Causes & Risk Factors
There is no single cause of depression.
Potential triggers of depression include:
- genetic or family history of depression
- psychological or emotional vulnerability to depression
- biological factors such as imbalances in brain chemistry and in the endocrine/immune systems
- major stress in the persons life.
Depression and physical illness
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Diagnosing And Treating Depression
There’s no physical test for depression.
If you experience depression symptoms most of the day, every day, for more than two weeks, you should visit your GP. This is especially important if:
- you have symptoms of depression that aren’t getting any better
- you have thoughts of self-harm or suicide
- your work, relationships with friends and family, or interests are affected by your mood
It can be hard for people with depression to imagine that anything can help them but the sooner you seek help, the sooner the symptoms start to get better.
Your GP may examine you and perform blood or urine tests to make sure there isn’t another condition causing your depression symptoms, like an underactive thyroid.
When you see your GP, they’ll try to find out if you have depression by asking you questions. These are likely to be about your health, how you’re feeling, and how that is affecting you mentally and physically.
Telling your doctor your symptoms and the affect they are having on you will help your GP to tell if you have depression, and how severe the condition is. It’s important to be as open as possible.
Your conversation with your GP will be confidential. This rule can only be broken if your GP thinks there is a significant risk of harm to you or others, and that telling a family member or carer would make that risk lower.
Which Types Of Talk Therapy Work Best For Depression
- Behavioral activation therapy The aim of this type of therapy is to reverse the downward spiral of depression by encouraging you to seek out experiences and activities that give you joy.
- Cognitive behavioral therapy CBT focuses on changing specific negative thought patterns so that you are able to better respond to challenging and stressful situations.
- Interpersonal therapy This very structured, time-limited form of therapy focuses on identifying and improving problematic personal relationships and circumstances directly related to your current depressive mood.
- Problem-solving therapy This therapy is a form of CBT that teaches take-charge skills that help you solve real-life problems and stressors, big and small, that contribute to depression.
- Self-management/self-control therapy This type of behavioral therapy trains you to lessen your negative reactions to events and reduce your self-punishing behaviors and thoughts.
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What Are The Complications Of Depression
When depression becomes very severe, dark thoughts can emerge and these can even lead to suicide. If you are having thoughts of suicide, talking to someone you trust can help.
If someone you care about has severe depression, learn the warning signs, since they may be feeling so bad that they cant see their way out alone.
Ways In Which The Findings Can Contribute To Nursing Practice
The findings indicated that structured reminiscence could decrease depression levels of older women living in ALFs. This was successful after offering the reminiscence sessions twice a week for a period of six weeks. The researchers concluded that engagement in the practice should occur for more than three weeks to help reduce depression among the participants. That being the case, nurses and caregivers in assisted-living facilities will find the ideas essential towards better nursing practice . This is possible because the use of structured reminiscences can significantly reduce stress levels and depression in aged women thus improving the healing process.
According to Jones and Beck-Little , reminiscence therapy sessions can be an effective intervention for different patients in healthcare facilities. Nurses and other professionals should use the study findings to design effective programmes for senior citizens in different healthcare institutions. This study also supports the use of different psychological therapies and role modeling theories to help reduce depression in elderly patients. The findings explain the need to provide care and reminiscence therapies to different patients and older women for more than three weeks to get the best results. With proper training, nurses can help improve mental positions of old women by reducing depression.
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Therapy Such As Talking Therapies
Supportive counselling is a treatment for milder forms of depression and is as effective as antidepressant medication.
More specific therapies, e.g. Cognitive Behaviour Therapy or Acceptance and Commitment Therapy , can be effective for more significant depression. Your GP will explain what is available locally and which type of talking treatment is most suitable for you.
You might be worried you wont know what to talk about with a counsellor. It might help you to make a list of what youd like to discuss, things that are bothering you, and feelings youre experiencing. Bring it with you to your appointment.
The list might include:
- Issues in your family/whnau or other relationships
- Symptoms like changes in eating or sleeping habits
- Anger, anxiety, irritability or troubling feelings
- Thoughts of hurting yourself.
If you feel therapy isnt working for you, try different styles of therapy or therapists until you find one that is right for you. There are lots of options, and no one approach will work for everyone.
What Are The Signs And Symptoms
Major depression symptoms vary from person to person. To receive a diagnosis of major depressive disorder, some of these signs and symptoms must be present for at least two weeks. Anyone who has questions should consult their doctor.
- Continued feelings of sadness, hopelessness, pessimism, emptiness
- Fatigue, lack of energy
- Insomnia or other sleep issues such as waking up very early or sleeping too much
- Anxiety, irritability, restlessness
- Lack of interest or joy in hobbies and activities
- Changes in appetite, leading to weight loss or weight gain
- Moving, talking, or thinking more slowly
- Trouble concentrating, thinking clearly, or making decisions
- Vague aches and pains, such as headaches, joint pain, back pain, or digestive problems
- Thoughts of death or suicide, or suicide attempts
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Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
Is Depression Caused By A Chemical Imbalance
The human brain is extremely complicated. Because antidepressants work by changing brain chemistry, some people have assumed that depression is caused by changes in brain chemistry which are then ‘corrected’ by the drugs. Some doctors may tell you that you have a ‘chemical imbalance’ and need medication to correct it.
But the evidence for this is very weak, and if changes to brain chemistry occur, we don’t know whether these are the result of the depression or its cause.
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Depression Is Treatable Even When Another Illness Is Present
Depression is a common complication of chronic illness, but it does not have to be a normal part of having a chronic illness. Effective treatment for depression is available and can help even if you have another medical illness or condition.
If you or a loved one think you have depression, it is important to tell your health care provider and explore treatment options. You also should inform your health care provider about all your current treatments or medications for your chronic illness or depression . Sharing information can help avoid problems with multiple medicines interfering with each other. It also helps your health care provider stay informed about your overall health and treatment issues.
Recovery from depression takes time, but treatment can improve your quality of life even if you have a medical illness.
Treating depression with medication, psychotherapy , or a combination of the two also may help improve the physical symptoms of a chronic illness or reduce the risk of future problems. Likewise, treating the chronic illness and getting symptoms under control can help improve symptoms of depression.
How Is Depression Diagnosed
If you are concerned about your mental health, or the mental health of someone you care about, its important you speak with a health professional, such as a GP. A mental health assessment usually involves a discussion or answering a questionnaire, as well as a physical examination. This will help your doctor differentiate between mental and physical health problems.
Your doctor will want to understand how you feel and think, and check for any symptoms of depression, such as in your energy levels, appetite, sleep and whether you are feeling restless, hopeless or sad. If you have a family history of mental illness either depression or some other condition tell your GP since this can help with your diagnosis. Your answers will help your GP determine whether a specialist such as a counsellor, psychologist or psychiatrist might be helpful.
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What Are The Symptoms Of Depression And How Is It Diagnosed
The NHS recommends that you should see your GP if you experience symptoms of depression for most of the day, every day, for more than 2 weeks.
Doctors make decisions about diagnosis based on manuals. The manual used by NHS doctors is the International Classification of Diseases .
When you see a doctor they will look for the symptoms that are set out in the ICD-10 guidance. You do not have to have all of these to be diagnosed with depression. You might have just experience some of them.
Some symptoms of depression are:
- low mood, feeling sad, irritable or angry,
- having less energy to do certain things,
- losing interest or enjoyment in activities you used to enjoy,
- reduced concentration,
You may also find that with low mood you:
- feel less pleasure from things,
- feel more agitated,
- find your thoughts and movements slow down, and
- have thoughts of self-harm or suicide.
Your doctor should also ask about any possible causes of depression. For example, they may want to find out if youve experienced anything traumatic recently which could be making you feel this way.
There are no physical tests for depression. But the doctors may do some tests to check if you have any physical problems. For example, an underactive thyroid can cause depression.
On the NHS website, they have a self-assessment test which can help you to assess whether you are living with depression: www.nhs.uk/mental-health/conditions/clinical-depression/overview/
How The Doctor Determines If You Have Depression
Your GP or health professional will need to spend some time with you to determine if you have depression. They will talk to you about how youre feeling, and they will be looking to understand the context of your life and how your mood fits into this. They may get you to fill in a test on paper. If you have difficulty reading or understanding the test, tell them and ask for a different way to understand how youre feeling. Your health professional should try to get an understanding of what youre going through and, if appropriate for you, this can also involve your whnau/familys perspective.
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Depression And Drugs And Alcohol
“Drowning your sorrows” is actually a bad idea when it comes to depression. Alcohol is categorised as a “strong depressant” which can make depression worse, and drinking or taking drugs to cope can lead to a downward spiral by having a negative affect on other parts of your life.
There’s evidence that cannabis can cause depression, particularly in teenagers, even if it helps you relax.
Take Care Of Yourself
You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.
Sometimes depression doesnt respond to medication. Your healthcare professional may recommend other treatment options if your symptoms dont improve.
These options include electroconvulsive therapy or repetitive transcranial magnetic stimulation to treat depression and improve your mood.
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Are There Different Types Of Depression
If you are given a diagnosis of depression, you might be told that you have mild, moderate or severe depression. This describes what sort of impact your symptoms are having on you currently, and what sort of treatment you’re likely to be offered. You might move between mild, moderate and severe depression during one episode of depression or across different episodes.
There are also some specific types of depression:
- Seasonal affective disorder depression that occurs at a particular time of year, or during a particular season. See our page on SAD for more information.
- Dysthymia continuous mild depression that lasts for two years or more. Also called persistent depressive disorder or chronic depression.
- Prenatal depression depression that occurs during pregnancy. This is sometimes also called antenatal depression.
- Postnatal depression depression that occurs in the first year after giving birth.
See our page on postnatal depression and perinatal mental health for more information. The PANDAS Foundation also has information and support for anyone experiencing prenatal or postnatal depression.
Is premenstrual dysphoric disorder a type of depression?
PMDD is a severe form of premenstrual syndrome . Many women experience PMS, but for some women their symptoms are severe enough to seriously impact their daily life. This is when you might receive a diagnosis of PMDD.
What Risks And Complications Can Depression Cause
Having depression can cause other problems. It can affect your mental health as well as your physical health, and it may affect other areas of your life too. For example, depression may cause:
- disturbed sleep,
- difficulties with work and your hobbies,
- difficulties keeping contact with friends and families, or
- suicidal thoughts or thoughts of self-harming.
Some people might also drink more alcohol to try and relieve depression. However, as we said in the previous section above, this can actually make depression worse.
If you have any of these problems, speak to your GP.
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How Is Depression Syndrome Diagnosed
Everyone may feel sad or down from time to time. However, clinical depression has more intense symptoms that last two weeks or longer.
To determine whether you have clinical depression, your healthcare provider will ask questions. You may complete a questionnaire and provide a family history. Your healthcare provider may also perform an exam or order lab tests to see if you have another medical condition.
Whats The Difference Between Grief And Depression
Given that the primary symptom associated with depression is sadness, it can be easy to think of grief or bereavement as depression. But grief is a natural response to specific experiences, such as the end of a relationship or the death of a loved one. While you might feel regret or remorse, and you might withdraw from usual activities if you are experiencing grief, youre unlikely to feel the overwhelming sense of worthlessness, thoughts of self-harm or suicide, and other symptoms of depression. Another important difference is that in grief, painful feelings usually come in waves and are often mixed with positive memories.
American Family Physician
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Information For Family Carers And Friends
You can get support if you are a carer, friend or family member of someone living with depression.
Being a carer might mean you can claim certain benefits that might help you and the person you care for. For more information, please see the Mental Health and Money Advice services website:www.mentalhealthandmoneyadvice.org/en/welfare-benefits/what-benefits-are-available-for-mental-health-carers/
You could also get in touch with carer support groups or sibling support groups. You can search for local groups in your area online or ask your GP.
You can ask your local authority for a carers assessment if you need more practical support to help care for someone.
As a carer you should be involved in decisions about care planning. There are rules about information sharing and confidentiality which may make it difficult for you to get all the information you need in some circumstances.
You can find out more information about:
How can I support the person that I care for?
You might find it easier to support someone with depression if you understand their symptoms, treatment and self-management skills. You can use this to support them to get help and stay well.
Below are some initial suggestions for providing practical day to day support to someone with depression.
You can find out more information about:
You can find more information about:
Website: www.web.ntw.nhs.uk/selfhelp/
Children And Adolescents With Chronic Illnesses
Children and adolescents with chronic illnesses often face more challenges than their healthy peers in navigating adolescence. Chronic illnesses can affect physical, cognitive, social, and emotional development, and they can take a toll on parents and siblings. These limitations put children and adolescents at higher risk than their healthy peers of developing a mental illness.
Children and adolescents with chronic illnesses experience many forms of stress. Parents and health care providers should be on the lookout for signs of depression, anxiety, and adjustment disorders in young people and their families.
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More Education Better Understanding
These findings point to some improvement in understanding and attitudes about mental health and mental issues. But more needs to be done. Efforts like McLean Hospitals campaign and the National Alliance on Mental Healths StigmaFree pledge have done much to bring understanding to the public.
More and more individuals are choosing to be open about their own mental illness. By speaking out, they show that psychiatric conditions like depression and addiction are common and no different than medical conditions like diabetes or asthma.
At the same time, many efforts to promote good mental health have been introduced.
Just as individuals are encouraged to exercise, improve their eating habits, and see a doctor when they are sick or injured, these programs teach mindfulness, stress reduction techniques, and gratitude. Many emphasize that good physical health is essential to good mental health. Some of these efforts are available online or through apps.
Though many are still confusedor unawareof the differences between mental health and mental illness, times are changing. Despite the terms becoming more mainstream, there is still much to be done to help others understand that each impact everyone differently.
We are all human, said Palmer. We are all vulnerable to illness. Its important to see the strengths and dignity in all people regardless of their health status and try our best to help alleviate suffering when we can.