Subjects we're afraid to talk about

Depression is so often still mistaken for ‘the blues’ with people telling others to ‘pull yourself together’. It is not that simple.

It’s so important for everyone to feel able to speak up about mental health issues, whatever they are. I immediately have a lot more respect for somone if they have an understanding of mental health and even more so if they talk about their own issues. Recently Rugby superstar Jonny Wilkinson opened up about his problems with depression and I hope this encourages others to be as honest and also to understand.

No matter what the mental health issue is, it helps to talk about it so those suffering with the issue need to know they have a support network around them. If you think you might have depression, then try and talk to someone about it be it family, friends, a doctor or support group. If you think you know someone who might have depression, then get to understand the illness and try making the first move. It really does make a difference.

Here’s a quick guide to Depression:

Depression is one of the most common forms of mental distress. Often occurring with anxiety it appears in about 10% of the population, and arises on its own in about 3%.

What is it?

We all have periods in our life where we feel sad. Often times, there’s a reason, a failed job, a failed relationship, but it’s when someone feels sad for long lengths of time for apparently no reason, then it can be described as ‘depression’.

There are 4 sets of symptoms:

1) Mood / emotional – describe themselves as sad, blue, miserable, helpless, hopeless, unhappy, worthless, ashamed, guilty

2) Thought / cognitive – thinks of self in very negative light.

3) Motivational symptoms – difficult getting started, motivated

4) Physical – every biological and psychological joy that makes life worth living is eroded. Loss of appetite is common, weight loos, get difficult to sleep, leads to weakness and fatigue

A person doesn’t need to be suffering from all of the above to be diagnosed as ‘depressed’

Research shows there is a gender difference with depression with women twice as likely to be diagnosed as men. Depression, however, isn’t choosy with age – it hits all age brackets and is becoming more frequent in younger people.

So what causes depression?

There are many theories to why people develop depression. Here are a few and very simplified, possible reasons:

The Biological Argument

Some researchers show that depression is linked to the depletion of biogenic amines (substances known as that help transmit nerve impulse across gaps between nerve cells). There also seems to be a genetic link. First degree relatives of depression have between 2-5 times risk for depression.

The Psychodynamic Argument

Anger turned against the self, excessive dependence on others for self-esteem and helplessness at achieving one’s goals

The Cognitive (Thought) Argument

The Cognitive Triad – negative thoughts about self, about ongoing experience and future. Negative thoughts about self consist of the depressive’s believe he is defective, worthless and inadequate. Slow self-esteem derives from belief he is defective. When has unpleasant experiences, he attributes them to personal unworthiness. – often misinterprets small obstacles as impassable.

Treatments

Drugs

There are a variety of different types of medication you can take. These include tricyclic antidrepssants, MAO inhibitors (monoamine oxidase an enzyme) and SSRIs (Selective Serotonin Reuptake Inhibitors eg Prozac). It’s the latter type that is the most popular form that is prescribed. All of these drugs help to lift the mood by working on chemical messengers in the brain, however they do all have side effects and can take up to 4 weeks to start to take effect.

Psychological treatments include:

Problem-solving therapy – a few sessions to help you put your problems into manageable proportions and find strategies for coping with them.

Cognitive therapy attempts to correct this distorted thinking

Psychodynamic counselling – this examines past experiences and relationships and how they contribute to feelings in the present.

Electro Convulsive Shock Therapy (ECT)

This remains a controversial therapy and is only used in severe cases when patients haven’t responded to drugs. The patient is put under a general anaesthetic and an electrical current is passed through the brain to alleviate the depression.

You can also help yourself

Depression can feed itself. By knowing this, you can help overcome it. Negativity breads negativity. There is no quick fix for this, but there are ways to help.

Be aware of your thoughts, try and recognise patterns that emerge surrounding times of feeling depressed and, if you can, try and change activity, preferably something more constructive. By getting out of doing whatever was making you feel down will help break this cycle.

One of the things people suffering from depression feel less inclined to do is physical activity. This, however, is a great therapy – for the mind as well as the body. Just 20 minutes a day will help improve your mood. Activity such has walking, gardening, cycling and dancing can stimulate endorphins, which are chemicals in the brain which help you feel better

Try to avoid alcohol and tobacco as these can exacerbate depression. You also need to look after yourself by eating a healthy, balanced diet and make sure you care for you general appearance and treat yourself from time to time. It’s also a good idea to set yourself some goals – nothing too extreme because you could be setting yourself up to fail and getting more depressed, but something that does offer a little challenge. A sense of achievement can really help.

TALK

That’s what this blog’s all about – getting people to talk. Depression, like many mental illnesses are isolating, so a good way to help yourself is to meet with others and share experiences, by doing this you realise you’re not alone. This is also a great way to hear other people’s stories on how they have managed and how they are getting better.

Talking is also a way of helping a friend or relative who is suffering from depression. By the very nature of their illness people who suffer from this condition will withdraw and not seek help themselves. Try to avoid blaming them or being negative. A positive attitude that something can be done will be much more effective.

There are also other forms of depression:

• Bipolar

• Postnatal

• Season Affective Disorder

I hope to return to these later.

For further information and links to helpful resources visit www.mind.org.uk

Recent TV coverage:

I was almost late for work this morning because I got side-tracked by an interview on ‘Lorraine’ with Ruby Wax.  Why was I interested? It was about depression. I was so pleased to see another feature on mental illness so soon after the last one.

For those who have seen Ruby Wax on TV it’s only natural to think of her as a brash, outgoing, happy, lively individual. Mention the word depression in the same sentance as her and I’m sure many people will be surprised she is the 1 in 4 that suffers from it. Depression isn’t selective. Anyone can have it.

Ruby really hit the nail on the head as she compared depression to diabetes. In both one of your organs is sick and is lacking in a chemical. People with diabetes aren’t embarassed to admit they need to take insulin and someone who has to take antidepressants shouldn’t be embarrased to admit this either.

She went on to say that attitudes have changed, the very fact that she was on the TV this morning talking about it proved this. A few years ago, this would never have happened. She admitted that she would never talk about it, for fear of being sacked. This is terrible. No one should have to cover up any illness, mental health included.

Ruby Wax is currently doing a tour and at the end of the show they have a talkback event where people stay behind and everyone talks about their depression. She delighted in saying how many people in the audience recognised the stories she was telling and how people actually felt relieved and good about talking to other members of the audience. If it works in this scenario, it should work elsewhere. It also proves, that people need to talk about it.

We’ve come along way, but as the stats show, 1 in 4 people suffer from depression. This means it’s highly likely that someone you know is suffering – and probably in silence too. The stigma is fading, but only gradually. We can all do something about this – we need to do something. It’s so important to talk about problems if you have them, if you haven’t, then it’s just as important to listen to those who do, or to talk to them in the first instance to show it’s okay to talk.

I’m really keen to get people to talk openly about mental health issues and I was pleased to hear on breakfast television the other morning someone doing just that. It’s great when mental health gets time on a TV show, though normally it’s only a couple of minutes and then they move onto cooking or the competition. It’s brilliant when someone is brave enough to go on and talk about their problems as it shows people suffering that they’re not alone. Sometimes I feel what works even better is when a public figure speaks out. A lot of people believe that celebrities are perfect individuals who have no problems, but are perfect. By speaking out, it shows other people mental illness can, and does, happen to anyone.

This week, one of the nation’s most well loved actresses from Coronation Street stepped up and talked about her severe depression. I didn’t see the full programme myself, but have seen clips on the internet. It was a good discussion, but once again far too short. I do, however, hope that people sitting at home watching this, thinking or knowing they are suffering similarly with depression, might be encouraged seeing someone so well known to get help themselves. She was certainly hoping so too. One word of warning though. Her depression was severe and as such she had to undergo ECT (electro-convulsive shock therapy). This treatment has a history and has often been portrayed as being barbaric. It’s now done under general anaesthetic and only in extreme cases, and not regularly as it once was. So, please do not feel worried or scared that if you go for help for depression then you will have to undergo this too. There’s a lot more the doctors will work with you on first. Don’t be put off by the mention of this therapy; because even if you do have it, it’s regulated and has shown to have some success.