Feeling down

Everyone feels down, fed-up, miserable or sad from time-to-time. These feelings don’t typically last longer than a few days or a week, and they don’t impact too much on our lives. This is natural and often a response to having a bad day or hearing sad news.

Equally, sometimes these feelings can just come out of the blue. We can often cope with them ourselves or with support from our family or friends.

Depression

Depression is not just ‘having a bad day’. It is more prolonged and persistent than what we experience normally. If you are feeling down and it is interfering with your ability to get on with your day-to-day life it may be useful to seek support from a medical doctor, a counsellor or a support organisation. You may have what is commonly known as ‘clinical depression’ if:

  • The low mood or symptoms of depression last for two weeks or more, and
  • The symptoms interfere with your everyday life, causing an inability to carry out daily activities.
  • ‘Clinical depression’ can be a serious development in a person’s life, as it can impact on health, wellbeing, relationships and work. It is very important that, in the first instance, it is correctly identified. This is because depression could also be part of a physical condition or be a feature of another mental health problem. When correctly assessed it means that the correct approaches to recovery or support can then follow.

    Common symptoms of depression include physical as well as mental changes:

  • Persistent feelings of sadness or hopelessness
  • Feelings of worthlessness, emptiness or pointlessness
  • Irritability, angry outbursts and negativity
  • Loss of energy
  • Lack of interest in daily activities and in the things you normally enjoy
  • Difficulty concentrating - restlessness and agitation
  • Marked anxiety and indecisiveness
  • Lack of motivation, loss of confidence and avoiding responsibilities
  • Sleep disruption and insomnia or having restless sleep
  • Comfort eating or decrease in appetite; no enjoyment of food
  • Tiredness or fatigue with no physical cause
  • Loss of vitality or sex drive
  • Turning more to alcohol, cigarettes or other substances to cope
  • Thoughts of self-harm, wishing to be dead or thoughts of suicide.
  • Men and women often show depression in quite different ways; so do younger and older people. It is often quite hard for the person to recognise it in themselves, and even family or close friends don’t see it. Sometimes the person is blamed by others for the change in their behaviour, or even feel they deserve to feel like that.

    It is important to remember that we should know what to look for and be open minded so that depression is not missed. Overlooking the chance to get this right can cost you or your loved one a huge price in personal happiness and wellbeing, not to mention the huge impact on health, relationships, career and success.

    Types of depression

  • Mild depression
  • With mild depression, you might experience tiredness, early morning wakening, indecision, poor concentration and loss of confidence. You may not necessarily feel depressed and may be generally coping well in your day-to-day life.

  • Moderate depression
  • Most of the symptoms listed above may be present in this case. You may feel extremely fatigued, have significant sleep disturbance and appear to others to be depressed.

  • Severe depression
  • In addition to the symptoms of moderate depression, your judgement may be more impaired in this case. You could have an extremely negative and pessimistic view of your own self-worth and future prospects. Suicidal thoughts may also be present.

  • Bipolar disorder
  • Depression can occur on its own or as part of a related condition known as bipolar disorder. Here depression symptoms are usually more severe and persistent. As well as depressive symptoms, at other times you may have had periods of over-activity and marked sleeplessness, overconfidence and even dangerous impulsivity or misjudgement. This can be quite harmful when unrecognised and often leads to quite damaging personal consequences. When present as part of the depression story, it warrants special consideration as to how the depression should be treated.

    Support for depression

    Depression can affect anyone, regardless of age, sex or social status. It is not a sign of weakness and any of us can experience low mood or depression at any stage in our lives. Even more importantly, depression can usually be effectively prevented and treated. Getting help for significant low mood or depression can really make a difference. There are lots of different things that can help - some that you can do yourself and some that involve getting support from others. With the right support and by doing the right things for yourself, you can get well.

    When thinking about support, it is important to recognise that everyone experiences mental health problems in a unique way and therefore help, treatment and support also varies from person to person. What works for one person may not for another. It is useful to think about what you feel will help you, and not to feel you are beyond help if a certain type of treatment doesn’t work out.

  • Little things can make a big difference
  • There are lots of things you can do to help mind your mental health, such as eating well, exercising, sleeping and spending time with friends.

  • Drink less
  • Remember that alcohol can act as a long-term depressant, so avoid or reduce your alcohol intake when you are feeling low. Misuse of other drugs, can also have a serious impact on your mood and mental health.

  • Talking
  • Talking about how you feel to someone you trust and who is supportive can be a great help. Most people begin to feel better after talking with someone who cares for them.

  • Medical help.
  • Talking with a medical doctor is important – many of the symptoms associated with depression could instead be caused by something else. A correct diagnosis from a medical professional is most useful, especially early on. A doctor can give you information about other people, supports or services that can be of help. A doctor can also offer you medication, if necessary.

  • Community and non-statutory services
  • You can access a wide range of supports and services from community and non-statutory organisations. Many of these services are low-cost or free.

  • Counselling
  • A doctor can recommend counselling services in your area. These might include free, low cost or private options.

    Many thanks to Dr Adrian McGoldrick for his ongoing support and continuing encouragement