Out of the Blue – how to recover from depression

What are the signs & symptoms of depression?

Recovery from a mental illness is possible. This article outlines the signs and symptoms of depression.  People experience depression in many different ways.  The most common feature is feeling low in mood or feeling “flat”. People who are depressed may also feel irritable or have a sense of guilt. He or she may lack energy or  lose interest in life. Other signs and symptoms are aches and pains. The person may have  trouble  sleeping either sleeping too much or not sleep at all ( insomnia) or loses his appetite. There are times when he or she becomes tearful.  The depressed person is pessimistic, negative in his thinking.  He is unable to concentrate or make simple decisions.  Some people ruminate when they’re depressed. A person who is depressed may isolate himself from others, neglect his personal hygiene, abuse substances, become mute, avoid eye contact or self harm.

What are risk factors of depression & why do people become depressed?

There are 2 types of depression:

  1. Endogenous depression: This type of depression does not need a trigger because it originates from within the person.
  2. Reactive depression:  There are triggers that cause the depression. Here are some examples of stressors.
  • Physical illness
  • Sense of loss: death of a loved one, loss of a role in life, loss of job, loss of support
  • Low self esteem
  • Substance misuse/ abuse
  • Inability of cope with stress within the work place, family or society
  • Unresolved trauma
  • Unsolved problems
  • Hereditary

I want a test for depression.

A health care professional will ask you many questions about your mood and your behaviour . This is called an assessment. Typically this takes about one hour. There are tests that you can take for depression. Examples of these tests are PHQ-9 , Beck Depression Inventory or BDI, Hospital Anxiety and Depression scale ( HAD). These tests are questionnaires that carry  a scoring system. Once the assessment is done ,the health professional then discusses a treatment plan with you.

How do depressed people think?

The way you think affects how you feel and the way you feel determines how you behave. We all have a tendency sometimes to think negatively or have distorted thinking. When we are either under stress or depressed these distortions become more exaggerated.  Below are 6 examples of common thinking distortions.

  1. All or nothing thinking: the persons thinks in absolutes – in black and white with no middle ground or grey area. They tend to judge others using general labels. ” I’ll never get a job” ” I’m completely useless”
  2. Awfulising  or catastrophising: the person tends to magnify or exaggerate how awful or unpleasant events can be. He tyically over estimates the chance of failure
  3. Personalising: the person takes responsibility and blames himself for anything unpleasant eventhough it has nothing to do with him
  4. Negative focus: the person focuses on the negatives and usually filters out the positive aspects of events.
  5. Jumping to conclusions: the person interprets events negatively without evidence or definite facts. Predicting the future negatively
  6. Living by fixed rules: the person is most likely a perfectionist, living by fixed rules with little or no flexibility. He has high expectations of people. He regularly uses the word ” should” “ought” ” must” or “can’t”. The more rigid the statement the more disappointed , angry, depressed or guilty he is likely to feel

Is recovery from depression possible?

Depression is a treatable illness. If you think you have depression, you should  see a health professional. You should ask as many questions to understand  the nature of the illness. Treatment should be a partnership between you and your health  professional.  If your doctor prescribed medication make sure she informs you of its effectiveness and side effects. You may want to combine medication with talking therapy.If the depression is very severe a short stay in hospital to help in your recovery is a good idea. If  you’re feeling suicidal the best thing to do is to present yourself in the A&E department of a hospital.

A CBT  ( cognitive behaviour therapy) specialist can help you challenge your negative thoughts , set you some homework to monitor your mood and suggest things to help you feel better. There are many things you can do towards your recovery. Below are some suggestions:

  • Practice mindfulness
  • Keep a journal
  • Practice yoga
  • Exercise regularly
  • Do things that bring you joy
  • Change your environment if possible
  • Counseling can be helpful to resolve past issues
  • Seeing a religious person for a spiritual perspective

What to do if I’m depressed?

Recovery from depression is possible.  If you think you’re depressed, you can do many things to get better. If you want a diagnosis you need to see a doctor.  Your doctor may prescribe medication. Make sure you get as much information as possible from your doctor and other reliable sources.  Below are some questions you may want to ask:

  1. What is the name of the medication?
  2. How does it work?
  3. When can I feel the benefit of the medication?
  4. How long do I have to take the medication for?
  5. What happens if I stop taking the medication?
  6. What are the side effects of the medication?
  7. How can I manage the side effects?
  8. What happens if I want to get pregnant?
  9. I’m taking other medication , will the antidepressant be effective?
  10. I’m breastfeeding , will the medication have any effect?
  11. How long do I need to see the doctor for?
  12. What happens if I want to stop taking the medication?
  13. What happens if the medication does not work?

Sometimes things become so bad that you need to be in hospital for a while. It is important that you fully discuss this with your doctor, your carer and those that you care for.  The purpose of being in hospital is to keep you safe. The environment and  health care professionals can help you get better. When you are discharged make sure you have a plan to remain well. Keep your appointments with the health professionals and keep active.

Action may not always bring happiness; but there is no happiness without action   – Benjamin Disraeli –

Feeling depressed is a vicious cycle. Your negative thoughts make you feel miserable, lack of confidence and unmotivated. This means you slow down, get tired and become less active. You avoid situations which means you don’t have any positive experience. Your confidence is then further reduced. The reduced confidence strengthens your negative thoughts.

What to do?

  1. Begin by writing down a “to do” list for the next day;  when you get up you already have a plan
  2. Mix pleasurable activities with duties and responsibilities
  3. Involve others with your activities for example; phone a friend to go for a walk with you
  4. Break big tasks into smaller ones.
  5. Be flexible . Do not fret if you are unable to achieve one of the task. Just go to the next one
  6. Increase the frequency of your activity taking it one step at a time.

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