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DEPRESSION
What
is depression?
Depression
is not a temporary low mood. It’s when the low mood
seems deeper and more prolonged than might be expected from
the cause. It’s sometimes called the illness of loss.
That loss could be a bereavement or redundancy, although it
might be loss of a lifestyle such as when you have a baby
or move house. Work related stress can also lead to depression.
Whatever triggers it, if it continues to the point where it
interferes with your life for more than a few weeks, it’s
a good idea to talk to your doctor about it.
Depression
may involve several of these symtoms:
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You
feel very low most of the time more days than not, and
this goes on for more than a couple of weeks. |
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You
feel tired and lacking in energy. |
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You
find it difficult to concentrate or make decisions. |
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You
aren’t sleeping well, or you’re sleeping far
more than you normally do. |
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You
find it difficult to begin or complete tasks. |
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You
feel hopeless, as though it’s always going to be
like this and you’re helpless to do anything about
it. |
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You
have low self esteem or strong feelings of failure. |
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You
may believe that you’re the only one who feels this
way. |
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You
may experience weight loss or weight gain. |
Good
News!
You are not the only one. Statistics vary but they all show
it’s quite common. Some medical textbooks say that it
affects three out of ten men and four out of ten women at
some stage in their lives. Because it’s so common, there
are lots of effective treatments, and doctors are used to
dealing with it. Because people (not just you) feel bad, quite
often they don’t talk about it for fear of being judged.
You probably know other people who have depression.
Depression goes away. It is treatable. People get over it,
and when they do, they feel stronger because they have overcome
it. This means that if they should ever feel the beginnings
of it again, they can recognise it and deal with it much more
quickly.
What
causes depression?
Depression is not the same as grief. This page is not about
bereavement (I recommend www.griefnet.org for people who have
lost someone close to them) but many of the techniques here
will help you deal with your feelings so that daily life is
less difficult. This is also true for depression arising from
other causes.
The
mind, body and emotions are closely linked. Whatever may have
been the trigger, the body responds by producing hormones
which affect our mood. These are in turn affected by how we
feel and what we think. In other words, the mood-hormone cycle
goes into a spiral. This can be aggravated by the changing
hormones of having a baby, especially a miscarriage or stillbirth.
When depression sets in, the body may come to recognise these
higher levels of unhelpful hormones as the new “norm”
and continue to produce these high levels until it receives
instructions to go back to lower, more helpful levels. Studies
have shown that the pleasure receptors in the brain also shrink
when we’re depressed so they can’t take in and
use our ordinary mood-lifting hormones to the same extent.
In other words we can stay “stuck” in depression
until we do something about it.
Quick
fixes
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If
you suspect you are suffering from depression, your first
port of call is the doctor. He or she is used to dealing
with this and won’t judge, criticise or condemn
you. He may also decide that some medication is advisable.
Quite often this is of the type which “eats up”
the surplus hormones, so that the body comes to recognise
it doesn’t need to produce such high levels. Medication
can also allow you to feel strong enough to tackle the
underlying causes, as well as cope better with day-to-day
living. Medication may take a week or two to kick in.
Different types suit different people, so if one particular
anti-depressant hasn’t worked for you, another might
be much better. There are plenty of anti-depressants which
are not physically addictive. |
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A
reasonable amount of exercise helps to balance out hormone
levels so you feel less depressed. Exercise uses up the
stress hormone adrenaline and produces the feel-good hormone
serotonin. Depending on your level of fitness you could
spend twenty minutes walking three or four times a week.
Or go swimming, go to the gym, learn yoga, work out at
home or play some sport. Quite often this may feel like
the last thing you want to do, but it can be very helpful.
Again, check with your doctor if you’re not sure
you’re up to this. Exercise can be one prong of
your attack on depression. |
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Sometimes
depression is linked to the use of alcohol, recreational
drugs or cigarettes. Cutting down or cutting out these
things can be very helpful in feeling better. |
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Set
yourself small, achievable targets. Sometimes this might
be just getting out of bed before noon one day a week,
or washing your hair once a week. When you set targets,
it’s helpful if they’re realistic, achievable,
safe and observable. Targets need to be specific, like
“I will get dressed before noon on one day this
week”. Maybe next week’s targets could include
getting dressed before noon on two days. |
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Don’t
overburden yourself by setting big targets. You don’t
have to do everything at once. The longest journey starts
with the first step. |
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Reward
yourself. Just recognising that you have had a problem
is an achievement. Carrying out your target once is an
achievement. Your reward might be having a cup of coffee,
taking a nice, hot bubble bath or making a phone call
to a friend. It could also be listening to some favourite
music or watching something uplifting on TV. |
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You
are allowed to ask for help. |
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You
don’t have to be perfect. Nobody else is. |
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Multivitamins
can be helpful, but please don’t exceed the stated
dose. |
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Some
people find St John’s Wort useful. It’s a
good idea to consult your doctor or pharmacist about this
before you start taking it, especially if you’re
on other medication. |
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Don’t
blame yourself. Having depression is not your fault. If
you get flu or break your leg, that’s not your fault,
is it? Depression is a curable illness. You are allowed
to ask for help to get better. You are allowed to believe
that even you in your situation can get better. |
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Listening
to people laughing can be very helpful. Even if you don’t
feel like it, watching or listening to comedy tapes or
videos for ten or fifteen minutes every day for three
weeks has been shown to have a positive effect even when
dealing with fixed circumstances. Even if the comedies
no longer give you the same pleasure they used to, it’s
also helpful to make yourself join in with the laughter,
as laughing has physical effects on the body and hormone
levels which can help you lift your mood. |
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Pleasure
is the best antidote. Finding even ten minutes a day to
have the best time you can is a good start. Interest is
what you put into an activity, not what you get out of
it. |
Longer-term
solutions
A lot of the problems associated with depression are affected
by how we think. People who have depression quite often think
bad things about themselves and believe this is the only possible
or realistic view. This is very unlikely to be true. You are
allowed to learn to think in different ways which are helpful
to you. Here’s how:
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Replace
words like “always” and “never”
with “ sometimes”. Instead of telling yourself
you never get things right, remind yourself that you sometimes
do things well. Look for any evidence of times, however
small, that you did do something well in any area. This
helps you to adopt a more positive outlook and build on
good things. |
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Replace
words like “ought to”, “have to”
and “should” with “could”. Sometimes
people punish themselves with negative thoughts because
they think there’s something wrong with them if
they don’t instantly do something they believe they
“should” do. Saying “I could do the
hoovering now but I choose to put my feet up for ten minutes”
puts your decisions more firmly under your control. |
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Recognise good things as being at least as important as
bad things. Although you may not be perfectly happy with
the way you are right now, you have some good qualities
and skills. It helps to make a list of them – though
you may need someone else’s help to get you started
on realising how much you’ve got going for you.
For example, you’re literate and can use the internet.
Perhaps you’ve done some good deeds, or been a friend
when somebody needed one. That means you’re kind,
friendly and likeable. You can carry your list around
with you or keep it where you can look at it often. You
can add to it. You’re allowed to use your good qualities
and skills to make life better for yourself. You’re
allowed to recognise and value good things that happen
to you. |
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Things
don’t always stay the same. Just because you feel
bad now, it doesn’t mean you’ll always feel
bad. Feelings aren’t fixed in stone. Nobody can
predict the future. When you’re walking down the
street, you don’t know what colour the next car
you see will be, do you? You may have some good luck.
You may meet new friends and find new and rewarding ways
of spending your time, even if that time is limited. You
can learn new skills, including the art of positive thinking
and how to be confident. |
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Do
a reality check. Have you been magnifying bad things and
discounting good things? Talking to other people can help
you put things in perspective. This is one of the ways
that counselling can help. If other people have overcome
a situation or made the best of it, you can learn to do
that too. |
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Label
the action, not the person. Lots of people make their
own lives worse by saying, “I’m stupid”
or “I’m a loser”. It’s much more
helpful to say, “I’ve done something stupid
but I won’t do it again”. You are more than
just one action! It’s also important to label the
action and not the person when dealing with children. |
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Separate
out feeling and thinking. Just because you feel silly,
it doesn’t mean you are. Nor does it mean that other
people think you’re silly. Most people are far more
concerned with themselves than with others, so don’t
believe your self-criticism is the way the world views
you! |
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Separate
out your responsibility from other people’s. You
are not responsible for another adult’s thoughts,
feelings or actions. They are. You are only responsible
for your own feelings, thoughts and actions (unless you
have pre-adult children). |
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Give
yourself permission to accept compliments and know you
deserve them. Even if you don’t think the compliment
was sincere, at least the person values you enough to
say something nice about you! And what if the compliment
is sincere? Aren’t you at least willing to acknowledge
that, like every human being, you have some good points? |
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Don’t
accept other people’s criticism blindly. If you
believe you’ve done something wrong, say sorry and
do your best to make amends. If you haven’t done
anything wrong, why believe you’re to blame? By
the way, nobody can make another person abuse them. The
abuser is responsible for how he or she responds and what
he or she does. |
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Other
people don’t necessarily know how you’re feeling
or what you want. They’re not mind-readers and neither
are you! It’s more helpful to negotiate for what
you – and they – want. Be clear and specific:
if you want sympathy, what ways do you want it shown?
In words, touch, action? Phone calls at a specific time?
Being clear about what you want and asking for it openly
cut down lack of communication and bad feelings all round. |
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You’re
allowed to recognise your own good qualities and skills.
It’s not big-headed. It’s not boastful. Telling
other people all the time how wonderful you are is boastful,
but being quietly pleased with what you’ve accomplished
or what you are is good. It’s self-supportive and
intelligent to know what you’re good at. Making
a list of your good qualities and skills – and looking
at it often – is helpful. If you’ve ever been
cheerful, even for one second, you can put “cheerful”.
If you’ve ever helped someone, you can put “helpful”.
You can start your list of skills with “internet
literate”! |
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If
you want a hug, ask for one! Hugs and kisses you ask for
count double because the person values your wishes enough
to go along with them! |
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You’re
allowed to ask for compliments. “Do I look OK in
this?” is a useful question – especially if
you’re talking to someone who’s nice to you. |
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There
is enough positive attention to go round. It’s not
useful to depend on those closest to you to lift your
mood. They are responsible for their own lives just as
you are responsible for making the most of yours. You
can also ask others for what you want, and begin to make
new friends as soon as you are ready. That way you’ll
have a wider support network – as well as more fun!
The section on Loneliness may be very helpful to you. |
Debbie’s
Story
I’m
43 now and I’m happy. At one time I thought I
never would be. I had depression for three and a half
years after having the twins, but I did get over it.
I had two more episodes, one for three months and one
for three weeks, but that was 15 years ago. In fact,
I don’t think I’ll ever have depression
again but even if I do, this time I’ll know what
to do to get out of it.
The
birth of my twins was quite traumatic. The hospital
was very busy, and the birth was long and difficult.
I reacted badly to the painkillers the nurse gave me,
so that I was hallucinating. For a long time I didn’t
realise that the screams I heard were my own. My husband
couldn’t take it and the midwife sent him out.
When I finally saw the twins I was angry and resentful
with them for hurting me so much. I felt guilty for
feeling that way. I thought I’d love them straight
off and I didn’t, so that made things worse. I
felt weird and abnormal, not a proper mother with all
the feelings I thought I was supposed to have. When
my husband had gone and the twins were taken to the
creche, I was left on my own until a nurse came to stitch
me up three hours later. She was horrified with what
she saw and exclaimed, “What a mess! It looks
like tramlines!” After she’d sewn me up
- without anaesthetic - I had a cup of tea and a biscuit
and they left me alone. Between the thirst and the drugs
still in me I had nightmares that left me sweating and
terrified, and in the morning when they took me to the
ward the children wouldn’t stop grizzling. I couldn’t
produce enough milk for them, and I didn’t know
babies need water too. Nobody told me and I didn’t
know to ask. I felt so lost and helpless and trapped,
it was awful.
Though
I continued to have weeping fits for years, I covered
up how bad I felt because I thought they’d label
me an unfit mother and take the twins into care. I felt
inadequate. The slightest thing was too much effort,
everything at home was a mess and I was lonely and frustrated
stuck at home. We’d only just moved in so I didn’t
know anybody, and my mother, who lived 50 miles away,
was no help at all. My husband would get impatient and
shout, “Pull yourself together!” which made
me feel worse. I looked really ill and I put on two
stone. Even when the babies slept through, which wasn’t
very often, I couldn’t sleep. I’d lie in
bed crying silently so my husband wouldn’t hear,
thinking over and over again how pathetic and useless
I was. Colours seemed muted as though everything was
only shades of grey, and I’d hear babies crying
where there couldn’t possibly be any. I thought
I was going mad and I couldn’t imagine ever feeling
happy again.
If
only I’d known sooner how to overcome depression!
But I’m so glad I found out. It’s really
made my life better, in all sorts of ways I’d
never dreamed of. Learning how to overcome depression
is such a gift – and if I can do it, you can!
My
recovery started when I broke down completely at the
Health Visitor’s Clinic. The twins were two and
a half, a real handful. When the health Visitor asked
me how I was, I just burst into tears. Far from being
critical, she was really sympathetic and helpful. She
found them a place in a nursery at a reduced fee. It
was just afternoons and it meant walking 20 miles a
week but it was such a relief to have two hours a day
when I could finally sleep. She also told me to go the
doctor for some antidepressants, and though the first
type didn’t suit me, the second lot did. She also
recommended seeing a counsellor.
At
that time I didn’t go, but when I next felt bad
I did. That was after we’d moved because of my
husband’s job, and I felt uprooted and isolated.
Because it had been so helpful before, I had no hesitation
this time in seeing the doctor, and I was lucky enough
to be referred to an excellent counsellor. She helped
me see things in a new perspective that was much healthier.
Here’s what I learned:
I’m
not alone, or weird. It’s normal to be stressed
in a stressful situation. It’s all right to feel
depressed – not that it’s comfortable, but
it’s not my fault. Lots of people feel this way,
and it’s OK to ask for help. I don’t have
to be perfect. Good enough is good enough. I’m
allowed to trust my feelings and know when things aren’t
right. Best of all, I don’t have to beat myself
up if I do something I’m not satisfied with. Very
few things are beyond redemption. Not being able to
do everything perfectly doesn’t make me a failure.
Anyway, I’m allowed to know that I do some things
well, and I can learn what I need to do other things
better. I don’t have to set myself up for failure
by demanding unattainable targets of myself. Small steps
are really valuable, and I can celebrate them. I’m
also allowed time off, and though my husband wasn’t
very happy at first when I started going to night school,
he got used to it. It was great to be doing something
just for me and to talk about something other than housework
and babies. And later, it was helpful in finding a good
job. I’ve now got friends, and I know that hiding
my feelings keeps others at a distance! Now that I value
my feelings, other people are much more likely to respect
them. I enjoy life, I’m getting on fine with my
husband, and the twins have grown up well and happy.
Best of all, I know that depression does go away.
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