How to understand and tackle depression

Scientists are still discovering the causes of depression but there are nine known currently, and only two of them are down to your personality or family history. The rest are lifestyle induced.

Recognising the symptoms of depression

Put very simply, depression is experiencing feelings of sadness for weeks months or even years. The World Health Organisation defines it as “characterised by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities”.

Depression can vary in severity from mild to moderate to severe, determined by the way the sadness is impacting on daily life.

Mild depression will have some impact upon daily life, for example, you may still be able to go to work and see friends but might be less productive at work and not enjoy socialising as much.

Moderate depression may cause people to start avoiding going to work and seeing friends altogether.

Severe depression can prevent people from getting out of bed and attending to basic personal hygiene.

The psychological signs of depression include feelings of hopelessness, lack of interest in social activities or hobbies, lack of pleasure from things you used to enjoy, suicidal thoughts, poor concentration and feelings of worry.

Physical symptoms can include loss of sex drive, aches and pains, weight changes, poor sleep, changes in menstrual cycle and drinking alcohol or taking drugs to help manage emotions.

Social symptoms can be avoiding friends and family, not doing social activities you enjoy, poor work productivity and difficulties with relationships.

Whilst understanding the above is helpful in being able to recognise the signs so that you can start to take action, the number one thing to remember is that depression is a sign that something is wrong. It does not mean that you are broken, failing, going mad or losing the plot. It’s simply your body’s way of alerting you that you need to make some changes.

What are the causes of depression?

Recognised causes include physical illness, head injury, thyroid dysfunction, drugs and alcohol, stressful life events, giving birth and loneliness. Whilst it may seem that some of these are physical triggers it’s important to understand that you are more likely to experience postnatal depression if you have a traumatic labour or have a poor support network, and you are more likely to experience thyroid dysfunction if you have experienced a stressful life event. So really these are all connected but just manifest in different ways.

It is widely believed that even the genetic causes of depression are not a prerequisite for experiencing it and that it’s still your environment that triggers the genetic element.

How can we treat depression?

The role of traditional medicine and antidepressant medication is a complicated one.

I am not against medication at all and have seen through my work as a nurse how it can save lives. But antidepressant medication can have some challenging side effects.

Studies show that the benefits generally depend on the severity of the depression: The more severe the depression, the greater the benefits will be. In other words, antidepressants are effective against chronic, moderate and severe depression. They don’t necessarily help in cases of mild depression.

The various antidepressants have been compared across many studies. Overall, the commonly used tricyclic antidepressants (SSRIs and SNRIs) were found to be equally effective. Studies involving adults with moderate or severe depression have shown the following:

  • Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.

  • With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.

So, in other words, antidepressants improved symptoms in about an extra 20 out of 100 people.

I believe that we need to concentrate more on life imbalance and less on chemical imbalances. If the cause of your depression is lifestyle-induced, medication is never going to get to the root cause of what’s going wrong, it’s just masking the problem. It’s important to discover what is causing you distress.

For some people, speaking to friends or keeping a journal can help them to discover what’s causing their distress. For others, the help of a psychotherapist or counsellor may be needed to gain a better understanding.

How can lifestyle medicine help with depression?

The main lifestyle elements that can help to improve our mood are:

  • Exercise

  • Eating a healthy diet

  • Having a positive mind-set

  • Nurturing healthy relationships

  • Regular relaxation

  • Being in a natural environment

  • Finding more meaning and purpose in life

Lifestyle elements are much more powerful when we know our personalities better and understand what it is that we are lacking or that is causing us to feel this way.

I will be speaking in more detail of each of these elements in the coming weeks.