Depression: Out of the blue
Depression is almost as common as it is debilitating: one in five people will experience it in their lifetime and it is the leading cause of disability in the world. How does it develop, how does it differ from 'feeling low' and what therapies can help to alleviate it?
Depression is common, but what distinguishes it from ‘feeling low’?
As many as one in five of us experiences depression at some point during our lifetime. At any one time, 10 per cent of us are depressed, according to the Mental Health Foundation. Not everyone seeks treatment for depression, and some people don’t ever share it with friends and family, let alone a healthcare professional.
This is why precise figures on the incidence of depression are hard to come by, but we do know that it is more likely to happen as a result of certain life events, or at certain ages, or times. Teenagers are about twice as likely as younger children to become depressed, and about 12 to 15 per cent of mothers become depressed after pregnancy and childbirth. There is a further peak at age 65 plus.
Depression is much more than feeling a ‘bit down’ or ‘low’ occasionally, perhaps as a reaction to bad news, or some temporary difficulty in your life or at work. You may be depressed if you feel tired a lot of the time, even if you’ve been sleeping a lot; if your motivation for doing even normally enjoyable things has gone; if you have mystery aches and pains or headaches.
Many people with depression have a strong tendency to ‘ruminate’, repeatedly churning over problems, difficult conversations and situations, to try to resolve them. But rumination is usually not helpful, and can actually get in the way of problem solving, and make depression worse.
There’s no single way of experiencing any of this, however. Some people become intensely depressed for a relatively short time, maybe lasting a few weeks; others may be mildly depressed for a long time, even years. Other people have variations on this, or a mix of experiences.
Different varieties of depression may need different forms of support. For example, bi-polar disorder brings with it low and high mood swings, with sometimes intense and difficult periods at either end of the spectrum. Seasonal Affective Disorder can occur in the autumn and winter and bring about depressive symptoms as a result of a reaction to the darker days and evenings.
Risks factors and inheritance
Although depression is not predictable, in that we don’t know who is going to experience it and when, there are definite risk factors that make it more likely to happen to some of us than others. Past experiences, perhaps going back to childhood and even infancy, can make some people less resilient to negative life events, and perhaps lead to a low opinion of oneself.
There’s some evidence that depression runs in families (especially bipolar depression) and there may be a genetic factor for some people. Major life pressures, especially bereavement or serious stress at work, or relationship difficulties, can also put people at higher risk.
Fortunately, there are a variety of psychological therapies available to alleviate depression and its cognitive, behavioural and emotional symptoms.
For example, Cognitive Behavioural Therapy (CBT) has been found to be as effective as antidepressants in alleviating depressive symptoms: CBT and antidepressants are associated with similar rates of recovery, but evidence suggests that CBT has far fewer cases of relapse. Researchers in Exeter also recently found mindfulness therapy to be as effective as antidepressants in preventing relapse of depression, and more effective in improving quality of life. It was also proved to be as cost-effective in helping to stay well in the long term.