People with depression can find it difficult to take the first step in seeking support. They may need to get help with the support of family members, friends or a health professional. There is no one proven way that people recover from anxiety and depression. The good news is that there is a range of treatments, health professionals and services available to help with anxiety and depression. There are also many things that people with these conditions can do to help themselves.
Depression is common
In any one year, around one million people in Australia experience depression. One in five women and one in eight men experience depression at some time in their life. The good news is that just like a physical illness, depression is treatable and effective treatments are available.
The sooner a person with depression seeks support, the sooner they can recover.
Types of depression
There are different types of depression. The symptoms for each can range from relatively minor (but still disabling) through to very severe. The main types of depression are:
- major depression
- bipolar disorder (which used to be called manic depression)
- psychotic disorder
- cyclothymic disorder
- dysthymic disorder
- seasonal affective disorder (SAD).
Treatment for depression
Depression is unlikely to simply go away on its own. In fact, if ignored and left untreated, depression can go on for months, sometimes years, and can have many negative effects on a person’s life. Every person needs to find the treatment that’s right for them. It can take time, strength and patience to find a treatment that works.
Different types of depression require different treatment. Mild symptoms may be relieved with lifestyle changes (such as regular physical exercise) and self-help (for example, online e-therapies). For moderate to more severe depression, psychological or medical treatments are likely to be required, with a combination of treatments often being the most useful.
Treatment for depression should start with seeing your doctor. Book an extended consultation to give you time to discuss your symptoms and treatment options. Treatment may include psychological therapy, medication or both.
Your doctor may refer you to a psychiatrist or psychologist. However, it can sometimes be difficult to get an appointment with a psychiatrist and you may need to wait some time before you can be seen. Whether this is okay for you will depend on the severity of your depression. If you feel that you need to see someone sooner, let your doctor know and work with them to find a solution.
You can also access a psychologist through Medicare. This requires that your doctor writes a mental health plan – ask them for more details.
Another option is your local community health centre. Your local council will have contact details. Most major hospitals also have a psychiatric department with staff available for assessments. If it is an emergency, call your local mental health crisis number for advice.
Psychological treatments for depression
Psychological treatments have been found to be an effective way to treat depression. They may not only help a person to recover, but can also help to prevent a recurrence. Psychological therapies help people with depression to change negative patterns of thinking and improve their coping skills so they are better equipped to deal with life’s stresses and conflicts.
There are several different types of psychological treatments including cognitive behaviour therapy (CBT), interpersonal therapy (IPT) and mindfulness-based cognitive therapy (MBCT).
The main medical treatment for depression is antidepressant medication. Antidepressant medication may be prescribed, along with psychological treatments, when a person experiences a moderate to severe episode of depression. Sometimes, antidepressants are prescribed when other treatments have not been successful or when psychological treatments are not possible due to the severity of the condition or a lack of access to the treatment.
People with more severe forms of depression (bipolar disorder and psychosis) do generally need to be treated with medication. This may include one or a combination of mood stabilisers, antipsychotic drugs and antidepressants.
Making a decision about which antidepressant is best for a person can be complex. The decision is made in consultation with a doctor, after careful assessment and consideration. Antidepressants take at least two weeks before they start to help, and it may also take some time for the doctor to find the most suitable medication and dosage.
Antidepressants can make people feel better, but they won’t change their personality or make them feel happy all the time. As with any other medication, some people will experience some side-effects.
Common side-effects, depending on which medication is taken, include:
- weight gain
- dry mouth
- sexual difficulties (e.g. difficulty becoming/staying aroused).
Some of these symptoms can be short-lived, but people who experience any of these symptoms should tell their doctor, as there are ways of minimising them. The likelihood of a particular side-effect happening varies between people and medication.
The length of time a person needs to takes antidepressants for depends on the severity of the condition and how they respond to treatment. Antidepressants are safe, effective and not addictive. Stopping medication should only be done gradually, on a doctor’s recommendation and under supervision.
Every person needs to find the treatment that’s right for them. Just because a treatment has been shown to work scientifically, doesn’t mean it will work equally well for every person. Some people will have complications, side-effects or find that the treatment does not fit in with their lifestyle. It can take time, strength and patience to find a treatment that works.
After seeking appropriate advice, the best approach is to try a treatment you’re comfortable with and one that works for most people. If you do not recover quickly enough, or experience problems with the treatment, discuss this with your health professional and consider trying another.
Depression – coping and recovering
While psychological and medical treatment can help with a person’s recovery, there are many other ways people can help themselves to get better and stay well.
When you are depressed, you may not enjoy activities that you once loved. You may also think you won’t enjoy something but, when you do it, you actually enjoy it more than you expected.
If you don’t try activities, you reduce the number of things that may help you cope with your depression. To increase the amount of activities you enjoy, you can:
If you keep going, it will help you get better. You will enjoy activities more as you recover.
- list activities you used to enjoy – include as many as possible
- plan one of these activities each day
- increase the amount of time available for activities you enjoy
- after an activity, think about or write down what you enjoyed about it
- talk to others about activities they like.
Sleeping patterns and depression
Depression can disrupt sleep patterns. It’s essential to try to restore a regular sleep pattern to make a full recovery. Some tips for restoring a regular sleep pattern include:
- Try to get up at about the same time each morning.
- If you’re worrying about things during the night, set aside some time for problem solving during the day.
- Avoid drinking caffeine after 4pm and try not to drink more than two cups of caffeine-type drinks (such as coffee, strong tea, cola or energy drinks) each day.
- Avoid using alcohol to help you sleep. As the alcohol is broken down in your body, it causes you to sleep less deeply and to wake more frequently.
- Allow yourself time to wind down before going to bed. If you are working or studying, stop at least 30 minutes before bedtime and do something relaxing.
Negative thoughts and depression
Worrying or thinking negatively is common in people with depression. This affects your ability to focus on getting better and makes you more vulnerable to unhealthy emotions.
Tips to help you control worry and reduce negative thinking include:
- Write down what you are worried about. Go through each concern and examine all the possible positive and negative outcomes.
- Think about how realistic your negative thoughts are. Explore alternative thoughts and explanations.
- Avoid talking about negative thoughts and feelings. Try to find realistic thoughts, which will at least balance your negative ones.
- Keep busy and focused on tasks.
- Think about your skills, talents and achievements. Look at the good things around you. Remember happy times.
- Write down your thoughts. Identify negative ones and try to correct them.
- Avoid making major decisions about your life at this time.
Dealing with irritability, agitation and fatigue
People with depression often experience irritability, agitation and fatigue. These feelings can become worse because of changes in sleeping patterns and lifestyle.
Help yourself to deal with this by:
- telling your friends, family and colleagues what you are going through and that you may appear to be irritable
- when you are agitated or irritable, stopping and thinking about what is causing you to feel this way and how you can calm down
- practising regular relaxation to reduce the effects of irritating or frustrating situations
- talking to people who are supportive
- being as active as possible, despite fatigue. Schedule activities each day, such as exercise, meeting people, going on outings or even doing household chores.
Where to get help
- Your doctor
- Your local community health centre
- beyondblue Support Service Tel. 1300 22 4636
- Lifeline Tel. 13 11 14
- Kids Helpline Tel. 1800 55 1800
- SuicideLine Tel. 1300 651 251
- SANE Australia Helpline Tel. 1800 187 263
- Australian Psychological Society – Find a psychologist service Tel. 1800 333 497 (outside Melbourne) or (03) 8662 3300 (in Melbourne)
- mind Tel. 1300 AT MIND (286 463)
Things to remember
- Depression is common and treatable.
- There is a range of treatments, health professionals and services available to help with anxiety and depression.
- The sooner a person with depression seeks support, the sooner they can recover.
- Treatment for depression should start with seeing your doctor.
- Every person needs to find the treatment that’s right for them – it can take time, strength and patience to find a treatment that works.
- If you do not recover quickly enough, or experience problems with the treatment, discuss this with your health professional and consider trying another treatment.