Depression | myjourney

Depression is more than simply feeling unhappy or fed up for a few days.

Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression isn't a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, unhappiness or anxiety during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression. Read more about low mood and depression.

If you've been feeling low for more than a few days, take this short test to find out if you're depressed.

When to see a doctor

It's important to seek help from your GP if you think you may be depressed.

Many people wait a long time before seeking help for depression, but it's best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.

What causes depression?

Sometimes there's a trigger for depression. Life-changing events, such as bereavement, losing your job or even having a baby, can bring it on.

People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Read more about the causes of depression.

Depression is fairly common, affecting about one in 10 people at some point during their life. It affects men and women, young and old.

Studies have shown that about 4% of children aged five to 16 in the UK are anxious or depressed.

Treating depression

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medication. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as "watchful waiting". They may also suggest lifestyle measures such as exercise and self-help groups.

Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that isn't improving or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medication.

Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily.

Reading a self-help book or joining a support group are also worthwhile. They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.

Treatment for depression usually involves a combination of self-help, talking therapies and medicines.

The treatment that will be recommended will be based on the type of depression you have.

Mild depression

If you have mild depression, the treatments outlined below may be recommended.

Wait and see – if you're diagnosed with mild depression, it may improve by itself. In this case, you'll be seen again by your GP after two weeks to monitor your progress. This is known as "watchful waiting".
Exercise – there's evidence that exercise can help depression and it's one of the main treatments for mild depression. You may be referred to a qualified fitness trainer for an exercise scheme. You can also find out more about starting exercise and exercise for depression.
Self-help groups – talking through your feelings can be helpful. You could talk to a friend or relative, or you can ask your GP to suggest a local self-help group. Find out more about depression support groups. Your GP may also recommend self-help books and online cognitive behavioural therapy (CBT).

Mild to moderate depression

If you have mild to moderate depression, the treatments outlined below may be recommended.

Talking therapy – if you have mild depression that isn't improving, or moderate depression, your GP may recommend a talking treatment (a type of psychotherapy). There are different types of talking therapy for depression, including cognitive behavioural therapy (CBT) and counselling. Your GP can refer you for talking treatment, or in some parts of the country you might be able to refer yourself.

Moderate to severe depression

If you have moderate to severe depression, the treatments outlined below may be recommended.

Antidepressants – antidepressants are tablets that treat the symptoms of depression. There are almost 30 different types of antidepressant. They have to be prescribed by a doctor, usually for depression that's moderate or severe.
Combination therapy – your GP may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. A combination of an antidepressant and CBT usually works better than having just one of these treatments.
Mental health teams – if you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medication.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) aims to help you understand your thoughts and behaviour and how they affect you.

CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present.

It teaches you how to overcome negative thoughts – for example, being able to challenge hopeless feelings.

CBT is available on the NHS for people with depression or any other mental health problem that it's been shown to help.

You normally have a short course of sessions, usually six to eight sessions, over 10 to 12 weeks on a one-to-one basis with a counsellor trained in CBT. In some cases, you may be offered group CBT.

Online CBT

Online CBT is a type of CBT that's delivered through a computer, rather than face-to-face with a therapist.

You'll have a series of weekly sessions and you should receive support from a healthcare professional. For example, online CBT is usually prescribed by your GP and you may have to use the surgery computer to access the programme.

Ask your GP for more information or read more about online CBT and the courses available.

Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focuses on your relationships with others and on problems you may be having in your relationships, such as difficulties with communication or coping with bereavement.

There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed.

Psychodynamic psychotherapy

In psychodynamic (psychoanalytic) psychotherapy, a psychoanalytic therapist will encourage you to say whatever is going through your mind.

This will help you become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems.

Counselling

Counselling is a form of therapy that helps you think about the problems you're experiencing in your life so you can find new ways of dealing with them. Counsellors support you in finding solutions to problems, but don't tell you what to do.

Counselling on the NHS usually consists of six to 12 hour-long sessions. You talk in confidence to a counsellor, who supports you and offers practical advice.

Counselling is ideal for people who are basically healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or a serious illness.

Getting help

See your GP for more information about accessing NHS talking treatments. They can refer you for local talking treatments for depression.

In some parts of the country, you also have the option of self-referral. This means that if you prefer not to talk to your GP, you can go directly to a professional therapist.