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Depression
At some point in their life, everyone experiences some sort of unhappiness, which is often triggered by a traumatic event such as the break-up of a relationship or a bereavement. Most people also feel "down" from time to time. However this unhappiness can develop into a bout of depression. This is a real illness that often goes unrecognised. This factsheet explains the symptoms and possible causes of depression.
Who is affected
Depression affects up to 40% of people at some point in their lives. It often appears first during a persons teens or twenties. Some people then experience recurrent episodes – or bouts – throughout their lives. It is twice as common in women than men.
Symptoms
The most common symptom of depression is low mood. In addition to feeling sad, some people are irritable and tend to lose their temper more easily than usual. Often, people notice that they feel worse either first thing in the morning or last thing at night.
Depressed people find that they can’t get pleasure from events or activities that they normally would. They tend to feel different and separate from the rest of the world.
Lack of energy, tiredness and poor concentration are also common symptoms. Additionally, sufferers find they don’t sleep well, either waking up unrefreshed from a long sleep, or waking up very early in the morning. Loss of sex-drive (libido) and disturbed eating patterns – either loss of appetite or eating too much – are also common.
Symptoms of anxiety routinely occur with depression. People may experience fearfulness, palpitations and even panic attacks. Very often these feelings subside when the depression is treated.
One of the most serious aspects of depression is the thoughts people have about themselves and their lives. Sufferers start to judge themselves excessively harshly or critically. They may think of harming themselves or feel that life is not worth living. People who are depressed are more likely than others to attempt suicide.
Many people with depression turn to alcohol or illegal drugs to try and blot out their difficult feelings. Unfortunately, this tends to make things worse. Alcohol, for example, lowers the mood further and, in excess, is harmful to physical health.
What causes depression?
Usually a bout of depression is set off by a stressful event, often involving some form of loss. This may be when somebody dies, or when a relationship breaks down.
Financial worries, a stressful job, redundancy or fear of unemployment, even moving house, can trigger depression in vulnerable people. New mothers are susceptible to postnatal depression (please see the separate BUPA factsheet on postnatal depression). And long-term or serious illnesses such as diabetes or cancer can also trigger depression.
Relationship problems are common in depressed people. These may be part of the cause of a person’s depression or a consequence.
Some forms of the illness seem to run in families, but researchers have yet to find a simple genetic explanation. Unhappy childhood experiences have been shown to be important in the development of depression in adult life. For example, a child who loses his or her mother before the age of 14 and lacks adequate care from another person is more likely to develop depression. Other difficult childhood events such as sexual abuse are linked to depression in adult life.
Lastly, some people tend to always look on the darker side of things – it’s part of their personality. These people are more likely to develop full-blown depression at some point in their lives.
The value of treatment
Depression interferes with the way people want to live their everyday lives. They may feel unable to go to work or do any of the things they used to enjoy. Despite this, many people do not seek help for their problems. This may be because they feel embarrassed about their feelings, considering them a sign of weakness, or because they blame themselves for their misfortune.
Fortunately, a number of treatments are available for depression and talking to a qualified professional about feelings is the first step.
Treatment options
The two main approaches to treating depression are psychological therapies, such as counselling, and medical treatment with antidepressants. These are described in greater detail in a separate BUPA factsheet called Depression treatments.
For mild forms of depression, psychological treatments are often sufficient. For more severe depression, a combination of psychological treatment and antidepressant drugs, or antidepressants alone, is usually recommended.
Regular physical exercise may also be helpful for mild to moderate depression.
Antidepressants
A wide range of antidepressant medication is now available. The two main types of antidepressants are known as SSRIs (which stands for selective selective serotonin re-uptake inhibitors) and tricyclics (the name refers to the molecular structure of the drug). They are both known to be effective in treating depression but SSRIs, a group of drugs which includes fluoxetine (Prozac), are now being more widely used because their side-effects tend to be slightly less troublesome.
Most antidepressants take at least two weeks to start working and their effects begin quite gradually. They are then usually required for around six months to treat a single episode of depression, even if the symptoms clear up sooner. This is because it’s been shown that a longer course makes a relapse of depression less likely.
Complementary therapy
St John’s wort (Hypericum perforatum) is now a popular complementary medicine for depression. It can be bought as tablets in health food stores and pharmacies. Some research studies have shown some promising results in treating mild to moderate depression. If you are taking prescription or over the counter medicines, ask for advice from your doctor or pharmacist before taking St John’s wort, as there can be harmful interactions.
Psychological treatment
GPs can often arrange for people with depression to have counselling as part of their treatment, and counsellors are sometimes based at the surgery. Counselling usually takes the form of a one-to-one session where you have an opportunity to express your feelings and problems, with the counsellor listening and asking questions. Generally in counselling, you won’t be told what to do about these feelings. A typical course of counselling is around six sessions.
More structured types of psychological treatment also exist. These include cognitive behavioural therapy and psychotherapy.
Further help
For the majority of people, depression responds to antidepressants and counselling. If depression is severe, or intense thoughts of suicide are experienced, GPs often refer sufferers to a psychiatrist. Psychiatrists are qualified doctors who have specialist training in treating mental health problems. A psychiatrist can suggest a wider range of therapy, both medical (medicines) and psychological.
Sometimes, people need to be admitted to hospital for severe depression. They (or their family) may feel they are unsafe to be looked after at home, due to suicidal thoughts. Depressed people are not typically a danger to others.
Prevention
Learning to manage stress is an important factor in the prevention of depression. Stress is a highly individual experience; we all have different things in our lives that cause frustration or unhappiness. We all need to be aware of how we are feeling and of how to develop positive ways of coping. This may simply mean making more time to relax, exercise, or learning to talk more openly with people you are close to.
At some point in their life, everyone experiences some sort of unhappiness, which is often triggered by a traumatic event such as the break-up of a relationship or a bereavement. Most people also feel "down" from time to time. However this unhappiness can develop into a bout of depression. This is a real illness that often goes unrecognised. This factsheet explains the symptoms and possible causes of depression.
Who is affected
Depression affects up to 40% of people at some point in their lives. It often appears first during a persons teens or twenties. Some people then experience recurrent episodes – or bouts – throughout their lives. It is twice as common in women than men.
Symptoms
The most common symptom of depression is low mood. In addition to feeling sad, some people are irritable and tend to lose their temper more easily than usual. Often, people notice that they feel worse either first thing in the morning or last thing at night.
Depressed people find that they can’t get pleasure from events or activities that they normally would. They tend to feel different and separate from the rest of the world.
Lack of energy, tiredness and poor concentration are also common symptoms. Additionally, sufferers find they don’t sleep well, either waking up unrefreshed from a long sleep, or waking up very early in the morning. Loss of sex-drive (libido) and disturbed eating patterns – either loss of appetite or eating too much – are also common.
Symptoms of anxiety routinely occur with depression. People may experience fearfulness, palpitations and even panic attacks. Very often these feelings subside when the depression is treated.
One of the most serious aspects of depression is the thoughts people have about themselves and their lives. Sufferers start to judge themselves excessively harshly or critically. They may think of harming themselves or feel that life is not worth living. People who are depressed are more likely than others to attempt suicide.
Many people with depression turn to alcohol or illegal drugs to try and blot out their difficult feelings. Unfortunately, this tends to make things worse. Alcohol, for example, lowers the mood further and, in excess, is harmful to physical health.
What causes depression?
Usually a bout of depression is set off by a stressful event, often involving some form of loss. This may be when somebody dies, or when a relationship breaks down.
Financial worries, a stressful job, redundancy or fear of unemployment, even moving house, can trigger depression in vulnerable people. New mothers are susceptible to postnatal depression (please see the separate BUPA factsheet on postnatal depression). And long-term or serious illnesses such as diabetes or cancer can also trigger depression.
Relationship problems are common in depressed people. These may be part of the cause of a person’s depression or a consequence.
Some forms of the illness seem to run in families, but researchers have yet to find a simple genetic explanation. Unhappy childhood experiences have been shown to be important in the development of depression in adult life. For example, a child who loses his or her mother before the age of 14 and lacks adequate care from another person is more likely to develop depression. Other difficult childhood events such as sexual abuse are linked to depression in adult life.
Lastly, some people tend to always look on the darker side of things – it’s part of their personality. These people are more likely to develop full-blown depression at some point in their lives.
The value of treatment
Depression interferes with the way people want to live their everyday lives. They may feel unable to go to work or do any of the things they used to enjoy. Despite this, many people do not seek help for their problems. This may be because they feel embarrassed about their feelings, considering them a sign of weakness, or because they blame themselves for their misfortune.
Fortunately, a number of treatments are available for depression and talking to a qualified professional about feelings is the first step.
Treatment options
The two main approaches to treating depression are psychological therapies, such as counselling, and medical treatment with antidepressants. These are described in greater detail in a separate BUPA factsheet called Depression treatments.
For mild forms of depression, psychological treatments are often sufficient. For more severe depression, a combination of psychological treatment and antidepressant drugs, or antidepressants alone, is usually recommended.
Regular physical exercise may also be helpful for mild to moderate depression.
Antidepressants
A wide range of antidepressant medication is now available. The two main types of antidepressants are known as SSRIs (which stands for selective selective serotonin re-uptake inhibitors) and tricyclics (the name refers to the molecular structure of the drug). They are both known to be effective in treating depression but SSRIs, a group of drugs which includes fluoxetine (Prozac), are now being more widely used because their side-effects tend to be slightly less troublesome.
Most antidepressants take at least two weeks to start working and their effects begin quite gradually. They are then usually required for around six months to treat a single episode of depression, even if the symptoms clear up sooner. This is because it’s been shown that a longer course makes a relapse of depression less likely.
Complementary therapy
St John’s wort (Hypericum perforatum) is now a popular complementary medicine for depression. It can be bought as tablets in health food stores and pharmacies. Some research studies have shown some promising results in treating mild to moderate depression. If you are taking prescription or over the counter medicines, ask for advice from your doctor or pharmacist before taking St John’s wort, as there can be harmful interactions.
Psychological treatment
GPs can often arrange for people with depression to have counselling as part of their treatment, and counsellors are sometimes based at the surgery. Counselling usually takes the form of a one-to-one session where you have an opportunity to express your feelings and problems, with the counsellor listening and asking questions. Generally in counselling, you won’t be told what to do about these feelings. A typical course of counselling is around six sessions.
More structured types of psychological treatment also exist. These include cognitive behavioural therapy and psychotherapy.
Further help
For the majority of people, depression responds to antidepressants and counselling. If depression is severe, or intense thoughts of suicide are experienced, GPs often refer sufferers to a psychiatrist. Psychiatrists are qualified doctors who have specialist training in treating mental health problems. A psychiatrist can suggest a wider range of therapy, both medical (medicines) and psychological.
Sometimes, people need to be admitted to hospital for severe depression. They (or their family) may feel they are unsafe to be looked after at home, due to suicidal thoughts. Depressed people are not typically a danger to others.
Prevention
Learning to manage stress is an important factor in the prevention of depression. Stress is a highly individual experience; we all have different things in our lives that cause frustration or unhappiness. We all need to be aware of how we are feeling and of how to develop positive ways of coping. This may simply mean making more time to relax, exercise, or learning to talk more openly with people you are close to.
