Depression is a hugely common condition. One in 5 of us will experience depression at one point in our lives, but how do you know if you are depressed? Sometimes we don’t notice it creeping up on us.

Experiences vary, but they might include:

• Feelings: Low confidence, feeling worthless, hopeless, guilty, more irritable and angry than usual, an inability to enjoy things.
• Changed behaviour: With blokes particularly, drugs and alcohol are often used as a way of dealing with these feelings. It can also take less to ‘snap’ at others.
• Anxiety: Constant anxiety, even to the point of terror.
• Thoughts: Onslaught of negative thoughts, like a runaway train that can’t be overcome, and churning over the same thoughts over and over again.
• Energy: low levels of energy, finding it hard to do anything, often to the point where it feels impossible to get out of bed. This can actually be experienced as aches and pains.
• Sleep: too little or too much sleep.
• You may feel you are in a Perspex bubble: you can’t reach out, and others can’t reach you. You might know you love your partner or family, but you can’t feel it.

Severe depression, above all, means three things:

1. Hating or disliking yourself.
2. Hating the world around you and wanting to escape it.
3. Seeing little hope or future for yourself

Depression is hard to ignore at its worst but at the same time we don’t want to admit it. Sometimes we don’t notice it creeping up on us.

Depression is not the same as a physical illness but it can be even more serious because when we are severely depressed we can feel like giving up on life itself.

Is it the same as sadness?

• No, we all have ups and down, and we get sad and then get over it, like a bad day at work.
• You can’t just pull yourself out of depression, and those who think you can are wrong.
• Depression is as real an illness as any physical ailment. You can’t think your way out of depression any more than you can reason your way out of a broken leg. And just like a broken leg, it takes time to recover.
• The difficult thing with depression is that your negative thoughts can get in the way of your recovery; hence the advice to do things that take you away from thinking, like exercise or gardening.

When severe, people describe depression like being in the depths of hell. They may have thoughts of harming themselves, and that others would be better off without them.

Men, in particular, may ‘externalise’ their depression at times, including emotional numbing, increase in risk taking behaviour, escapism, use of substances such as alcohol and drugs to cope, and anger issues, allowing their distress to build up to the point that they might ‘snap’ and take it out on themselves or others. Men with depression may sometimes get into excessively blaming others, or not feel the need for help.

Where can people go for help?

• There is so much help available out there. You are not alone, even though you probably feel that you are.
• Your GP is often the first port of call and may refer you for suitable (usually free) treatment such as cognitive behavioural therapy, counselling, mindfulness meditation or exercise programmes. They might also suggest prescribing antidepressants.
• Friends or others who have had depression – friends who listen without trying to give solutions, who are just there for you, and might even help you with practical things, are an amazing tool for recovery.
• Internet – support groups like Depression Alliance and websites such as www.healthtalkonline.org are available to find out what others with depression have been through and how they dealt with everything.
• Blue Pages – find out what works and does not work for depression: https://bluepages.anu.edu.au/index.php?id=what-works-for-depression-and-what-doesnt
• Private talking therapists e.g. Google ‘Counselling Directory’. Please note that private counselling services cost money, although you can ask for a discount.

What if my GP is unhelpful?

• It’s really hard for patients with depression to deal with unhelpful GPs when your self-esteem and confidence is so low, so maybe bring a trusted friend, partner or family member along to your appointment.
• Write down your experiences and take this in to your appointment and read it out to the GP.
• See another GP and seek a second opinion if you feel you have not received the treatment or help you feel you should. Most people have the option of a few different GP practices within the same catchment area.

Does talking therapy work?

• Talking to someone who can really listen is a key way in which people say they overcome depression.
• Many come to see that they have been ‘actors’ in their own lives, rather than being themselves and fully involved, and it is helpful to feel more authentic within themselves.
• Talking can also help you to notice how your thoughts have been distorted (e.g. blaming yourself for everything that has gone wrong). Therapy like CBT looks at shifting these thought patterns towards a more healthy style.

Where can I get talking therapy from?

• GPs can refer you to a suitable therapist in your local area.
• There’s a comprehensive list of professional services on the Counselling Directory and BACP websites or call our helpline to find out what services are available to you.

Does medication work?

• It does for some people, especially those with severe depression, but not everyone’s experiences with medication are the same.
• There are loads of myths about medication, but it can be a life raft. Some people feel more like ‘themselves’ on medication, others less so. There are side-effects associated with the use of anti-depressants and coming off medication may need to be gradual and can take a long time. It’s not as simple as being an ‘easy fix’, and is certainly not the only option, regardless of what your GP may offer you, so it’s always worth checking out all the options available.

What is recovery?

• Recovery is all about building a meaningful and satisfying life, as defined by you.
• Depression tends towards recovery, but it may take time, so you have to be patient. Depression is a treatable chronic condition and, although it may not feel like it when you experience a depressive episode, there are always treatments and therapies available. The most important thing to remember is that you ARE NOT ALONE. Help is out there. There is always hope.