Depression – Part 1

Depression affects one in five people in their lifetime, and is one of the most common health problems of our time. Up until recently there has been great misunderstanding in the community about the nature of depression, but we are now witnessing an increasing appreciation of what a complex illness it is.
What is depression?
Depression affects our thinking, our emotions and our body. We don’t know for certain how the process of depression evolves, but we know that it does involve a disturbance of the chemicals in the brain (called neurotransmitters) that affects how the brain cells communicate with one another. The effect of this can range from being very subtle to being completely incapacitating.
Who gets depression?
We are all vulnerable to depression, though some are genetically more inclined to become depressed than others. In addition to genetic factors, a number of other things can contribute including stress, relationship breakdown or social isolation, unemployment, drug and alcohol use, illness and chronic disease. Often there is no obvious reason why someone has become depressed – it just seems to come out of the blue.
What does depression look like?
Popular misunderstandings have seen an overemphasis on sadness and low mood when we think of depression. It is true that depression may manifest itself in this way, but more commonly people describe a feeling of emptiness or numbness. Many people with depression even feel unable to cry – they simply feel nothing at all.
In fact depression often surfaces as tiredness and a loss of interest in the things that used to bring pleasure, rather than sadness. Below is a questionnaire to screen for depression. If you find yourself answering ‘yes’ to many of these questions, you may like to seek further advice about the possibility of depression.

For more than two weeks have you:
1. Felt sad, down or miserable most of the time?
2. Lost interest or pleasure in most of your usual activities?
3. Lost or gained a lot of weight, or had a major change in appetite?
4. Had difficulty sleeping?
5. Felt persistently sluggish, or unusually restless?
6. Felt tired and lethargic?
7. Felt worthless, or excessively guilty (about things that you shouldn’t feel guilty about)?
8. Noticed that your concentration seems reduced, or that your thinking has been sluggish?
9. Had recurrent thoughts of death?

Depression – Part 2

Depression affects one in five people in their lifetime, and is one of the most common health problems of our time. In Part 1 we looked at the common symptoms of depression. In this section we will consider the treatment of a depressive episode.
How long does depression last?
The length of a depressive illness can vary greatly. Typically we expect an episode to last approximately 6-12 months, or a little longer in adolescents. Recurrence is common, particularly if the previous episode(s) were untreated, and some sufferers can become chronically depressed.
How is it treated?
There are many ways to treat depression. Counselling and psychotherapy are helpful for some people, while others benefit from having their negative thought patterns “retrained” through Cognitive Behavioural Therapy. Antidepressant medications are also effective in treating depression.
It is important to treat depression and not just wait for it to go away, because untreated depression has been shown to increase the likelihood of further episodes.
What are antidepressant medications?
These medications help correct the chemical disturbance in the brain which is part of depression. They take several weeks to work, and do have some side effects (some people drowsiness, agitation, nausea, clouded thinking) that tend to improve with time. Patience is required to endure the early side effects while waiting for things to improve, but within 2-4 weeks most people begin noticing a significant improvement in their symptoms.
Antidepressant medications need to be taken for extended periods (usually until at least 6 months beyond the end of the depressive episode) to reduce the risk of further bouts of depression later in life.
Are they addictive?
Many patients are concerned about this, but antidepressant medications are not addictive. However, they should never be stopped abruptly without advice from a doctor, because this can cause unpleasant and potentially dangerous side effects.
Is depression a spiritual illness?
This is a difficult question to answer. Each of us are faced with the fundamental questions of life: Who am I? Why am I here? What is the meaning of life? We will always remain empty and unfulfilled if we can’t find the answer to these questions, and depression can certainly be the result. However, we shouldn’t expect that a strong faith makes someone immune to depression, nor that depression represents a weakness in someone’s spirituality ... neither are true. It is more helpful to say that depression can affect (and be affected by) our spiritual life, just as it impacts us physically, psychologically and emotionally.

If you would like more information about depression, please refer to the Beyond Blue website: www.beyondblue.org.au, or see your local doctor.