• Depression: more than just the blues
• Depression: your questions answered

Depression: more than just the blues

While we may all experience emotions and moods that make us feel sad, flat or bleak, people experiencing depression may live with these emotions every day. The effects can be completely overwhelming. Fortunately there are strategies you can learn to help manage symptoms of depression.

What is depression?

Depression is a serious and common illness that affects one in five Australians. People with depression find it hard to function each day, both physically and mentally. Depression is more than feeling sad or blue. It involves more persistent and extreme negative thoughts and feelings. It can stop us doing everyday activities, like eating and sleeping, as well as change the way we think, feel and behave.

What causes depression?

We can’t really say there is one single cause of depression. Rather it seems there are many influencing factors that may contribute. These  include:

• Biochemical changes occurring in the brain, involving neurotransmitters (brain chemicals) that  may dull how you feel
• Genetics
• Lifestyle factors, including nutrition and physical  activity levels
• Prolonged stress or anxiety
• Personality
• Traumatic experiences
• Social and cultural factors
• Health status, including chronic illness

Depressed or sad?

One of the Jean Hailes psychologists, Gillian Needleman, says it’s important to understand that depression is different from sadness, stress, anxiety or even grief. “We may all feel sad or low at times. What distinguishes depression is a combination of factors, which may include continuously feeling miserable or losing interest in things that you usually enjoy, to the point where you feel you are no longer functioning,” she says.

Either your GP or a psychologist will make a diagnosis of depression based on factors including a range of feelings, thoughts, behaviours and physical symptoms that have been experienced continuously over a period of time.

While most people will experience some symptoms at various stages of their life, according to Gillian, depressed individuals experience many symptoms, often intensely, so that the way they think, feel and act is significantly impacted.

Once depression is identified, many people wonder whether treatment is required. Can it just be left to pass? And if treatment is necessary, what types are available and how do we know which to choose?

Difficult to see yourself

Depressed individuals may not consider themselves depressed, as their mood becomes their ‘status quo’ and is often considered to be ‘just the way things are’, rather than the result of a psychological illness. This makes it important for others to monitor changes seen in those close to them and to talk about these changes.

Good news!

“The good news is that help is available, and has been shown to be very effective in treating depression”, says Gillian. “There are many categories of depression and your GP is well-placed to manage these, to clarify what is occurring for you and assist you in finding appropriate treatment.”

Your GP may wish to discuss antidepressant medications with you, as well as refer you to a psychologist or mental health professional for treatment. Generous Medicare rebates are now available for up to 12 counselling sessions with a psychologist.

How to choose a therapist

If you are unsure about the suitability of a therapist, it is a good idea to telephone a potential therapist and ask about their experience with treating depression – or get a family member to do this. Ask what you can expect from counselling, the type of therapy they practise and any other questions you may have. Make an appointment only if you feel comfortable. If you’re still not finding sessions helpful talk to your therapist about this. It may be that you look for another therapist – not everyone is a perfect fit.

What if you think you or someone close to you might be depressed

“Depression will not pass easily if ignored, and in fact may get worse,” says Gillian. “The longer it continues, the more difficult it may be to shift. People cannot just ‘snap out of it’, nor can they just ‘cheer up’ or ‘get over it’ without help”. “Depression is complex and needs time, together with a range of strategies, for it to be managed. A person with depression will need understanding and support from those around them,” she says.

“There is no colour in my world. It’s all just grey.”

“When my depression eased I felt a big weight had lifted off  me and I started to enjoy things again.”

Tips to help manage depression

There are a number of strategies you can put in place to help you recognise and manage depression on a daily basis.
How to help yourself

• Plan your day. Set achievable tasks so that each day something – no matter how small – is achieved. Give yourself credit for even the smallest achievement.
• Note what you are doing, not what you aren’t.
• Break down big tasks into smaller, manageable parts.
• Stay focused in the present – take one day at a time.
• Do some physical activity. Exercise stimulates natural endorphins (‘feel good hormones’) in the brain to help improve mood and has been shown to be highly effective in managing depression.
• Eat well throughout the day to help balance mood. Eliminate/minimise caffeine and foods that provide no nutritional value.
• Spend time with people who make you feel good. Individuals experiencing depression often feel they don’t want to ‘burden’ others. In fact, those around them are often happy to provide support.
• Listen to music you enjoy, and do things that bring you joy.
• Educate yourself about depression and how to manage it.
• Notice the things you do that improve your situation – do more of them. Stay away from things that you notice worsen thoughts and feelings.

Remember, you can beat depression.

How to help a friend or loved one who is depressed

• Offer to listen and provide support. Ask how you  can best help.
• You don’t need all the answers – just being there  is important.
• Look after your own wellbeing.
• Don’t preach, patronise or lecture. It’s helpful to adopt a position of trust in their capacity to  improve.
• Maintain your perspective – don’t get overwhelmed by the negativity so you lose sight  of  the big picture.
• Reinforce and support any positive initiatives they  make.

Further information Beyondblue – the national depression initiative – info line – 1300 22 46 36 (not a helpline). Remember, if you are in need of urgent medical or psychological assistance contact your local health professional or hospital. If you need to talk to someone straight away please call: Lifeline Australia helpline 24 hours, 7 days – 13 11 14 Lifeline’s ‘Just Ask’ mental health info line national rural information and referral Mon–Fri, 9am-5pm (EST) – 1300 13 11 14 SANE mental health info helpline Mon–Fri, 9am–5pm (EST) – freecall 1800 18 72 63 Mensline Australia 24 hours, 7 days – 1300 78 99 78

Depression: your questions answered

Have you ever wondered about whether antidepressants are addictive, whether your body should take a break from medication or if you can ever really ‘get over it’? Foundation psychologist Gillian Needleman and GP Vivienne Whitechurch answer some of your most  pressing questions about depression.

What do you do if your GP or psychologist thinks you’re depressed and you don’t agree – or vice versa?

This is a good starting point for discussion. Feel free  to question your health practitioner further, ask what it is they’ve noticed that makes them reach that conclusion. Find out as much information as you  can about depression. Try asking those close to you whether they think you may have depression. If  you  are not sure seek a second opinion.

I feel better now, so can I stop taking my  medication?

Feeling better may be due to the medication or therapy you’re having. It’s best to discuss stopping medications with your GP as many medications are best stopped gradually and need to be taken for a certain length of time so depression won’t come back. Don’t stop medication suddenly. If one medication doesn’t suit you there are others that will. Some people need to try several to find one that  suits them. Talk over your concerns with your  GP and/or psychologist.

Is it okay to change the dose after two  weeks?

It can take a while to find the dose and medication that best suits you. Talk to your GP if you’re not sure. Some medications take two to three weeks to start working. Speak to your GP at this stage about doses and any side-effects.

Does everyone need medication for depression?

Medication can be an effective way to treat depression for some people. Sharing your feelings with trusted friends may help you feel better and supported. Studies show that depression is often best managed through a combination of medication and counselling. Talk to your GP and/or psychologist about your particular needs.

How do you tell your workmates you have depression when you get back to work?

You are under no obligation to disclose depression or any other medical condition at work. On the other hand, you may decide that you’d like support and understanding in the workplace. This is an individual decision and one in which many factors need to be considered. For example, how supportive is your workplace? Who would be the best person/people to tell? What are your needs at  work that require support?

How long will I need counselling for and  what can I  expect to get out of it?

Today therapy is an interactive experience and will depend on your issues, your therapist’s style and how beneficial you’re finding the experience. Therapy will focus on assessing your depression, and  providing you with skills to assist you to manage. Depending on how you’re coping and the support you have, therapy may only be for one  or two sessions. On average there are about six to eight sessions. Remember, this may not need  to  be  weekly or continuously.

What’s the difference between a psychologist  and a  psychiatrist?

While there may be some overlap between the services offered by psychologists and psychiatrists, there are some differences in training and services. Psychiatrists are medically-trained and can prescribe medication. A psychologist’s studies focus more on counselling skills and psychologists can use a variety of different counselling techniques. There are also differences in the regulating bodies that the two professions are affiliated with.

Are antidepressants addictive?

Today’s antidepressants don’t cause addiction in the sense that you don’t need to keep increasing the dose to get the same effect and you won’t find yourself craving for them physically if you stop taking them. Some people have withdrawal symptoms if they stop medication quickly, however in the case of antidepressants this is not due to addiction.

Should you go off antidepressants to  give  your body  a  break?

Your body doesn’t need a break from the antidepressants. If you need to, take them every day – they won’t work if you don’t. Stopping medication too early may mean symptoms come back. It’s a good idea to discuss this, as well as how long you may need to stay on them, with your GP.

Is being diagnosed with depression a  life  sentence? Can  you ‘get over it’?

A diagnosis of depression doesn’t have to mean a life sentence. It’s possible for people to have just one episode in their lives. The more you learn to manage your symptoms, the easier you’ll find it to recognise early warning signs. It’s a good idea to get to know what your personal triggers are and find out ways to manage them or be aware that certain situations, such as changing or losing a job, health issues or losing someone close to you, could increase your chance of having a depressive episode. Lifestyle decisions, including good nutrition, regular physical activity and learning skills through counselling, can help you to cope in the future.

I think my friend is depressed, but she won’t  talk about  it, so how can I help?

It can be hard to know what to do or say in this situation, as everyone responds to situations and talks about things differently. Be there as a support to listen, rather than offer solutions. Think about the best time to talk to your friend, as well as your choice of words. It may help to reflect back to the person what you have noticed about them that worries you, for example, “I’ve noticed that you’ve not come to any social events lately.” Ask if there’s anything you can do, now or in the future.

I’ve had postnatal depression.  Am I at  risk of  getting depression?

Having postnatal depression can lead to further depressive episodes in life, particularly if you’ve had depressive episodes earlier. It’s important to know that postnatal depression is treatable. Whether you will have further depressive episodes in your life can depend on a number of factors, including your particular life circumstances, the way you live your life, the stresses you face and the ways you manage them, as well as the support you have around you.

Content updated May 14, 2007