What is a depression?
Depression is the most common of all mental health problems and a lot of people worldwide suffer from a depression at least once in their life (1 out of 6 adults).
Depression is a mental problem but nevertheless it is a real disease. That means it is not “just in your mind”. A depression is extremely impairing and affects your mind and body in a very serious manner.
You could say that it is a “brain- disease” because there are actual physiological changes on different levels in the neurological and chemical processes that take place in our brain.
Serotonin is one of the neurochemical particles in our brain, which is out of balance during a depressed episode.
How does it feel?
“Take your worst day, multiply it by one thousand and imagine this will never end”, “Living in a dark, lonely, black hole of emptiness and despair”; “Paralyzing, terrifying, hopeless, unbearable..”..; “Feeling completely useless, utterly empty and ashamed.”
There are many ways how people describe what they felt during a depressive episode. Some of the common conditions are the following:
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
- Feeling worthless or guilty
- Difficulty in thinking, concentrating and/or decision making
- Thoughts of death or suicide
These symptoms can vary from mild to severe
Who can get a depression?
Generally speaking, anyone can get depressed but some people are at higher risk for developing a depression.
More women than men suffer from depression due to the stronger influence hormones have on women. Changing levels of estrogen make women more vulnerable towards depression as it shows in the high number of women suffering from depressive episodes before their menstruation starts, after giving birth or during menopause.
Adolescents around the age of 20 (18-25) belong to the majority of depressed patients.
Genetics: if one or more family members suffered from depression, there is a possibility that you inherited a genetic vulnerability of developing depressive symptoms.
There are personality types that have a higher chance of reacting with a depression towards stress. If you are someone who avoids conflicts and tends to blame yourself for problems (internalizing coping style), you might end up feeling depressed due to the fact that you are suppressing your anger.
Some people suffer from Seasonal depression. When there is only little sunlight some people get affected – especially in the North of Europe (think of Northern Scandinavia for example where there is no sunlight at all during winter) people suffer from Winter depression and need “light therapy”.
Substances (medication and drugs) can induce depressive states because of the chemical imbalance they produce in the body. Long term abuse of alcohol, drugs or medication (e.g. sedatives etc) can lead to depression and anxiety. But sometimes people start abusing drugs due to mental health problems in order to alternate their mood (self-medication).
Medical conditions can cause depressive symptoms like endocrine problems (e.g. thyroid problems), neurological conditions (stroke, seizures, Multiple Sclerosis, Parkinson’s disease..), infectious disease (Hepatitis C, Lyme disease etc) and a chronic lack of vitamins ( B 12) and folate.
Also, lifestyle choices can make you more prone to developing depression. A chronic lack of sleep, physical inactivity, high stress and pressure regarding work and private life, unregular working-hours and especially night-shifts, unhealthy choices of food and so on.
What can you do about it if you experience a depressive episode?
The first step is to realize that you do have a depression. Because it is extremely important not to be led by the miserable feelings and thoughts but to understand that this is a temporary condition, which makes you feel and think that way.
It helps to talk to friends, partner or family members whom you trust about how you are feeling at the moment so that they understand why you are acting differently. You’ll be surprised about how many people might be able to relate to this feeling.
Talk to your General Practitioner. It might be advisable to get a health check in order to eliminate possible medical factors.
If this is the first experience of a depressive episode, a short-term psychological treatment with Cognitive Behavioral Therapy might be sufficient to help you recover.
Also, it is important to implement a day structure, that helps you to stay active even if you feel like staying in bed all day. The longer you stay in bed, the longer your depression might last.
Physical activity and regular work-outs help to reduce stress and elevate the mood.
Try to stay in contact with close friends but don’t force yourself to go on parties and look happy and joyful if you don’t feel like it.
If the depression is severe or returning regularly, your GP might advise you to take anti-depressant medication. This shouldn’t be the first choice and it is definitely not a magic pill, but in some cases, it can save lives and maintain psychological stability to people who are vulnerable to mental health problems like recurring depression or anxiety.
In case you do experience recurring depressive episodes, it is advised to counsel a Clinical Psychologist in order to get a better understanding of why you relapse and what you need in order to maintain long-term stability. There might be an underlying problem that leads to relapsing. For some people this might be the habitual way of coping with problems, emotions or stress. Or there may be a deeper issue like unprocessed trauma, a negative self-image, personality problems or a neurodevelopmental disorder like ADHD or Autism.
Understanding how you process information and function on a psychological level, helps to indicate which specific treatment or therapy method can help you best to become stronger and more resilient in the long run.
Can things change for you?
When people are depressed, they feel completely lost and hopeless.
It is very important to let people who suffer from depression know that change is possible. But it is important to act. If you don’t do anything, nothing will change.
Get help and be honest with yourself and with the people who want to help you.
It is important to understand what is going on and moreover to start working on yourself.
People can change. They change by starting to act, think and finally feel differently.
And often a depression can signal that it is time to change and to adjust your life to what you really want and need.