2 months ago ·

Understanding: Depression

By Andy – Arch Care Services

Depression is the most common mental illness across the world. The Office of National Statistics estimates that around 20% of the UK population aged 16 and over show some signs of depression. In fact, in 26 countries depression is the most common kind of disability reported. But despite being so common, depression is also widely misunderstood, and there are a lot of misconceptions floating around regarding how depression presents itself and how to treat or manage the condition. This week we’re going to be looking at the causes of depression, how depression manifests for different people, and the various ways that it is treated and managed.

What causes Depression?

The truth is, we don’t exactly know. If you injure yourself physically it’s usually pretty easy to work out how you did it. If you fall off your bike and afterwards are told that you have a broken arm it’s probably fairly straightforward to work out what happened! But if you’re suffering from depression it’s difficult to isolate the exact cause, as it’s probably a variety of things or sometimes nothing specific at all. But we can identify some common trends that seem to apply more often than others:

  • Childhood Experiences

Nowadays we don’t tend to ask people to lie down on the sofa and talk about their parents when they go for counselling, but there is a lot of evidence that suggests that things that happen to us when we’re children can have a major impact on our emotions when we get older. And it’s not always major traumatic events, although these can also cause depression as well. Sometimes it’s a general instability or a lack of support, things that may not seem too significant but add up over the years. It certainly appears that what happens to us when we’re younger can have an effect on our mental health when we’re adults.

  • Genetics

Now we’re getting into the old ‘Nature vs Nurture’ debate! There is a lot of evidence out there that seems to suggest that if we have close family members with depression, we’re more likely to suffer from depression ourselves. Now, whether this is because there is a ‘depression gene’ hidden away somewhere in our brains, or whether it’s because we’re likely to have been brought up and had experiences that are similar to close family members isn’t as obvious, but there certainly seems to be a connection.

  • Life Events

This is one that most people will understand, because we’ve all had sad, stressful or emotionally difficult experiences that impacted us afterwards. The death of a loved one, a breakup or a major change such as a house move or job loss can be emotionally straining, and sometimes that strain can stay with us for a while. For some people, these events can be a trigger for a more serious episode of depression.

  • Physical Health Problems

Our physical and mental health are very closely linked, and changes to one can cause or contribute towards changes in the other. Sometimes those connections are direct, such as a brain injury that may affect the physical structure of the brain, or hormonal problems that impact on the way that the brain produces certain chemicals, or they may be indirect and caused by stress or difficulties in managing a condition, such as chronic or life threatening illnesses, or disabilities that may cause significant changes or limitations to your lifestyle.

Exercise and diet can also affect our mental health, with depression being a common outcome of unhealthy lifestyles and habits. There is significant evidence that physical exercise and a healthy diet can have a major positive impact on our mood, so consider digging out those running shoes! But remember, it’s ok to seek alternative treatments (including medication) if that works for you, lifestyle changes may not work on their own for some people.

  • Drugs, Alcohol or Prescribed Medication

Drug and alcohol use can be both a cause and an effect of depression, which can lead to a vicious cycle whereby people feel low, use drugs or alcohol in an attempt to feel better, which only makes them feel worse, leading to increased use of the very same substances. I could write an entire blog on how street drugs affect mental health, but for now Mind have a fantastic guide.

Depression can also be a side effect of many prescribed drugs, including some anti-depressant medication. Make sure you always read the leaflets that some with your medication and take them as prescribed, and if you have any concerns you should contact your GP immediately, as these side effects can be serious.

The causes of depression are far from clear-cut, and in most cases are likely caused by a variety of different things all acting in conjunction. It’s also important to remember that we all cope with things differently, so people will have varying degrees of tolerance to stress or trauma and will react in completely different ways. The same life event could cause me to become depressed and have no affect on you whatsoever, and that doesn’t mean that you’re emotionally stronger than I am or that I’m a weak person! We are all different and deal with things differently, and that’s absolutely fine.

Symptoms of Depression

Depression has come to be used as another word for sad, so when we say the word depression we naturally think that depressed people must feel sad. Personally, when I hear the word depression the following picture pops into my head:

These kinds of pictures are used a lot in the media when they talk about depression, but they’re not really a good representation of what a mental illness actually feels like. This might be why some people find it really hard to understand just how serious and difficult depression can be. After all, they know what it’s like to be sad, they felt a bit sad last week and then they watched some television and went for a walk and then they felt fine, so why is everyone always complaining about feeling depressed all the time? Since we already know that around 20% of adults will display some symptoms of depression at some point in their lives and that not everyone who has depression is sad all of the time, maybe a better image to use would be something like this:

Or this:

Or even this:

Of course, depression is much, much more than just a feeling of sadness. Some of the most common symptoms of depression are:

  • Low self esteem, or a feeling of worthlessness.
  • Intense sadness or unhappiness that doesn’t improve.
  • Being unable to enjoy or appreciate things that would normally make you happy.
  • Weight loss or weight gain.
  • Sleeping too much or too little.
  • Difficulty concentrating or focussing.
  • A sense of hopelessness or despair.
  • Physical aches or pains, especially in the head, shoulders, back or stomach with no obvious cause.
  • Feeling isolated or detached and avoiding people or social situations
  • Mood swings.
  • Use or increase in consumption of drugs, alcohol or tobacco.
  • Moving very slowly or feeling anxious and agitated and moving too much.
  • Self harm or suicidal thoughts or actions.

Have you noticed that some of these symptoms are complete opposites? That’s one of the most unusual things about depression, it can cause completely different symptoms in different people or at different times, but is still classed as the same illness. One person could be tired all the time and sleep too much, gain weight and struggle to speak to people, and another could lose weight quickly, struggle to sleep and have too much energy throughout the day and they could both be diagnosed with depression. This is one of the reasons why it can be so difficult to identify and diagnose, and some people may be depressed and not even realise it, because they don’t feel sad.

How Depression is Treated.

Unlike some other illnesses, there is no single treatment for depression that works 100% of the time. The treatment plan will depend on the person and their preferences, the symptoms and how serious the depression appears to be. In general, treatment can be split into three groups:

1. Medication

There are multiple different kinds of medication that are used to treat depression and other mental illnesses, all with their own positives and negatives. Some people are nervous about taking medication because they are worried about side effects, or that the medication might take something away from their personality or ‘turn them into a zombie’, and this is understandable but may be based on some misconceptions about how some of this medication works. Some people also say that if you use medication that you are somehow masking the problem rather than dealing with the cause, and that it’s better to deal with depression ‘naturally’. Again, this is an understandable way of thinking about it, but may not be entirely accurate. The evidence suggests that medication can be a very effective way of treating or managing a mental illness, and for lots of people medication has been invaluable. There is no shame in using medication to treat depression or any other mental illness, just as there would be no shame in taking antibiotics for an infection. However, you should always talk to your doctor about any concerns that you might have prior to agreeing to try them out, and follow the instructions carefully. A general guide to the kinds of anti-depressants that are available can be found here.

2. Counselling or Talking Therapies

As I mentioned earlier, this won’t usually involve lying on a sofa and talking about your childhood (although sometimes it might!). Nowadays the main kind of therapy available on the NHS is Cognitive Behavioural Therapy, or CBT for short. CBT can be delivered one-on-one or as part of a group, in person or online, and is a short term therapy designed specifically to help us to understand how we think and behave, and how these things might be connected. It is very practical, so you won’t be digging through your past or talking about previous trauma, it’s more likely that you’ll be exploring tools and techniques that can help to manage low mood as it arises. You can find more information about CBT by clicking here. Availability and access to CBT will depend on your symptoms and the area that you live in, you can always ask your GP about any local groups that you could be referred to.

You may also be encouraged to try out some mindfulness techniques, either as part of a broader course of CBT or more informally. Mindfulness encourages us to focus on our daily experiences in the moment, and spend less time worrying about the future or feeling regretful or guilty about the past. Understanding how we respond to certain triggers can help us to change those responses, although this does take patience and practise! You can find more information about mindfulness here.

More traditional talking therapy is still available, but mostly through private practise and you may need to fund it yourself.

3. Lifestyle Changes

This will generally be utilised when the depression is milder, or used in conjunction with other types of treatment. Changes to your lifestyle, whether that be improving your diet, trying to exercise more, cutting down on drugs or alcohol, considering a change in jobs or relationships or spending more time socialising can have a significant impact on mood, and can play a major role in the treatment of depression. It is likely that this process will be your responsibility, although general advice from a GP may be helpful when starting out. For some general tips about the kinds of habits that encourage good mental health, you can read one of our previous blogs here.

The evidence suggests that people may need to try several different things or a combination of different types of treatment in order to identify the most effective plan for them, and this will often take some time, but that all of these approaches are effective at treating and helping people to manage the symptoms of depression.

To summarise what we have covered today:

  • The causes of depression are complicated and difficult to isolate, and different people will have completely different causes and respond differently to different triggers or life events.
  • Depression is not just a feeling of sadness. Depression can be a very serious illness.
  • There is a wide variety of different symptoms caused by depression, and people will experience it in vastly different ways. The same person may even have different experiences over time.
  • There is no single treatment for depression, and most people will try various plans and combinations of treatments before they find the one that works for them.

If you are worried that you or someone you know may be experiencing depression or any other mental illness, you should either contact your GP or advise them to contact theirs to ask for help. If you need someone to talk to, you can contact the Samaritans for free on 116 123, 24 hours a day, 7 days a week. If you need immediate help or feel suicidal, you should always call 999.

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2 months ago ·

7 Habits that Encourage Good Mental Health

By Andy – Arch Care Services

A healthy mind is just as important as a healthy body, but sometimes we can forget just how important it is to form habits that ensure that you are happy, confident and secure. We all understand that we should eat well and get plenty of exercise, but what can we do to make sure that we are emotionally strong, resilient and content, as well as physically healthy?

 

1. Get some rest!

Sleep is vital, although the adorable puppy is optional.

We spend around a third of our lives in bed, and sleep is just as vital as eating, drinking and breathing, and going just a couple of days without a good nights sleep can have a huge impact on your emotions, memory and critical thinking abilities. A common misunderstanding of people with mental health concerns is that they should just ‘pull themselves together’, or ‘get up and do something!’, but in reality it’s probably more important that these issues are addressed and understood, as they can often be both a contributing factor and a side effect of a mental illness.

Make sure that you have an established sleep schedule and stick to it. Go to bed at a set time, and this means no television or mobile phones! In fact, it’s probably best to keep screens out of the room altogether if possible, and only go to bed when you intend to sleep. Your brain is fantastic at making connections, and it’s important that your brain connects your bedroom with sleeping. Make sure the room is comfortable and free of distractions, and if you can’t sleep pick up a book and read for a while rather than scrolling through Facebook!

2. Think positive thoughts!

Try to start the day on a positive note!

Sometimes when we feel low, positivity can feel like an impossible task, but there’s loads of evidence that says that positive thinking can have a major impact on your mood, which makes you feel more positive, which increases your mood even further! It’s a fantastic, happy cycle, and we should do everything we can to get ourselves into that cycle.

Start small. Every morning, tell yourself out loud that today is going to be a good day. When something good happens, notice it! We are all excellent at remembering the bad and forgetting the good, try to pay special attention to the good things in your life, even if they’re small. A random encounter with a stranger that made you smile, a particularly delicious sandwich, even something as small as doing the washing up, pay attention to them and remind yourself that they exist.

3. Exercise and eat well

Sometimes something as simple as a quick stroll can make all the difference.

I know it sounds cliché, but the saying ‘healthy body, healthy mind’ is absolutely true! We are biological machines, and if we use the wrong type of fuel or allow our joints to rust then everything else will be impacted. You don’t need to enter a triathalon, or eat only protein shakes and broccoli, you’re not entering the Olympics! Start by getting outside and moving around, even if it’s only for 10 minutes a day. Just a small amount of exercise and fresh air can have a huge impact. Try to make sure that you eat something green with every meal, avoid junk food, cut down on the carbs and sugar, maybe consider brushing up on your cooking skills! You’ll be amazed at the difference that these small changes will make to your mood. And it’s a great excuse to brush up on your cooking skills while you’re at it!

4. Give yourself a break!

Smartphones can be a blessing and a curse!

We live in a high pressure, fast paced world. Social media and the internet mean that we get our information quickly, we’re always on the go, absorbing information and responding emotionally. In some ways this is great, we’re more connected than ever before, we can communicate with friends and family wherever we are, and we have new support networks available to us that we wouldn’t have been able to access 20 years ago. But it can also cause stress, anxiety, a feeling of being overwhelmed and huge pressure to be available at all times. Go easy on yourself! Practise some self care, and make sure you put aside some time for yourself. Go out into nature and spend some time away from your screens, try to reduce the time you spend on social media, and if you’re a news junkie like me, maybe consider reducing the amount of time you spend reading about current affairs! It’s alright to have some downtime and focus on things that relax you and make you feel happy, whatever those things may be.

5. Pick up a hobby!

Learning to play an instrument is a fantastic creative outlet!

One of the best ways to maintain a healthy mind is to keep your brain active and occupied. If you have a hobby already, try to make sure that you keep it up. One of the first things that we tend to do when we feel low is stop doing things that previously made us happy, and it’s important that you avoid that if possible. If you have lost track of your hobbies, don’t worry! Just try to take some small steps to pick it up again and get back into it. Or maybe consider something entirely new! It could be anything, from sewing to fishing to whittling to collecting stamps, anything that interests you and gives you something to focus on in a positive way. The internet is an incredible resource for picking up information about possible new hobbies that are cheap or free and can be started almost immediately. Some of them may even have local organisations or clubs that you could attend, which has the added bonus of encouraging you to meet other people with similar interests. Don’t worry if this doesn’t appeal, there are plenty of hobbies that you can do on your own if that’s more your style.

6. Be mindful!

Take time to stop and appreciate your surroundings.

Mindfulness is a technique that teaches you to try and focus on how you are feeling in the moment and paying attention to physical sensations and emotional reactions. There is a mountain of evidence that suggests that practising mindfulness regularly encourages us to let go of negative encounters from the past and anxieties about the future and pay attention to our experience of life as it occurs. Try to pay attention to the physical sensations, sounds, smells, or tastes of your day to day routine, notice how things make you feel and how your body and mind react to them. Don’t try to deny emotions or run away from them, just notice them, understand them and move on. Don’t worry if it doesn’t work immediately, mindfulness is a technique that takes practise and needs time to develop, but if you stick with it then it will help enormously.

7. Open up!

Sometimes a friendly word from someone you trust can make all the difference.

Despite all our best efforts, it can sometimes still feel difficult to be honest about your struggles with mental health. We don’t always know how people are going to react, and that can be scary. But being honest with yourself, allowing yourself to be vulnerable, and asking for help is a really important part of staying mentally healthy. We’re not made of stone, everyone struggles sometimes, and the best thing we can do for ourselves, and for everyone else, is to be honest and open. That could be something as small as calling a friend and asking to talk, or going online and finding an anonymous support network if that’s easier, or it could be something bigger like calling a doctor and asking for help or attending a local support group. Whatever route is best for you, talking to other people and asking for advice, support and guidance can be an incredibly fulfilling experience. And who knows, maybe one day you’ll be the person that someone turns to when they need help or advice, and you’ll be able to offer them the same help that you received when you needed it the most.

It can be easy to forget just how important it is to look after our mental health, but if you take steps to embed healthy habits now, they will pay off in the future. The steps above are a great place to start!

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