What is depression and who experiences it?

Depression is something that effects many people at some time in their lives. In general, women experience depression at nearly twice the rate as men*and it can start at any age, from childhood right through to old age, eg. 75 per cent of the women who visit Leichhardt Women’s Community Health Centre with varied emotional and social issues are affected by depression.

Every person is unique, as is every person’s experience of depression. There are varying degrees of depression and not all women feel all of the same things. Depression can range from feelings of sadness and loneliness, to intense feelings of utter hopelessness. Women often blame themselves and feel guilty, and this may also impact upon the way they see other, more positive, events in their lives.

Depression can be brought on by many different things.

Some people have biological depression and are inclined to develop depression because of a chemical imbalance in the brain. In most people experiencing depression, their depression is brought on because of social factors or their response to an event (or events) that have happened to them, eg. losing someone important and close to you; the stresses of single parenthood, poverty, unemployment and poor housing, illness and feeling isolated or not having family or friends close by.

Other ‘causes’ of depression can be domestic violence, sexual abuse, alcohol or other drug problems, prolonged periods of stress, childhood traumas, grief and loss, sexuality issues, or other unresolved concerns you may have about your life.

Women from diverse cultural backgrounds often have added stresses to deal with, some of these may be cultural and social isolation, trouble with settling in after migration and a lack of English language skills. In some cultures depression is expressed more in physical ways than in feelings and emotions (Kleinman & Good 1985), eg. women speak about their depression in terms of feeling nervous or headachy, tiredness, or being ‘heartbroken’.

Facts about depression

Depression is often caused by a combination of emotional, physical and social factors and all these have to be addressed when dealing with depression. We hear a lot about depression, but what is it?

The symptoms or signs of major depression are:

• depressed mood loss or interest, or pleasure in life, people and events

and at least four of the following:

• weight or appetite change

• sleeping change (sleeping a lot, or alternatively, wakefulness)

• activity change (eg. a depressed person may literally appear have gone into ‘slow motion’. Also called ‘movement disorder’, ‘psychomotor retardation’, or ‘agitation’.)

• tiredness or lethargy

• guilt or worthlessness

• poor concentration or decision making

• suicidal thoughts

Symptoms of depression There are no hard and fast rules about depression, why it happens or how it is felt in individual people, but there are some signs which health professionals use as a guideline.

Mood & Thought Changes

• low self-esteem

• negative self image

• life can seem meaningless

• thinking life is not worth living

• anxiety

• feelings of emptiness

Physical symptoms (signs)

• low energy and feeling

• exhaustion

• loss of interest in sex

• disturbed sleep patterns

• poor concentration

• weight loss or gain

• headaches

• crying

• loss of appetite

Behavioural Symptoms

• drug and alcohol misuse

• worrying

• panic attacks

• restlessness

• obsessional symptoms

There are other signs and symptoms of depression that have not been listed, but these seem to be the most common. Not all of these symptoms will necessarily be experienced by everyone.

Some common myths are:

Myth: only women get depressed

Fact: women and men experience depression

Myth: you’re depressed because you’re not a capable person

Fact: some of the most capable, bright people experience depression. Depression can effect anyone.

Myth: you’re imaging things. If you’d only pull up your socks you’d feel a lot better

Fact: depression is very real. Treatment is available, but its not just a matter of ‘getting over it’. A treatment regime needs to be decided and put in place.

What you can do

You may not feel like there is any hope but there is actually a lot you can do a lot to help yourself. Depression can be successfully treated and most people can start feeling well again in just a few weeks.

Complementary Therapies and treatment options…

RELAXATION AND MEDITATION - Getting in touch with yourself can relax the body and clear the mind. It helps you to deal with stress and life’s problems. Relaxation takes only a few minutes and can be done almost anywhere.

COUNSELLING is talking about your problems with someone outside your own circle who is there to listen to you without judging you. When you start to understand problems better things often start falling into place. Counselling is a process where you can express your thoughts and feelings in a way that helps to clarify difficulties. This in turn assists you to work towards new experiences with renewed confidence.

NATUROPATHY is a medical discipline that uses herbal medicine, bach flowers, vitamins and minerals, aromatherapy, massage and nutrition to treat people within a wholistic framework. Naturopathy has little or no side effects and it focuses on preventing disease and promoting health.

HERBAL REMEDIES focus on helping the body heal itself. The natural remedies are made from substances that come from plants. These have little or no side-effects and are safe and effective to use. Some of the herbs used in depression are: St. John’s Wort, (scientifically proven to treat mild to moderate depression), Oats, Damiana, Vervain, Chamomile, Lavender, Rosemary, Passionflower.

HOMOEOPATHY is based on the law of minimum dose and ‘like cures like’. In other words, a medicine producing certain effects in a healthy human being can cure any illness that displays similar effects. Homeopathy is excellent at dealing with emotions, moving ‘stuck’ emotions, long held beliefs and old emotional patterns.

SOCIAL CONTACT / FAMILY AND FRIENDS - Having people around that you can trust and confide is often beneficial. Even when you least feel like it, try to spend time with people you care for and who care for you. It is good to have more so called ‘positive’ experiences on which you can build new memories to replace the pain and sadness.

ACUPUNCTURE is an ancient Oriental healing method which can restore the balance of energy in your body, it helps heal disease and relieve tension. Acupuncture involves inserting fine needles into strategic energy points on the body.

SUPPORT GROUPS - Women share their experiences and ideas about what they have gone through and what works for them. It could be a way of understanding your own experience of depression. It is also reassuring to know that you are not alone, that other women feel the same way.

OTHER TREATMENT OPTIONS include exercise (walking half an hour three times a week has been shown to help lift depression), massage, eating nutritious food (this is a must for a healthy body and mind), stress management classes, yoga, art therapy, self-esteem and assertiveness groups, positive thinking (try re-designing your thought processes – focussing on the positive rather than the negative, or re-write the stories in your life placing less blame and more understanding on yourself), light therapy, laughter (eg. hire a funny video or go to see a comedy a the local movie theatre), a good night’s sleep, taking joy in the natural things in life - a walk in the park, a swim in the sea....

The medical approach: anti-depressants 

When prescribed appropriately for major or severe depression, anti-depressants can be useful in the treatment of depression. There are several different types of antidepressants available and quite a few different brand names. This can often get confusing so, if you are prescribed this medication, make sure you find out exactly what you are taking and what the side effects can be. For anti-depressants to have their desired effect they should be used in combination with counselling. Two of the most commonly used classes of medication are:

Selective Serotonin Re-Uptake Inhibitors (SSRI’s) These are the more recent drugs and they are a commonly prescribed anti-depressant. A couple of the brand names you may recognise as they have often been spoken about in the media. They have fewer side effects than the other types and they have often been marketed heavily. They also have a larger margin of safety if taken in overdose. Brand names include: Aropax, Lovan, Luvox, Prozac, Zoloft, Zactin Side effects may include: nausea, diarrhoea, constipation, tremor, dry mouth, sweating, decreased sexual drive, weight loss, decreased appetite, anxiety, insomnia, dizziness, rash.

Tricyclic Anti-depressants (TCA’s) These have been around for a long time and even though there are newer types around these days, TCA’s are still commonly prescribed to people. Brand names include: Anafranil, Sinequan, Prothiaden, Tryptanol, Tofranil. Side effects can include: dizziness, anxiety, drowsiness, confusion, mild tremors, co-ordination difficulties, dry mouth, headache, insomnia, blurred vision, diarrhoea, constipation, weight gain, difficulty concentrating, decreased sex drive. Be sure to tell your doctor if you have any cardiovascular problems before you take tricyclic antidepressants. Care must be taken with this type of medication. In the event of overdose, seek immediate medical help and call an ambulance.

There are other types of antidepressant medications on the market. It is always important to speak to your doctor about the reasons why they have chosen one for you and to discuss the individual side effects. Remember: When taking any form of medication – you have every right to ask questions of your health professional.

If you or someone you know suffers from depression, reach out to Leichhardt Women’s Community Health Centre. Help is at hand.