Coping with depression

What is Depression? **

Depression is more than just feeling sad or a depressed mood.  Depression will affect people differently. Although there may be similar symptoms it can look very different in people’s lives.

Clinical depression involves a cluster of symptoms, which may include:

• An unusually sad mood that does not go away
• Loss of enjoyment and interest in activities that use to be enjoyable
• Lack of energy, and tiredness
• Loss of confidence in self and poor self-esteem
• Feeling guilty when you are not really at fault
• Wishing you were dead and/or thinking about harming yourself
• Difficulty concentrating or making decisions
• Moving more slowly or alternatively becoming agitated and unable to settle
• Having difficulty sleeping or alternatively sleeping too much
• Loss of interest in food or alternatively eating too much.

Not all people will have the same symptoms, and not all people will have all these symptoms.  The severity of depression can vary.

The symptoms of depression are thought to be due to changes in natural brain chemicals called neurotransmitters, which send messages from one nerve cell to another in the brain. Depression often means that your brain has less of these chemical messengers such as serotonin, a mood regulating brain chemical.

What causes Depression? **

There is no single cause of depression. It often involves a complex interaction of biological, psychological and social factors.

Depression can often be a response to a situation when something very distressing has happened, particularly if you cannot do anything to control the situation such as:

• Past trauma or abuse – e.g. child sexual abuse, physical abuse etc
• Current trauma or abuse – e.g. domestic violence
• Relationship break up
• Having a baby (10 – 15% or women experience depression after childbirth)
• Loss of job, difficulty finding a job
• Having an accident that results in disability
• Significant loss e.g. death of a loved one
• Developing a long-term physical illness (or caring for someone with this)
• Being a victim of crime

Depression can also occur from…

• A medical condition e.g. Stroke, Parkinson’s disease
• The side effects of certain medication/drugs
• The stress of having another mental health issue (e.g. severe anxiety, schizophrenia)
• Alcohol abuse or drug abuse
• Changes in hormone levels
• Lack of exposure to bright lights in winter (seasonal affective disorder)

Some people will experience depression in a distressing situation whereas other may not – some people may be more prone to it where as other people may be more resilient to it. Studies have shown that those most prone to developing depression are women, people with depression running in their family, and people who have experienced abuse during childhood (sexual, physical or emotional).

What are the effects of depression? **

Depression may have you feeling:

• Sadness  
• Anxiety  
• Guilty  
• Angry  
• Mood swings
• A lack of emotional responsiveness  
• Helpless  
• Hopeless
• A mixture of feelings that are hard to identify and feel all rolled in to one

Depression may have you thinking:

• Self criticism – “I always do things wrong”   
• Self Blame – “It’s all my fault”
• Worry – “What if…”  Suicidal ideation “The world would be better off without me”
• Pessimism – “Everything sucks”  
• Confusion – “I can’t think straight”  
• Self Doubt – “I can’t do anything”   
• Self Hatred - “I’m disgusting”
• That others are judging you – “they wouldn’t like me if they really knew me”.

Depression may have you:

• Crying or even emotionally flat (e.g. beyond tears)  
• Withdrawing from others
• Neglecting responsibilities  
• Losing interest in personal appearance
• Losing motivation    
• Self-harming

Depression may affect your physical body:

• Lack of energy  
• Sleeping too much or too little   
• Constipation
• Appetite – to much or too little and subsequent weight gain or loss
• Irregular menstrual cycle  
• Loss of sexual desire  
• Unexplained aches and pains

Depression may have you believing about yourself:

• That you are crazy  
• That you are a worthless person

Depression can have a significant impact on your life.   Depression may even have you questioning your connection to life.  If you are feeling overwhelmed, or are thinking about hurting yourself, it is important to seek help.  You can speak with a counsellor from Counselling Services at Adelaide University by phoning 8303 5663.  If it is after business hours, support is available by ring Adult Mental Health Services for 24 hour crisis and emergency assistance on 13 14 65 or lifeline on 13 11 14.

How can you manage depression?

There are lots of different options to manage depression that may work for different people such as:

Physical activity

Physical exercise is a proven mood lifter as it increases the release of endorphins and other ‘feel good’ chemicals to the brain and body.   It does not have to be an organized sport that you do to feel the benefits. Going for a walk, gardening, or taking a bike ride is equally as good.  Anything that get your heart rate moderately lifted for about 30 minutes a day will have significant benefits for your physical and mental health.  

Anti-depressant medication 

For some people, anti-depressant medication can make a real difference to their ability to manage the depression.  It is important to note however that depression can be successfully managed without the use of medication.  Try to find a doctor you feel comfortable with, who can talk with you over your issues and concerns about the depression and the right medication for you.   You have a right to ask your doctor questions about the depression, the medication prescribed and the possible side effects.  Some people might worry that if they start using medication that they will be on it for the rest of their lives, however anti-depressant medication can be time limited.   In some cases your doctor may refer you to a psychiatrist who can then monitor your mental health and medication. 

Counselling

There are many different options available if you want counselling.  The Counselling Service at Adelaide University has experienced counsellors who can offer you support.  This is a free service.  To make an appointment you can phone the service on 8303 5663.  You can access a private counsellor or psychologist with no referral.  Many are listed in the phone books or you can search for them on-line.    If you are on a mental health plan by your doctor you may be eligible for some sessions with a psychologist that can be bulk billed through Medicare.   Some of the things a counsellor may do with you in a session include listening non-judgmentally to how you are feeling, discussing with you issues in your life that may be affecting your mental health and well-being, helping you to identify and change unhelpful thought patterns, and offering you practical strategies to help manage the depression.  Sometimes depression can have you feeling like ‘what’s the point?’  Taking some time out to reflect on what is important in your life may help you to find motivation to keep going.   You may find speaking with a counsellor helpful in this process. 

Alternative therapies

These may work for some people to help them relax and release tension.   Some popular therapies available include acupuncture, massage therapy, and aromatherapy.

Yoga and meditation

Yoga and meditation can be used to help you relax, tune in to your body and your “inner awareness”, and reduce the effects of stress on your life.   The Counselling Service at Adelaide University runs free lunchtime workshops on meditation and yoga practices.  Drop in to the centre to pick up a timetable. 

Stress reduction/lifestyle changes/self care

Being aware of personal self care needs such as getting enough sleep, avoiding alcohol and other drugs, eating healthily, and taking time for yourself will make a difference to how you feel and cope with daily life pressures.  Do things that make you feel good and take time out for yourself.  Have a bath, read a good book, watch a funny DVD…

Good supports

It is important to seek out supports in your life and avoid social isolation.   You may not feel like socializing or going out with friends when depressed, however isolating yourself will usually make it worse.   Create a support network in your life – this could include friends, family, pets, on-line chat groups or social network sites, support groups, sporting clubs, interest/hobby groups,  spiritual connections and communities,  and professional support (e.g. counselor, GP). 

Get creative!

• Journaling
• Drawing
• Music
• Mosaics
• Craft
• Scrap-booking
• Painting
• Singing…

Get informed!

• Learn about depression and find out what other people have found helpful.

Usually the best approach is a combination of all of these strategies.  Try things out. Little steps combined over time do make a difference. Different strategies may suit different people depending on their personal style. It is important to be gentle on your self and remind yourself that you can reduce the impact of depression on your life.

Where to go for help and resources?

The Counselling Service provides appointments Monday – Friday from 9:00am – 5:00pm and a drop-in service Monday – Friday from 1:00pm – 4:00pm.   Contact the service on 8303 5663 or drop in at the centre located ground floor, Horace Lamb Building.

Your local GP

There are lots of great websites with information and support around depression.  Try these as a start:

• www.beyondblue.org.au
• www.reachout.com.au
• www.moodgym.anu.edu.au
• www.headroom.net.au
  

24 hour support is available through contacting the following services:

• ACIS – 13 14 65
• Lifeline – 13 11 14
• Youth Health line – 1300 13 17 19

**   Information sourced from Kitchener BA & Jorm AF (2002) ‘Mental Health First Aid Manual’. ORYGEN  Research Centre , Melbourne.