Everyone has times when they feel the ‘blues' or when they get sad from time to time. Depression on the other hand, is a sadness so severe that it can cause:
- Difficulties functioning at home, work or school
- Changes in sleep, energy, appetite and concentration,
- Feelings such as sadness, anxiety, irritability or anger,
- Low self-esteem or feelings of hopelessness. When extremely severe, people who are depressed may have thoughts of hurting themselves.
Depression is a common condition that can affect anyone at any age. In any given year, it is estimated that it affects almost 1 in 10 adults each year, affecting more women than men. Although it can occur at any age, it usually starts in late teens to mid-20's.
Symptoms of depression include (but are not limited to) the following:
- Sad, depressed (or irritable) mood most days
- Loss of interest or enjoyment in activities
- Problems with appetite
- Problems with sleep
- Problems with concentration
- Feeling guilty, hopeless, or worthless
- Thoughts that life isn't worth living (such as thoughts of suicide) or attempts at suicide
When the above symptoms are consistently present for more than 2-weeks, it may be depression.
There is no single cause of depression, and every person's depression may result from a combination of different things. Many factors can contribute to depression:
- Family history of depression: if other people in the family have had troubles with depression, then it may make someone at higher risk.
- Stressful life situations or events, such as problems with relationships, or stresses at work, home or school. Particularly stressful situations may include childhood abuse or neglect; separation/divorce, or conflicts.
- Imbalances in neurotransmitters, which can be triggered by lack of sunlight, or drug use, medications, or medical problems.
There are numerous effective treatments for depression, which are generally given by mental health professionals.
Commonly used therapies include:
- Cognitive behaviour therapy (CBT): Helps individuals cope with depression by focusing on changing their thoughts and behaviours. In depression, individuals tend to have negative, depressive thoughts. In CBT, individuals learn to replace depressive thoughts with more positive, helpful thoughts.
- Interpersonal psychotherapy (IPT): Helps with depression by focusing on improving relationships. Regardless of how the depression started, individuals with depression tend to have tension in their relationships from either 1) conflict or withdrawal, or 2) life transitions or changes. IPT helps improve these difficulties.
- Solution-focused therapy: Helps by finding solutions. In depression, individuals tend to focus on life stresses and problems. In solution-focused therapy, individuals get support in finding solutions to these difficulties.
- Medications: May be helpful in certain cases, and these may be prescribed by a family physician, paediatrician or psychiatrist. Medications are generally used only when other treatments have not been successful, or when the depression is so severe that other treatments are not possible.
Depending on the severity of the depression, more intensive support and services may be required, such as admission to a hospital.
If you know someone who is depressed, it affects you too. The first and most important thing you can do to help a friend or relative who has depression is to help him or her get an appropriate diagnosis and treatment. You may need to make an appointment on behalf of your friend or relative and go with him or her to see the doctor. Encourage him or her to stay in treatment, or to seek different treatment if no improvement occurs after six to eight weeks.
To help a friend or relative:
- Offer emotional support, understanding, patience and encouragement.
- Engage your friend or relative in conversation, and listen carefully.
- Never disparage feelings your friend or relative expresses, but point out realities and offer hope.
- Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor.
- Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don't push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.
- Remind your friend or relative that with time and treatment, the depression will lift.
(Adapted from the National Institute for Mental Health (NIMH), retrieved from http://www.nimh.nih.gov/health/publications/depression/depression-booklet.pdf)
If you have depression, you may feel exhausted, helpless and hopeless. It may be extremely difficult to take any action to help yourself. But it is important to realize that these feelings are part of the depression and do not accurately reflect actual circumstances. As you begin to recognize your depression and begin treatment, negative thinking will fade.
To help yourself:
- Exercise or do activities. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.
- Set realistic goals for yourself. In other words, don't set goals for yourself that are too large. Make smaller ones.
- Break up large tasks into small ones, set some priorities and do what you can as you can.
- Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
- Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
- Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
- Remember that positive thinking will replace negative thoughts as your depression responds to treatment.
(Adapted from the National Institute for Mental Health (NIMH), retrieved from http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml#pub11)
If you suspect that you may have depression, then see your physician. Your physician can make sure there aren't any medical problems (such as hormone imbalances) that might be causing or contributing to the depression. Your doctor can also help recommend where else to get help, such as seeing mental health professionals such as a psychologist, psychiatrist or social worker.
If you are thinking about harming yourself, or know someone who is, then get help immediately.
- Call a family member, friend or co-worker.
- Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
- Call a crisis line.
If you know someone else who is in crisis, then:
- Help the other person get help
- Make sure that you don't leave the other person alone.
- Depression Information from the Public Health Agency of Canada
- Interactive Health Tutorial on Depression from the National Library of Medicine
Written by the eMentalHealth Team and Partners.
Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.
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Date of Last Revision: Nov 14, 2012