Learn about the symptoms of different mental health conditions and what you can do to tackle them.
What do I do if I feel sad?
Sadness can be a difficult emotion to deal with. It can be the result of loss, helplessness, or disappointment, among many other things. Sadness is one of the most common and natural human emotions, however sometimes it is possible for sadness to deepen, and this may be a sign that you are suffering from a form of depression. If you feel as though you are increasingly sad, and feel like your sadness is difficult to explain, this information on depression may help.
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You can also check out our practical, self-paced online program that teaches step-by-step strategies for tackling symptoms of depression.
What is depression?
It is normal to experience feelings of sadness and despair in response to life events such as loss, major life changes, stress, or disappointment. In most cases, the sad feelings resolve as you come to terms with the changes in your life. In situations such as loss, these feelings may persist for months and return at significant times, such as birthdays and anniversaries related to the lost loved one. However, if you have times when you can enjoy things, this sadness is not a sign of depression.
Depression is a disorder that is characterised by excessive sadness, loss of interest in enjoyable things, and low motivation.
Depression is common. One in three people will experience an episode of major depression at some stage in their lives. While most cases of depression are mild, about one in ten people will have a moderate or severe episode.
What are the signs of depression?
Any of these features may be warning signs of depression. You need to be experiencing at least five of these symptoms for at least two weeks to be considered as having a depressive disorder. Remember, only a qualified mental health professional can diagnose depression following a thorough assessment of your personal situation and circumstances. If you’re concerned about the way you’ve been feeling, please don’t delay speaking with your regular healthcare provider. You can also check out our anonymous online test and see if one of our online programs could help.
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What causes depression?
No one knows exactly what causes depression. Genetic factors are important in many cases of depression, where depression seems to run in families (as do other mood disorders), and about 30% of the vulnerability for depression is due to genetic influences.
Stressful life events also play a part in depression. Ongoing conflicts with others can take their toll on our wellbeing, as can other social and environmental stressors such as financial difficulties, retirement, unemployment, childbirth, loneliness, or loss of someone or something important. In vulnerable people, these stressful life events may be enough to cause or worsen depression.
Personality style is another important factor. When people are depressed, they usually have a very negative view of themselves and the world. They do not appreciate good things, and bad things seem overwhelming. Some people have a tendency to view themselves and the world this way even when they are not depressed. In other words, they may have a depressive personality style.
Other possible causes of depression that should not be overlooked is physical illness or medications. Glandular fever, influenza, hepatitis, thyroid hormones, anaemia, diabetes, birth control pills, alcohol and substances of abuse, or certain medications such as those for heart or blood pressure conditions, may all cause symptoms of depression.
How can I deal with depression?
There are a range of ways to deal with depression, and often they are best used in conjunction with each other. The top medical options are Cognitive Behavioural Therapy (CBT), antidepressant medication, and in some severe cases, Electroconvulsive Therapy (ECT).
Psychoeducation is also important when learning to manage your depression.
Take a look below to find out more about each option:
Psychoeducation refers to learning about the way depression develops and is maintained. Education for people with depression is extremely valuable. Education provides a knowledge base that can give the person greater control over their disorder. Greater control in turn may lead to reduced feelings of helplessness and an increased sense of wellbeing. Providing education for families or carers is also very important to help increase the support and assistance they provide to the person.
The most essential pieces of information for a person with a depression are that depression is a common disorder and that effective treatments are available. It is important to remember:
- Depression is an illness, not a sign of weakness or a character defect.
- Recovery is the rule, not the exception.
- Treatment is effective, and there are many treatment options available.
- The goal of treatment is to get completely well and stay well.
- The likelihood of depression recurring is quite high: half of people who had one episode of depression will have another, and the likelihood increases with the number of previous episodes.
- The person and their family can be taught to recognise and act upon early warning signs of depression. By seeking early treatment, the severity of the episode may be greatly reduced.
CBT is a proven treatment for depression, alone or in conjunction with medication. CBT is very effective and 80% of people with mild, moderate or severe depression improve. CBT involves learning to:
- Control the negative thoughts that lead to loss of interest and feelings of worthlessness
- Combat the emotions of sadness and hopelessness, and loss of energy, even when not physically active.
- Counteract the behaviours related to poor concentration and thoughts of death
CBT will often be recommended when:
- The depression is mild, moderate, or severe.
- The person has had a prior positive response to CBT.
- A competent, trained clinician who has expertise in CBT is available, or the person is prepared to use internet CBT (iCBT).
- There is a medical contraindication to taking medications.
- The depressed person prefers CBT or iCBT.
Click here to see if our online CBT course can help you tackle your depression to improve the way you feel.
For some people, antidepressant medication will be the first line of treatment for the elimination of severe depression, however it would be unadvisable to manage very severe depression without a trial of medication. For mild to moderate depression, antidepressant medications are not often recommended as a first line of treatment.
Different antidepressant medications work in different ways. You may need to trial more than one type to find the medication that works best for you. Make sure to keep in close contact with your prescribing physician during the early stages of taking medications as the side effects can often be difficult to deal with.
Some things to remember when taking antidepressant medications are:
- Take the medication daily.
- Don’t stop the medication without contacting the health professional who prescribed it.
- Side effects lessen as your body adjusts. If the side effects don’t diminish, or are unreasonable, contact your health professional.
- Don’t stop the medication when you feel better or your depression may return.
ECT is an effective form of treatment for depression, especially if:
- There are medical contraindications to medication.
- There is a need for rapid improvement because of suicidal intent or refusal to eat.
- The person has experienced treatment failure following CBT, several medications, or combined medication and CBT treatment trials.
- The person has had a previous positive response to ECT.
- Somatic symptoms are prominent.
- Psychotic symptoms are present.
ECT involves the application of a brief electric current to carefully selected sites on the scalp. These electric currents, which are administered by a psychiatrist and anaesthetist, produce a minor seizure in the brain. Prior to the procedure, the person is given a short-acting general anaesthetic and a muscle relaxant to reduce awareness of the procedure and to prevent a physical seizure.
Although many people are fearful of ECT, this technique is arguably the safest and most effective medical treatment for severe depression, although there can be some memory related side effects. ECT works more quickly than antidepressant drugs and CBT. You can also use antidepressants and CBT alongside ECT, as they can help prevent relapse after ECT is completed.
What is CBT?
How can Cognitive Behavioural Therapy (CBT) help with depression?
Cognitive Behavioural Therapy or CBT is one of the most effective psychological treatments for depression. CBT uses cognitive and behavioural strategies to help target the thoughts, feelings and behaviours associated with depression. All of our online programs use CBT strategies.
Click below to see if our online CBT program can help you tackle your depression to improve the way you feel.
Cognitive strategies to help with depression
People who are depressed generally have a negative thinking style. They often think of themselves as worthless and that the world is bad or unfair, and they have little hope that their lives will improve in the future.
When something bad happens, people with depression often blame themselves, but when good things happen, they tell themselves they are just lucky. They are also less likely to recognise and appreciate positive events when they happen, and instead are more tuned into the bad things in their lives and brood over those events.
The cognitive strategies in CBT can help people identify and correct this biased way of thinking. These strategies identify and challenge sometimes hidden assumptions and beliefs, and can reframe the way they think about life.
When people with depression are able to reframe their thoughts, they are able to recover from failures more effectively and recognise and take credit for the good things in their lives. Having these skills has been shown to reduce relapse and a recurrence of depression.
A key feature of depression is low activity. People with depression do less than they normally would, and feel worse because of this. Behavioural strategies for depression aim to identify and change behaviours such as low activity that may worsen depression.
One of the advantages of this strategy is that once acquired, these new behaviours can be applied throughout life, and help to prevent relapse. Behavioural strategies for depression include:
- Setting goals for daily activity by making a list of the activities you are going to engage in at different times during the day. Try to stick to this plan as closely as possible.
- Increasing the amount of time spent on activities by engaging in the activities you enjoy.
- Avoiding making comparisons between the way you are behaving or feeling while depressed with the way you used to behave or feel before becoming depressed.
- Rewarding yourself for your efforts and asking others around you to encourage and praise you for each small step you take.
- Breaking down any difficult daily activities into small, easy steps and doing each slowly.
How can I cope with the individual symptoms of depression?
The symptoms of depression can be addressed to help you feel better. Here are some ways to deal with some individual symptoms:
Eat small portions of food that you particularly like. Take your time and do not feel under pressure to finish if you are eating with others. Drink plenty of fluids.
Seek nonsexual activities with your partner that you still enjoy. Explain to your partner that your loss of interest and affection is a symptom of your depression, not a rejection of him or her, and that these symptoms will be temporary.
Get up at the same time every morning and avoid napping during the day. Across the day, expose yourself to natural sunlight and reduce tea and coffee intake if excessive (no more than two or three cups per day, and none after about 4:00 p.m.). At night, do not lie in bed awake for more than 30 minutes, and instead get out of bed and find a relaxing activity such as reading or listening to music to do until you feel tired again.
Put your worry to a useful purpose. Pick out one or two of your problems that worry you and make a decision to resolve them (you may like to ask a friend to help you).
For each of these problems, try go through the following steps:
- Say exactly what the problem is.
- List five or six possible solutions to the problem. Write down any ideas that come to mind, not just the good ideas.
- Evaluate the good and bad points of each idea in turn.
- Choose the solution that best fits your needs.
- Plan exactly the steps you will take to put the solution into action.
- Review your efforts after attempting to carry out the plan. Praise all efforts. It is okay for the solution not to work the first time, and you can always choose another solution from Step 3 and try again.
Negative thoughts and feelings can make you focus your attention on things you do not like about yourself or your life situation. You can also underestimate positive characteristics and your ability to solve problems. These thoughts tend to make your problems seem worse than they really are. A number of strategies may help you achieve a more balanced view of things:
- Make a list of your three best features— (perhaps with the help of a friend or relative). Carry the list with you, on paper or on your phone, and read it to yourself whenever you find yourself focusing on negative thoughts.
- Keep a daily record of small pleasant things that happen and discuss these events with your friends when you see them.
- Recall pleasant occasions in the past and plan pleasant occasions for the future.
- Consider alternative explanations for unpleasant events or thoughts. Although your initial explanation may be that you are at fault, write down other possible explanations for these events or thoughts.
- Keep yourself busy by doing useful or pleasant activities. Avoid sitting or lying down for too long.
Interested in learning more?
Check out our practical, self-paced online program that teaches step-by-step strategies for tackling symptoms of depression.