Depression

What you will find on this page

What is depression
Some causes of depression
Signs and symptoms of depression
Depression treatments
Self help
Who else can help

What is depression

Depression is when you feel persistently sad and unhappy for a long period of time and affects your daily life. Depression can often be viewed as trivial and not regarded as a real health condition. This is not the case and untrue. Depression is a real illness with real symptoms and a very common Mental Health Illness that affects millions of people worldwide.

Feelings of depression can be clearly connected to an event or experience in a person's life, such as a tragic loss or a violent event.

However, some people can become depressed and not understand why. They may not be able to identify a “reason” to be depressed—especially if they perceive their life as being “great ” or relatively “easy going” compared to others.

There are several types of depression and the condition itself can be a resulting symptom of a mental health illness such as bipolar disorder.

Major Depressive Disorder - When the term clinical depression is used, it generally refers to major depressive disorder. Major depressive disorder is a mood disorder characterized by a number of symptoms.

Postnatal depression - women can develop depression a short time after giving birth; this is known as post natal depression, and is in a similar way to other types of depression - with antidepressant medicine and talking therapies.

Seasonal affective disorder - a type of depression with a seasonal pattern,usually related to winter. Coincidentally, this conditions also known as “winter depression”

Signs and symptoms of depression

Thoughts of self harm or suicide
Continuous low mood, feeling sad or upset and tearful
Lack of motivational interest in things
Changes in appetite or weight loss/gain
Lack of energy,muscle aches and pains
Feeling hopeless and low self esteem
Lack of motivation or interest in things
Avoiding contact with family or friends
Not doing so well at things you normally enjoy
Feeling irritable and intolerant of other people.
Avoiding social events and neglecting hobbies
Disturbed sleep patterns
Low sex drive

Some causes of depression

Relationships

The breakdown or separation from a significant relationship can cause major upheaval in a person’s life as well as experiencing difficult emotions, such as loneliness, anger, or grief.

Stressful events

Most people take time to come to terms with stressful events, such as a partner being imprisoned, or being suspected of a crime and the criminal justice process that follows. When these stressful events occur your risk of becoming depressed is increased if you shut yourself off from your friends and family and try to deal with your problems on your own.

Family History

If someone in your family has had depression in the past, such as a parent or sister or brother, it's more likely you will also develop it.

Loneliness

Being cut off from your family or friends can increase your risk of depression.

Alcohol or drugs

When life becomes overwhelming and we feel a low mood, some people will turn to alcohol or drugs to suppress their feelings. This can result in a spiral of depression.

Cannabis has been known to help people relax, but there's evidence that it can also bring on depression particularly in teenagers.

“Drowning your sorrows” with an alcoholic drink is also not recommended. Alcohol is categorized as a “strong depressant”, which of course only makes depression worse.

Giving birth, Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as the added responsibility of a new life, can lead to postnatal depression.

Illness

You may have a higher risk of depression if you have a longstanding or life threatening illness, such as coronary heart disease or cancer.

Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems.

Some people may have an underactive thyroid (hypothyroidism) resulting from problems with their immune system. In rarer cases, a minor head injury can damage the pituitary gland at the base of your brain that produces thyroid-stimulating hormones.

This can cause numerous symptoms including extreme tiredness, and a lack of interest in sex (loss of libido), which can in turn lead to depression.

Some treatments for depression

Treatment for depression usually involves a combination of self help, talking therapies and medicine.

The treatment that will be recommended will be based on the type of depression you have.

Mild depression

If you have mild depression, the following may be recommended.

Wait and see

If your GP diagnoses you with mild depression, they may suggest waiting a short time to see if symptoms persist or if you start to show signs of it getting better by itself. In this case you'll be seen again by your doctor after 2 weeks to monitor your progress. This is known as watchful waiting.

Exercise

There's evidence that exercise can help depression, and it's one of the main treatments for mild depression. You may be referred to a group exercise class.

Self help

Talking through your feelings can be helpful. You could talk to a friend or relative or you could ask your GP or local psychological therapy service if there are any self help groups for people with depression.

You could try self help bookstore cognitive behavioural therapy (CBT)

Mental health apps

You can also find mental health apps and tools in the NHS apps library

Mild to moderate depression

If you have mild to moderate depression that isn't improving, or moderate depression, you may find talking therapy helpful.

There are different types of talking therapies for depression, including CBT and counselling.

Your GP can refer you for talking treatments or you can refer yourself directly to a psychological therapies service.

Moderate to severe depression

If you have moderate to severe depression, the following treatments may be recommended.

Antidepressants

Antidepressants are tablets that treat the symptoms of depression. There are almost 30 different types of antidepressant. They have to be prescribed by a doctor, usually for depression that's moderate or severe.

Combination therapy

Your GP may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. A combination of an antidepressant and CBT usually works better than having just one of these treatments.

Mental health teams

If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists:

These teams often provide intensive specialist talking treatments as well as prescribed medication.

Talking treatments

Cognitive behavioural therapy CBT

Cognitive behavioural therapy aims to help you understand your thoughts and behaviour, and how they affect you. CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present. It teaches you how to overcome negative thoughts - for example, being able to challenge hopeless feelings.

CBT is available on the NHS for people with depression or any other mental health problem it's been shown to help.

You normally have a short course of sessions, usually 6 to 8 sessions. over 10 to 12 weeks on a one-to-one basis with a counsellor trained in CBT. In some cases, you may be offered group CBT.

Online CBT

Online CBT is a type of CBT delivered through a computer, rather than face to face with a therapist. You will have a series of weekly sessions and should receive support from a healthcare professional.

Interpersonal therapy (IPT)

Interpersonal therapy focuses on your relationships with others and problems you may be having in your relationships, such as difficulties communicating or coping with a bereavement. There's some evidence that IPT can be as effective as antidepressants or CBT but more research is needed.

Psychodynamic psychotherapy

In psychodynamic (psychoanalytic) psychotherapy, a psychoanalytic therapist will encourage you to express whatever is going through your mind.

This will help you become aware of hidden meanings or patterns in what you do or say that may be contributing to your problem.

Counselling

Counselling is a form of therapy that helps you think about the problems you're experiencing in your life so you can find new ways of dealing with them. Counsellors support you in finding solutions to problems, but may not tell you what to do.

Counselling on the NHS usually consists of 6 to 12 sessions that last for roughly an hour. You talk in confidence to a counsellor, who supports you and offers practical advice. It's ideal for people who are generally healthy but need support coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or a serious illness.

Getting Help

See your GP for more information about accessing NHS talking treatments for depression, They can refer you locally and support treatments for depression.

You also have the option of self referral. This means that if you prefer not to talk to your GP you can go directly to a psychological therapist service

Self help

Two examples relating to family members of prisoners who are suffering with depression

“I just feel terrible, I thought we were in a perfect little bubble then Bam !! out of nowhere he disappeared and was put on remand, It's been 7 months now and im struggling to put on that happy face and keep him positive, My mom says its normal and will pass but each day is getting harder”

“He's just like his dad, i did everything possible to prevent him ending up this way, and i mean everything, i just don't know what i did wrong, I constantly worry, i feel like i've let him down, he says i let him down, i feel a complete failure and have no idea what to do”.

There is no manual on how to support a loved one in such a crisis as imprisonment, you may have experienced the above examples or have your own struggles dealing with it in your own personal way but It’s important to understand that depression is an illness, not a sign of weakness. The magnitude of coping with a loved one inside and managing your own personal affairs such as bills, work, children, or even illness can be overwhelming. You really don’t have to struggle with depression – Safer Landings can help. Self help doesn't have to be fancy activities, weekend spas for massages, self help is a collection of little things you can do daily to improve your mood.

Below we have put together some suggestions you can do to self help against the symptoms of depression:

Join a Safer landings support group for depression and anxiety. Speaking with others dealing with depression can help in reducing your sense of isolation or loneliness. Our support groups offer you the opportunity to meet people, you can also encourage each other, give and receive support on how to cope, and share all your lived experiences.

Join a Facebook or online support group. There are heaps of online or social media groups you can join and meet other people and talk about how you feel.

Create a support group. It’s nice to receive support, but research shows you get an even bigger mood boost from providing support yourself. How you feel and how you cope may be very useful to someone. Think of ways to help someone, be a listening ear for a family member, loved one or friend, volunteer, do something nice for somebody else.

Stay connected

You may always hear people say “just talk to someone it really helps” but may not want to or have the confidence to express how you are feeling but there are plenty of ways to stay connected.

10 tips for staying connected

Take a pet for a walk, or consider having a pet, such company can lift your mood
Have coffee or a snack in the park with a family member or friend.
Tell your partner, friend or family member to check in on you, tell them you need support.
Attend a small get-together.
Reach out to an old friend via email or Facebook
Help someone else by volunteering, join a local charity
Get out, walk and breathe some fresh air
Schedule a weekly visit with your partner or loved one
Meet new people by taking a class or joining a club.
Keep a journal and share your thoughts and feelings.

Prepare a mood booster list

What are the little things you enjoy ? try and do a couple each and every day, make a list the more you have the better, below are some examples.

10 Mood boost ideas

List everything you like about you
List everything you like about your loved one in prison, remind yourself of why your together
Watch a series that makes you laugh.
Take a long, hot soak in the bath
Draw or paint or write your mood
Take a pet for a walk or take yourself somewhere local and scenic and enjoy a little nature.
Talk to friends or family face-to-face.
Listen to uplifting music.
Do something spontaneous, such as a youtube exercise video or meditation or yoga, only has to be for 10 minutes

Keep healthy.

When we feel low all the unhealthy aspects of life seem the easier choice, a takeaway instead of home cooked nutritious food, stay in bed instead of getting up and out, stay up late “as there's nothing to get up for '' and disrupt our sleeping patterns. All these choices influence our mood and can cause symptoms of depression to exist.

Tips on staying healthy

Don’t eat when you feel like it.. Going too long between meals can cause you to feel irritable and tired, so aim to eat something small every two hours or eat at least three meals a day.

Boost your vitamins intake. We always know how the lack of vitamins affects our physical health , it's no different with mental health. Deficiencies in folic acid and B-12 can trigger depression. To get more, take a vitamin supplement or eat more fruit, greens, chicken, beans and eggs.

Reduce sugar and carbs. Feeling low may increase the craving for sugary snacks, Greggs bakery, or comfort foods such as Mcdonalds French fries, but these “feel-good” foods quickly lead to a crash in mood and energy. Aim to have these as a treat at the end of the week for staying connected or applying your mood boost daily.

Try to get a good night's sleep. Aim for at least eight hours, keep a note of nights you have so you can try and understand what you did right that day. Depression typically disrupts sleep which exacerbates problems; whether you’re sleeping a lot or having lots of little nana naps in the day your mood will suffer. Don't read from your phone before bed. Bright screens keep our brain awake, drinking less caffeine in the evening helps us to relax more. Try and get into a routine that provides a healthy sleeping habit.

Exercise. A ten minute walk can do wonders for lifting a mood. Try to at least do one activity a day that gets you out of the house and into open space. Try stretching or think of exercise and find ways to add small amounts of physical activity throughout your day.

Download our resource on self help for depression below

Who else can help

Breathing Space

www.breathingspace.scot

A free, confidential phone and web based service for people in Scotland experiencing low mood, depression or anxiety.

Depression UK

depressionuk.org

A self-help organisation made up of individuals and local groups.

Mental Health Foundation

mentalhealth.orq.uk

Provides information and support for 1 anyone with mental health problems or learning disabilities.

NHS Choices