods of depression, it is not uncommon for a person with bipolar disorder to be misdiagnosed as having major depression until they have a manic or hypomanic episode. Bipolar disorder can also sometimes be confused with other mental health conditions such as schizophrenia. 

The treatment for bipolar disorder is often different to that for major depression. It is therefore important to check for this condition whenever a person is being assessed for depression. 

Cyclothymic disorder

Cyclothymic disorder is an uncommon condition which is often described as a milder form of bipolar disorder. The person experiences chronic fluctuating moods over at least two years, involving periods of hypomania (a mild to moderate level of mania) and periods of depressive symptoms, with very short periods (no more than two months) of normality between. 

The symptoms last for a shorter time, are less severe, and are not as regular, so they don’t fit the criteria of bipolar disorder or major depression.

Seasonal affective disorder (SAD)

SAD is a mood disorder that has a seasonal pattern. The cause is unclear, but may be related to the variation in light exposure in different seasons. SAD is characterised by mood disturbances (either periods of depression or mania) that begin and end in a particular season. Depression in winter only is the most common way in which people experience SAD. 

SAD is usually diagnosed after the person has had the same symptoms during winter for two or more years. People with SAD are more likely to experience lack of energy, sleep too much, overeat, gain weight and crave carbohydrates. 

SAD is rare in Australia, and more likely to be found in countries with short days and longer periods of darkness, such as the cold climate in the Northern Hemisphere.

Treatment can help reduce and even eliminate the symptoms of depression. Talk to us today on how we can help you overcome depression.