Depression

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Depression affects about 1 in 5 Australians at some stage in their lives

If you are depressed, it is more serious than regular sadness or grief so it’s important to seek help. Our survey, Australia’s Biggest Health Check, found that almost one in ten women over 40 are being treated for depression.

There are many different treatment options available, and each has its pros and cons. If you have depression, finding the right treatment, or combination of treatments, that works best for you will require careful thought, and maybe also some trial and error.

1. What are the signs and symptoms of depression?

Common behaviour associated with depression includes:
• moodiness that is out of character
• feeling irritable and frustrated
• finding it hard to handle minor personal criticism
• spending less time with friends and family
• loss of interest in food, sex, exercise or other pleasurable activities
• interrupted sleep
• increased alcohol and/or drug use
• staying home from work or school
• increased physical health complaints such as fatigue or pain
• being reckless or taking unnecessary risks (e.g. driving dangerously)
• slowing down of thoughts and actions.

If you notice these symptoms for two weeks or more, you may be depressed. It’s a good idea to get help sooner, rather than later as this can help prevent your symptoms from becoming worse, and help you recover more quickly. If you're feeling sad, tell someone - a friend, family member, doctor or even colleague. And don't hesitate to call Lifeline on 13 11 14 for 24-hour support.

2. Diagnosis:

Your doctor will chat to you about your symptoms, and will either assess you based on your answers, or will ask you a series of questions from a standard test such as:

1. K10 – 10 questions, with answers ranked on a scale, that can help detect depression and related conditions such as anxiety
2. DSM IV – 9 questions based on common symptoms of depression
3. SPHERE – A checklist of 27 symptoms. According to SPHERE, having three or more of the listed symptoms is a strong indication of depression.

Your doctor may also give you a physical exam, check your medical history and run some tests.

3. Treatment:

There are two main types of treatment available for depression: antidepressants and counselling.

The most appropriate treatment for you will depend on lots of things, including:
• the severity of your symptoms;
• your own personal preferences; and
• the cost and accessibility of options available to you.

To help you be as informed as possible, we’ve included some information about a number of the most common treatment options available. However, you should speak to your health care professional before making a decision.

4. Lifestyle and other approaches

Even when people need an antidepressant, they will often obtain the greatest benefits if they combine their medicine with non-medicine treatments and strategies.

Eating a healthy diet, keeping to your normal routines, getting regular exercise, doing fun activities, and keeping in contact with work, family, and friends can make a big difference when you have depression.

5. Counselling:

Counselling may take many forms, including psychotherapy, cognitive behavioural therapy, interpersonal therapy and general counselling. These usually involve seeing a specially-trained GP, a psychologist, a psychiatrist or another type of health worker, over a period of several months. It helps by teaching you to change negative patterns of thought and behaviour, and negative feelings. It can also prevent relapse by teaching you new ways to cope with stress.

Counselling alone can be as effective as antidepressants, particularly for mild depression. People with moderate to severe depression usually need an antidepressant, but they are more likely to benefit in the long-term if they receive counselling while taking the medicine.

6. Other therapies:

Learning about depression and how to manage it, and gaining supportive monitoring from loved ones and healthcare professionals, can be very helpful, and may even be all that is needed to treat mild depression.

Coping skills can help you better manage the things that contribute to your depression – so what works for you, will depend on your individual situation. This could include relaxation therapy, reading self-help books, developing better sleeping habits, reducing alcohol intake, or stress management practices such as deep breathing, massage or yoga.

Some people develop these skills under the guidance of a health professional, while others prefer to develop them on their own.

7. Medicine-based treatment:

Antidepressant medicines Antidepressant medicines increase the level of chemicals in your brain that control mood. There are several types of prescription antidepressants available.

Despite their proven ability to help with depression, it’s impossible to know in advance how each person will respond to each particular medicine. Around one in three people find they cannot tolerate the side effects of the first antidepressant they try, or that it does not work for them, so you may need to try a few different medicines before finding one that works best.

There are also some natural medicines that can treat depression, the most common of which is St John’s wort. This herb has been found to help relieve mild to moderate depression, and works in a similar manner to many modern antidepressants.

However, whether herbal or synthetic, all antidepressants can interact with other medicines and may cause side effects. Even St John’s wort and many over-the-counter cough and cold products can cause potentially serious medicine interactions with antidepressants. Eating certain foods while taking some antidepressants can also be dangerous. You’ll need to speak to your doctor about potential risks associated with your particular antidepressant.

Once you start a course of antidepressants, it can take up to 4–8 weeks for depressive symptoms to be relieved. However, most people will notice some improvement after 1–3 weeks.

The length of time that antidepressants need to be taken for will depend on the severity of the illness, how well the medicine works for you, and whether you’ve had depression before. Some people will be able to stop taking their antidepressant after 6–12 months. Others may benefit from continuing treatment for longer, sometimes indefinitely, depending on the type and severity of the depression.

For more information, visit beyondblue, the Black Dog Institute or Lifeline on their 24 hour crisis telephone support, 13 11 14.

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