WHAT IS DEPRESSION ?
Depression is common and can happen to anyone. It affects approximately 280 million people worldwide and more than
1 in 10 Australians each year.1,2
Persistent sadness, dark thoughts, low self-esteem, loss of interest or pleasure are all signs of depression. It is not just a case of ‘the blues’ – it is a real disease and affects all aspects of daily life.
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1 in 10 Australians
More than 1 in 10 Australians will
experience depression each year
280 million people
Approximately 280 million people
worldwide experience depression1,2
Many things can be linked to the onset of depression.
It usually appears after a combination of recent issues and other longer-term factors (e.g. long-term unemployment, an abusive relationship, prolonged work stress), rather than one sudden issue.
Major life events such as losing your job, or a particularly stressful event, may be the trigger if you’re already at risk. Family history, chronic disease, smoking, an addiction to alcohol or other substances can also increase the risk of depression.
In up to 90% of cases, depression and anxiety occur at the same time or precede one another.3 To learn more about anxiety, head to our anxiety page.
SYMPTOMS
Depression affects how people think, feel and act. A person may be depressed if they:
- Feel sad, down, or miserable most of the time
- Have lost interest or pleasure in most of their usual activities.
In addition, they may also experience the following symptoms:
- Decreased ability to think or concentrate
- Loss of energy or feeling tired more often than usual
- Feeling worthless
- Sleeping too much or not enough
- Large change in weight or appetite (increase or decrease)
- Agitation or slowness.
Depression affects different people in different ways. Not everyone experiencing depression will have all of these symptoms. It can also be a symptom if your friends and family have notice a change in your behaviour.
Only a trained clinician (such as a GP, psychiatrist or psychologist), can diagnose you with depression. The symptoms listed can help you decide whether you need to seek support and treatment.
FIVE COMMON MYTHS:
“Depression is just feeling sad”
Not true
Depression is much more than feeling sad. Depression also involves persistent feelings of hopelessness, worthlessness, guilt, and emptiness, as well as changes in appetite, sleep patterns, and energy levels.
“Depression is a sign of weakness”
Not true
Depression is not a sign of weakness or personal failing. It is a complex mental health disorder that can affect anyone, regardless of their strength or character.
“You can just snap out of depression if you try hard enough”
Not true
Depression is not something that you can just “snap out of.” It is a serious medical condition that often requires professional treatment, such as therapy, medication, or a combination
of both.
“Only women get depression”
Not true
While depression may occur at a higher rate in women, both genders can be affected by depression.
“People with depression are just lazy and don’t want to work”
Not true
Depression can make it difficult for people to work, but it is not a sign of laziness. People with depression need support and understanding from their colleagues and employers.
TREATMENTS
Psychotherapy and medication are often effective treatments for depression. Some people may also benefit from talking to a psychologist, psychiatrist, or another mental health professional.
Psychological interventions:
Psychological interventions are a form of treatment that aim to help individuals identify and manage their thoughts, feelings, and behaviours in a more effective way.
Cognitive behavioral therapy (CBT) is a psychological treatment that focuses on strategies to change thought patterns. It is the most thoroughly researched psychological treatment and has proven to benefit patients with depression.5
Other psychological interventions such as relaxation, mindfulness, interpersonal, and acceptance and commitment therapies can also be beneficial.5
Antidepressants
Antidepressants are medications that may help with managing depression, and sometimes other conditions such as anxiety.
Most antidepressants work by affecting three main chemicals in the brain – dopamine, noradrenaline, and serotonin. Some may also help to reset our circadian rhythms (internal body-clock).5
Common antidepressants classes include:
SSRIs
Selective Serotonin
Reuptake Inhibitors
These increase the amount of serotonin in the brain.
SNRIs
Serotonin and Noradrenaline Reuptake Inhibitors
These increase the amount of serotonin and noradrenaline in the brain.
Melatonergic
Antidepressant
Resets circadian rhythms (internal body-clock), which may be disrupted by depression and anxiety.4 Also increases the amount of dopamine and noradrenaline in the brain.
If medication is right for you, speak to your doctor about the benefits, risks, and potential side effects before commencing treatment.
Working together with your doctor and deciding on a treatment plan is called shared decision making. This tailored approach is often based on your symptoms and takes your medical history, preferences, and concerns into consideration.
Click here to download a discussion guide to use in your next consultation with your doctor. It will give you some ideas on questions to raise about treatment.
Do not feel afraid to speak up if something isn’t right.
Lynn* – 31 years old. Living with depression
Questions to Ask Your Doctor
Finding the right treatment for your depression involves asking your doctor the right questions. This will help you to better understand your symptoms and the different treatment options available.
It is important that your doctor understands what matters most to you, so together you can decide on which treatment is right for you.
The following questions will support you to start the conversation the next time you see your doctor. You can download the discussion guide:
STEP 1
Explain how you are feeling
You may then want to ask:
- Why do I feel like this?
- What caused these symptoms?
- What is my diagnosis?
STEP 2
Understand your treatment options
- Do I need treatment and if so, what are my treatment options?
- What are the risks and benefits of this treatment?
- How likely is this treatment to be successful?
- Do I need to see a specialist and if so, what kind and why? If your doctor recommends medication see step 2b
STEP 2B
Learn about the recommended medication
- What does this medication do and how does it work?
- Is this medication suitable for me? (i.e. if you’re pregnant, breastfeeding, taking other medications)
- What are the potential side effects of this medication? Will it:
– Affect my sleep?
– Affect my weight?
– Impact my sexual function?
– Be difficult to stop?
- How do I take this medication and how long for?
- How long until I start to feel better?
- What happens if this medication doesn’t work for me?
STEP 3
Ask about ways you can support your mental health
- What can I do to help myself?
- Where can I find more information or support?
- What should I do if my symptoms don’t improve or get worse?
- When do I need to come back and see you again?
You can downlooad this discussion guide:
USEFUL TIPS TO MANAGE DEPRESSION
When living with depression, managing daily tasks and finding the right balance can sometimes feel overwhelming. There are many things that you can do when living with depression to take care of yourself and help yourself recover and stay well.
Being active
Try hitting the gym with a friend or going for a walk. Physical activity has been associated with improved physical health, life satisfaction, mental functioning, and psychological well-being. It can also decrease the symptoms of depression.
Walking to the bus stop may be enough for some days. On others I walk to the one further away. It is enough, I am enough.
Alma* – Living with depression
Coping with Extremes
Some people experience a downward spiral of depression. It can be helpful to recognise and look out for warning signs of extreme behaviours and when extremes of moods occur, have an action plan ready that includes external help and support.
Eating Healthily
When depressed, some people don’t feel like eating and are at risk of becoming underweight, whilst others find comfort in food and are at risk of becoming overweight. Research has shown that symptoms of depression can improve when people eat a healthier diet compared with their usual one. There is no specific diet to treat depression, but experts suggest that eating a regular, well-balanced diet could help people suffering from depression.7 Try to eat nutritious foods, rather than the easy to grab fast-food. Remember, alcohol is a depressant and may work against your medication – so try to cut down.
The hardest thing for me is healthy eating and when I’m depressed, sugar is my “go to”. So, when I’m well I remove “quick-fix sugar” items such as bars of chocolate but leave the tea and biscuits because making a cup of tea means I’m out of bed and doing something. I try to drink as much water as possible and keep microwave meals in the freezer that are quite healthy.
Thomas* – Living with Depression
Being in Nature
Scientists have suggested that natural environments can lead to feelings of happiness and pleasure. What’s more, there can be a positive relationship between time spent in nature and a reduced risk of depression.8,9
Although energy levels might be low and I might be disinterested in my surroundings, I have found that even a short walk in a park helped.
Helen* – Living with Depression
Bulding a Routine
Because depression can stop you feeling in control, you may find that setting up a regular routine can help. The science behind this is that when we organise ourselves and know what to expect, we have more personal resources that can be used to look after our mental and emotional health.10 Having a routine can help reduce stress and have a positive impact on mood.
When my depression was at its worst, nothing gave me any pleasure, even things that had mattered earlier. So, I had to force myself to eat, to exercise, to sleep, and so on. Then I made a schedule of things that were good for me and as it became a routine it was a bit easier. After a while I started to enjoy things again.
Lauri* – Living with Depression
Sleeping
Around 90% of people with depression experience sleep problems.11,12 There are things you can do to help. Try going to sleep at a similar time each night. Stay away from screens and avoid eating rich food or drinking coffee for the hour or so before bed. If you experience sleep problems, it is important that you discuss these with your doctor who can offer help and advice on how to overcome them.
When thoughts are keeping me awake during the night I know I have too much stress on me. I need to cut something out.
Alma* – Living with Depression
Managing Stress
Stress can lead to over-activity of the body’s stress response mechanisms. It can impact your emotional, mental, and even physical health.13 Relaxing in the way you like can help you manage stress.
When internal stress overwhelms me, I decide to take a warm bath whilst listening to relaxing music.
Paul* – Living with Depression
Seeking Human Contact
When you’re depressed you might feel like you want to be alone.14,16 It’s sometimes good to have personal space and some alone time, but experts tell us that isolating yourself can make you feel more depressed, whereas social interaction can have a positive influence on your symptoms.15,16
Even if you don’t feel like talking, being with other people, family and friends, is still connecting with the outside world.
Helen* – Living with Depression
DEPRESSION IS NOT A
SIGN OF WEAKNESS4
Resources
Information and support can help you manage your symptoms and experience of depression. Follow these links to useful websites and resources:
BEYOND BLUE
Provides large number of resources and information for depression, anxiety, and bipolar disorder
www.beyondblue.org.au
BLACK DOG INSTITUTE
Provides a range of information on depression and bipolar disorder
www.blackdoginstitute.org.au
SANE AUSTRALIA
Promotes the understanding of mental illness through a range of publications and services. It is not a crisis counselling service
www.sane.org.au
LIFELINE
A telephone crisis support service, operating 24 hours a day. Phone 131114
www.lifeline.org.au
Questions to Ask Your Doctor: Finding the right treatment for your depression starts with asking your doctor the right questions. Download the discussion guide by clicking here.
References:
- WHO. Depression Fact Sheet. Available from: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed on: March 14, 2023.
- Australian Bureau of Statistics. 2018. National Health Survey: Mental Health. Available from https://www.abs.gov.au/statistics/health/mental-health/mental-health/2017-18.
- Möller HJ, Bandelow B, Volz HP, et al. The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice. Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725–736.
- NHS. Clinical depression. Available from: https://www.nhs.uk/conditions/clinical-depression/.
- Andrews, G et al. “Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder.” Australian & New Zealand Journal of Psychiatry 52.12 (2018): 1109-1172.
- Coles ME et al. Sleep, Circadian Rhythms, and Anxious Traits. Curr Psychiatry Rep. 2015 Sep;17(9):73. doi: 10.1007/s11920-015-0613-x. PMID: 26216591.
- Beyond Blue. Eating Well. Available from: www.beyondblue.org.au/get-support/staying-well/eating-well.
- van den Bosch M, Meyer-Lindenberg A. Environmental exposures and depression: Biological mechanisms and epidemiological evidence. Annu Rev Public Health. 2019;40:239-259.
- Pearson DG, Craig T. The great outdoors? Exploring the mental health benefits of natural environments. Front Psychol. 2014;5:1178.
- Heintzelman SJ, King LA. Routines and meaning in life. Pers Soc Psychol Bull. 2019;45(5):688-699.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5 ed. Washington, DC: American Psychiatric Press 2013.
- Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry. 2005;66(10):1254-1269.
- NHS. Stress. Available from: www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/. Accessed on: August 2, 2023.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM5. 5 ed. Washington, DC: American Psychiatric Press 2013.
- Teo AR, Choi H, Valenstein M. Social relationships and depression: ten-year follow-up from a nationally representative study. PLoS One. 2013;8(4):e62396.
- Steger MF, Kashdan TB. Depression and everyday social activity, belonging, and well-being. J Couns Psychol. 2009; 56(2):289–300.
*Quotes and insights reflect the experiences of real people living with depression.
For more information or to report an adverse event contact Servier Medical Information on 1800 153 590.
Material prepared April 2023. 104713.