DEPRESSION

What is it?

Clinical depression is more than feeling a little bit low, which often passes when something pleasant takes our minds off our worries. It is a mixture of feeling miserable and other negative feelings, such as lack of interest, guilt, low self-esteem and disturbed sleep. Your mind will dwell on negative things and even your favourite activities will seem less appealing.

What causes it?

Depression is often due to a shortage of certain natural chemicals in your brain. It may be the way your body reacts to outside stresses.

Who gets it?

Up to one in ten patients seen by your GP will have symptoms related to depression - it is a very common problem. You may be more likely to get depression if you tend to be anxious. You may also get it if something upsetting happens to you, such as a difficult bereavement, family or work problems or even childbirth.

What are the symptoms?

You may notice that the main symptom is feeling miserable or always looking at the negative side of things. You may find yourself avoiding things you used to enjoy, such as seeing friends. You may feel tired and weepy, feel guilty or anxious with no obvious cause, find it hard to sleep or wake early in the morning, and find it hard to concentrate. Your appetite may be affected and you may even feel life is no longer worth living.

When should I go to my GP?

If any of these feelings last a long time or start dominating your life, or if you have several of them at one time, you should see your GP. He or she will have seen this problem often and will not think you are wasting his or her time. You should certainly make an appointment if you have suffered from depression before and get the same symptoms. If you start to feel that life is not worth living, you should seek help urgently.

What tests will my Doctor want to do?

Your GP will want to ask you questions about your feelings and what affects them. There is no blood test or scan which will tell if you are suffering from depression.

What is the short-term treatment?

This depends on the cause of your depression and how severe it is. You may be asked to come back regularly to see your GP or a counsellor (or occasionally a psychiatrist). Your GP may prescribe tablets or suggest you take some time off work. If your depression is caused by one specific thing, your GP may advise you to concentrate on tackling that - for instance, if you have problems with money or at home, he or she may suggest help from a social worker or Citizens Advice Bureau.

Will I need long-term treatment?

Again, this depends on how bad the problem is. If you need antidepressant tablets, your GP will probably advise you to continue with them for a few months after you start feeling better, and then to tail them off gradually. If you have several episodes of depression, you may need long-term medicine or counselling.

Will I need to go to hospital?

If your depression is very severe, suddenly gets worse or does not respond to treatment from your GP, you may need to be referred to hospital. You should also be referred if you begin to think life is not worth living. Many hospitals now have an emergency psychiatric service, where you can go without referral if things get bad.

How can I stop them getting worse?

If your doctor prescribes antidepressants, they will take a couple of weeks to work. You should try not to stop them without asking your doctor, and make - and keep - regular follow-up appointments. These tablets are not addictive, but you may find that when you stop them you start to get anxious or depressed again. If you do, you should see your GP again quickly. You can also help by looking after yourself - eating well, not drinking too much alcohol and talking to your friends. You may also find relaxation techniques, such as yoga, very helpful.