Depression is not merely 'feeling down' or 'low'; not simply 'sad' or 'miserable'. These emotions & feelings are part of existence and do not, by themselves, constitute true 'clinical depression'. Reactions to stressful events,the struggles of life & various disappointments one might experience are often referred to as depression or 'feeling depressed', though the more accurate definition of true pervasive depression relates to the severity of the symptoms, the length of time these symptoms have been present and the effect on psycho-social functioning; when it consumes your everday life and interferes with your capacity to work, sleep, eat appropriately and enjoy aspects of life that would normally bring you pleasure. The sensation of hopelessness, helplessness, 'impending doom', worthlessness and no ability to find any relief from these feelings would strongly suggest 'clinical depression' of some type. Many sufferers of depression describe their mental state as 'like being in a dark hole with no way out'; or 'no light at the end of a long black tunnel of darkness'. They might not even 'feel sad'; they might not 'feel anything'; 'numb' & devoid of emotion. They might feel anxious or irritible; angry and bitter or they may feel lifeless, apathetic and 'empty'. Each individual will experience depression in slightly different ways and express these in similar fashion - individually. There are, however, certain commonalities that define 'Depression' as an illness and that which will most likely require assistance of some type be it counselling, treatment or other intervention.
Common Signs & Symptoms Possible Stressors leading to Depression
- Financial problems
- Marital or relationship disharmony or problems
- Alcohol &/or Drug abuse
- Health Problems such as injury that has you sidelined or has ended your career
- Abuse or trauma experienced as a young child
- History of having been bullied at school
- Family History of Depression or Mental Illness
- Perception of under-acheivment or not living up to others' expectations
- Death of someone close
- Unresolved Grief
- Low or poor self esteem
- Contract problems
- Change of Club or geographical relocation
Causes of Depression
Depression has often been referred to as being either 'Exogenous' (external cause or source) or 'Endogenous' (biochemically based or without any specific 'trigger'), though clearly these two distinctions are complicated by a raft of issues, events, stressors, biochemical factors, substances and so on. As such, it is more accurate to view any individual's presentation as being a probable combination of factors involving the following areas:
- Biological (this includes, but is not limited to, genetic predisposition, neurotransmitter anomolies, hormonal changes, illness, dietary deficiencies, cerebral changes through injury)
- Psychological (Personality type & coping mechanisms established through developmental stages, low self esteem, 'belief system' are but some of these factors)
- Social (this can include abuse as a child, dysfunctional families, serious marital conflict, divorce of separation of parents, death of parent or significant other and so on. They are events, incidents & experiences that impact upon the individual now & that have impacted on their behavioural development in the past)
Types of Depression Misconceptions & 'False Beliefs' about 'Depression'
(1) Melancholic depression
(2) Atypical depression
(3) Catatonic depression
(4) Postpartum depression
(5) Seasonal affective disorder (SAD)
(7) Adjustment Disorder with depressed mood
(8) Minor depressive disorder
(9) Recurrent brief depression
(10) Psychotic depression
(11) Bipolar disorder (depressive phase)
The type of depression experienced & the subsequent diagnosis is largely determined by a range of factors such as duration & severity of symptoms, along with recurrence & history.
- Medication -Primarily 'antidepressants', though sometimes medication to reduce anxiety or aid sleep may also be prescribed. Be guided by your GP or Psychiatrist.
- Counselling & therapies - Therapies such as 'CBT' (cognitive behavioural therapy); 'Supportive Psychotherapy'; 'Family Therapy' etc.
- ECT - 'Electro-Convulsive Therapy' - usually used in more extreme cases of 'Depression' or 'Treatment-resistent Depression'. Generally undertaken in a hospital setting and very carefully administered & monitored.
- Hospitalisation - Largely used for those considered 'at risk' of 'self harm' or 'suicide'.
- They seem 'happy enough', how can they be Depressed'? Many of those who suffer serious Depression may offer a 'cheery' facade or amiable disposition to those around- very contrary to how they are truly feeling, 'inside'.
- You have to be 'down' & 'miserable' all the time to be suffering 'Clinical Depression'. Some are able to exhibit periods of bright, responsive mood - though this tends to be 'forced' or how they believe they are 'expected to behave'. Self pride and thoughts of shame can impact upon the individual to the point of 'hiding' and 'pretending'.
- You must be suicidal or have suicidal thoughts to be Depressed. Not all people with Depression are suicidal. Suicidal thoughts are not a pre-requisite for Major Depression.
- A person suffering Depression 'curls up in the foetal position'; can't work, can't do anything; can't function. Individuals may manage to 'hold it together' for a time; maybe at work, training, during a game or during a dutiful family gathering or social occasion.
- People with Depression are not hostile, volatile or abusive. They're 'sad', 'flat' 'lacking energy', 'tearful' and 'morose'; that's Depression. Anger & irritibility can be manifested in some presentations of Depression and in some individuals. You don't have to cry all the time or never smile or lack any type of 'emotional energy'; quite the contrary, Depression can involve high emotional energy; sometimes expressed as anger & hostility.
- It's easy to tell if someone is Depressed. Signs of Depression may be very subtle & minor, though significant in the context of the person involved and more likely to be 'picked up' by those 'close to them' and certainly not indicative of the severity of the illness.
- Once you have Depression, you never get better, you'll have it forever. Depression is very treatable. It is certainly not a life-long illness or disability.
- They're not depressed, it's just 'self pity'. Depression is NOT 'feeling sorry for yourself'. This attitude by others & belief held by some has led to many cases of 'curable', genuine & serious illness to go untreated; often with tragic consequences.
Facts & Statistics
- On any given day, more than 100 million people 'world-wide' will suffer from 'Depression'.
- By the year 2020, 'Depression' will be the number two (2) illness in the world
- Approximately 20% of Australians will suffer 'Depression' at sometime in their life and 6% will experience a 'major' depressive disorder
- Depression is one of the most common 'mental health' problems in young people (primarily those between 18 & 24 yrs)
- In 2004; 2,098 people died by suicide - of these 1,661 were males
- In 2005, suicide accounted for more than 23% of ALL deaths for males aged 15 years to 29 years
- Current research & experts believe the 'under-reporting' of suicide in Australia suggests the figure for suicide being closer to 3,000 deaths year
- Depression is strongly linked to 'substance abuse'; 'relationship difficulties'; 'physical illness'; 'self harm & risk taking behaviours' and significant loss of productivity in the workplace
Untreated Depression is a serious illness with potentially dire consequences. Should you believe you are suffering from Depression, please seek assistance; even if your amotivation & negativity is impacting on your desire to address the problem. If you cannot summon the energy to take this step, talk to someone who may be able to encourage & support you toward resolving your problems; be they a family member, clergyman, friend etc. There is no 'shame' in experiencing Depression and the associated thoughts & feelings; remind yourself that it is an 'illness not a weakness'; many people have, and continue to suffer Depression - from all walks of life. It is not 'insanity' or 'madness' and can be treated with sound recovery as can many physical ailments or illnesses, if you seek assistance. Do not also convince yourself that you'll 'snap out of it' or that you can 'sort it out yourself', particularly if the signs & symptoms have been present for an extended period of time, & more particularly, if they have worsened.
What to do & where to go.....
The most important step in the process of 'healing' and becoming well is 'communication'. It is probably the greatest hurdle to overcome and the most serious impediment confronted by the individual suffering Depression. Talk to someone; particularly someone who cares for your well-being or someone who is in a position to provide assistance. Often times, the symptoms of Depression are difficult to express; sometimes you might feel like you don't know what to say, how to explain your feelings, or you might not even have the mental or physical energy to do so. Summon what strength remains, put aside your own self-deprecatory, negative thoughts; ignore the myths & misconceptions about Depression & mental illness and make the decision to communicate your thoughts, emotions and feelings. Once you have taken this step, follow through with active 'treatment-seeking'. There are a variety of organisations and individuals who can assist you becoming well. It may be your GP, Public Health Mental Health Service, Psychologist; organisations such as 'Beyond Blue', 'Black Dog Insitute', 'Headspace', 'Lifeline'. The resources and services are there, but you have to make contact with them or decide to engage with them. Help is available; you will get better; you will rid yourself of the torment that comes as a consequence of a widely experienced, very treatable illness. The one thing not to do is 'suffer in silence'.
Should you have concerns regarding any issue relating to your 'mental or physical well-being', 'Kick off' strongly recommend you seek professional assistance. This may entail contacting your GP or similar clinician (Psychologist, Psychiatrist, Counsellor etc.). You may also contact the appropriate agency or service that might assist you. Irrespective of your choice, ensure you see someone who might help.