Depression
When the light leaves
Depression can feel like the light has left the world, like you are completely surrounded by darkness or grey. There is less or no joy, happiness, motivation or energy. Thoughts about wishing you were dead and suicidality can be common. You can feel worthless and like a burden to others. I speak from personal experience. The good news is that treatments and help are available.
People often use the term depression quite loosely, but here we are referring to more than some simple sadness. Rather we are referring to clinical depression or Major Depressive Disorder.
Depression is very common affecting 1 in 7 people in Australia and causes significant impairment in function and ability to be happy.
See the videos from Beyond Blue at the bottom of the page for a good description of depression and it's symptoms.
Symptoms
Depression symptoms can include:
Depressed mood including feeling sad, flat, empty or hopeless. Can also present as irritable mood for some and particularly adolescents.
Diminished or decreased interest in activities
Weight loss or gain or decreased or increased appetite
Difficulties sleeping or excessive sleep
Increased or decreased thinking or physical activity (psychomotor agitation/retardation)
Fatigue or loss of energy
Impaired concentration, may be seen as indecisiveness
Thoughts of death or suicide
Causes
There are various potential causes including genetics, stressors, grief and trauma. For a more comprehensive list of causes please visit the following website:
https://www.blackdoginstitute.org.au/resources-support/depression/causes/
Treatments
Treatment options often depend on the severity of depression you experience. Hence it is best to see your general practitioner or psychiatrist for an assessment of your level of depression and treatment options. Your GP and/or psychiatrist can also help develop a tailor made treatment plan. It is important to note that often a combination of treatments works best. Some treatments that are available include:
Medical Treatments
Medication
Medication treatment is indicated for those suffering from moderate to severe depression. The most common class of medications used are antidepressants. However other medications such as mood stabilisers and antipsychotic medications are used in the treatment of depression. See Medications section for further details.
Neuromodulation Treatments
These treatments are mainly reserved for very severe and/or treatment resistant depression.
Electroconvulsive Therapy (ECT)
ECT is a noninvasive procedure that treats serious mental disorders by using an electric current to induce seizure activity in the brain.
This could be considered the most effective and evidence based treatment for depression
However has a number of side effects and stigma associated.
Repetitive Transcranial Magnetic Stimulation (rTMS)
rTMS is a noninvasive approach that uses a magnetic fiel to induce an electric current to depolarise neurons in a particular area of the brain.
Has evidence supporting its use to treat depression that has not responded to medication.
Psychological Treatments
Psychological treatments can be the most important part of treating depression. There are many different psychological treatments that are available including, but not limited, to the following:
Cognitive behavioral therapy
Interpersonal psychotherapy
Problem solving therapy
Short term psychodynamic therapy
See the Psychological Treatments section for more details about the above psychological treatments.
In addition to the above therapies there are a number of online mental health treatment programs which can be useful and convenient for patients to use. These inlcude:
Adults
https://thiswayup.org.au/ (small fee required for some courses)
https://moodgym.com.au/ (free)
https://www.mindspot.org.au/ (free)
Young people
https://www.biteback.org.au/ (ages 13-16)
https://www.eheadspace.org.au/online-and-phone-support/ (ages15-25)
https://au.reachout.com/ (under 25)
https://www.beyondblue.org.au/who-does-it-affect/young-people (ages 12-25)
https://brave4you.psy.uq.edu.au/ (children and adolescents)
Other Treatments
There are a number of other treatments that may be useful for those suffering from depression. These include:
Mindfulness- See Mindfulness section
Sleep hygiene- See Sleep Hygiene section
Healthy diet and exercise
It is important to maintain a healthy diet to help maintain energy levels whilst unwell.
It is ideal to maintain your exercise levels from before you were unwell. Exercise has been frequently shown to help and improve patient's mental health.
Support services by telephone
The following support services may be beneficial for patients particularly if you are in crisis.
Suicide Helplines (See Contact Numbers section)
SANE Helpline-1800 187 263
Carer support services
It is not uncommon for a patient's loved ones to need support as well as the patient. This can allow them to relieve their stress and better support their loved one.
For carer support services see the Carer Support section.
Additionally it may be beneficial for carers to seek their own professional mental health supports to provide face to face support on an ongoing basis. In which case I would suggest going to your general practitioner for a referral to a psychologist and/or counsellor.
Further Information
Read further about depression at:
Beyond Blue provides an overview summarising many treatments for depression and the evidence behind them. Please visit the link below to view this document.