Depression

What is depression?

Depression is a medical disorder just like high blood pressure, diabetes or asthma. It's an abnormal mood associated with specific and reversible chemical changes in the brain. Depression is not a sign of weakness, nor is it a state you can just snap out of.

Who gets depression?

Nobody is immune to depression and it can happen at any age. In fact, around 10% of men and 25% of women will develop depression at some point in their life.

What triggers depression?

For many people, depression is triggered by a stressful event, alcohol or drug use, or an unresolved long-term difficulty. However, in some people there is no obvious trigger.

What are the symptoms?

You should not confuse depression with sadness and loss, feelings that often pass quickly. These feelings are often understandable and do not normally prevent you from coping with your normal life.

The symptoms of depression are different. They include a significantly lower mood, irritability and not being able to enjoy usually pleasurable activities. A depressed person has negative thoughts about themselves, the world and the future - thoughts that cause a loss of self-confidence. Physical symptoms include changes in appetite and sleep patterns, and loss of interest in sex. People with depression have reduced energy levels, leading to fatigue (extreme tiredness), lack of activity and difficulty concentrating.

How will depression affect my life?

Symptoms can be intense and disrupt your work, social and family life. In the Medical Outcomes Study, depression was found to be as socially debilitating as coronary artery disease (that is, you may find it difficult to mix with people or may not feel comfortable leaving home).

Why should I have a psychiatric assessment?

Just as a patient sees a doctor about a physical illness, a psychiatrist will look at your symptoms and explore how they have developed.

A psychiatrist will try to find out what makes you likely to suffer depression. Are you generally more negative or do you suffer from low self-esteem? Does depression run in your family? Are there unresolved long-term problems? The way you use alcohol and drugs, both medicinal and recreational, has important influences on your mood. You must provide information about your medical history as some illnesses, like an underactive thyroid, may cause depression and it helps the psychiatrist to decide what medicine is most suitable.

The psychiatrist will look for a wide range of psychiatric symptoms. One of the most important is to know if you are so depressed you may commit suicide.

Should I go into care?

Most people can be treated as an outpatient. However, some people want more intensive treatment and support within either a day-care programme or as an inpatient, at least until they feel signs of improvement.

What types of treatment are available?

Although it's hard for you to believe, you can overcome your depression by receiving treatment. The treatments most commonly used are cognitive behavioural therapy - a type of psychotherapy - and antidepressants. Both have been proven to be successful.

How does cognitive behaviour therapy work?

Cognitive behaviour therapy tackles your negative thoughts. For example, when something bad happens depressed people blame themselves, but when good things happen they tell themselves that they've just been lucky. They also assume that other people are reacting negatively to them. Cognitive behaviour therapy helps people think in a more balanced way and challenges a person's assumptions about their lives. It aims to identify and change aspects of behaviour that may cause or prolong symptoms of depression.

What change will cognitive behaviour therapy have?

By helping you change the way you think about life, you'll be able to accept failures more easily and take credit for your achievements. Cognitive behaviour therapy aims to give you skills for life, reducing the likelihood of you becoming depressed again.

Will cognitive behaviour therapy work for all cases?

Although cognitive behaviour therapy is likely to form the basis of a psychotherapy programme, other forms of therapy may be helpful. For example, if you were abused as a child, or you are finding it difficult to come to terms with a death, this would need to be dealt with in its own right.

When are antidepressants used?

Antidepressant medication will be the first line of treatment if:

your depression is severe or comes and goes;
you've responded well to medication in the past;
there's a history of depression in your family; or
you have not responded to psychotherapy.

Which antidepressants will I be given?

There are many different antidepressants. The choice of medicines is based on a number of factors, and we will discuss this with you and possibly members of your family.

How long will antidepressants take to work?

Antidepressants take time to have an effect, often a number of weeks, because they're helping nerve cells recover and resume their usual role in regulating mood.

Are antidepressants dangerous?

Antidepressants are not dangerous when you take them as prescribed. They are not addictive and can relieve your depression effectively. We will tell you about the possible side effects, but it is unlikely that you will have any.

What can I do to help myself?

Self help can make a difference. Joining a self help group is a great way to discover you are not alone and are not the only one to suffer from self-blame, rage and despair. Try to eat regularly and have a good diet, including fresh fruit and vegetables. Exercise will help relieve stress and tension, whether aerobic exercise such as jogging or more relaxing exercise such as yoga.

Please remember the following:

Depression is an illness, not a sign of weakness.
Treatment is effective and there are many treatment options available.
There is a suitable treatment for every person.
The aim of treatment is to get 100% well and stay well.

Self help

Finding help

Contacting your GP is often the easiest way to get help and further treatment. He or she may offer you counselling or refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment.

If you're worried about talking to your GP, consider writing down your concerns and questions. You can:

take a friend or family member with you;
see another doctor in the practice; or
join a new GP practice.

The type of professional support offered will depend on the services that are available in your area and the arrangements that your primary care trust (PCT) have with other health authorities or private providers. Treatment for depression is also available privately through Priory.

If you feel that you or a close relative are affected by depression and would like help or more information, you can ask your GP or contact any of the following organisations:

Depression Alliance
0845 123 23 20 (www.depressionalliance.org)

NHS Direct (England and Wales)
0845 4647 (www.nhsdirect.nhs.uk)

NHS 24 (Scotland)
08454 242424 (www.nhs24.com)

The Samaritans
08457 909090 (www.samaritans.co.uk)

Priory
0845 2 774679 (www.priorygroup.com)

If you are interested in receiving treatment from us, your GP will be able to refer you.

If you or your relative has private medical insurance your insurer will probably insist that your GP refers you to us.

Why should I choose Priory?

Our service

At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.

Expertise and innovation

As Europe's leading independent provider of specialist mental health, neuro-rehabilitation and special education services, we bring experience and an excellent reputation. Through our close links with the public and private sectors, we've developed the expertise and innovation to offer consistent and successful treatment.

We admit patients 24 hours a day, seven days a week.

To view a list of Priory hospitals that can help with depression please click here.

This document has been created by Dr Jeremy Broadhead MA Mphil MRCPsych, The Depression Alliance (www.depressionalliance.org) and Plain English Campaign (www.plainenglish.co.uk)

For more information please click here to download our self-help leaflet.