What is depression?
While we all feel sad, moody or low from time to time, some people experience these feelings intensely and for extended periods of time. A diagnosis of depression, also referred to as Major Depressive Disorder, involves experiencing low mood and significantly reduced interest in activities for at least two weeks. We may also experience changes in our appetite and sleep patterns, feelings of guilt or worthlessness, feeling fatigued, difficulty concentrating, feeling agitated or alternatively slowed down, and for some persons there may be thoughts of suicide. Experiencing depression can contribute to significant challenges in continuing to function day-to-day, and we may have an urge to withdraw from others and stop doing the activities we used to do.
How common is depression?
Depression is the most frequently diagnosed of all mental health problems. It has been estimated that in any year 4% of Australians will experience a major depressive episode, with a lifetime prevalence of 16.6%.
Distinguishing different mood disorders
Different types of mood disorders have different symptoms and thus can require different treatment approaches. Some of the primary diagnostic categories are found below.
- Perinatal Depression
- Bipolar Disorder
- Major Depressive Disorder
- Persistent Depressive Disorder (Dysthymia)
What is perinatal depression?
Perinatal depression refers to symptoms of depression which develop during pregnancy or within the first few weeks after the birth of a child. It is different from the ‘baby blues’ in that the symptoms last longer than two weeks and can be more intense. Some of the symptoms that can be experienced are:
- Feeling low or down most days
- Lacking enjoyment and pleasure
- Feeling excessive guilt or inadequacy, for example in our ability to parent
- Feeling hopeless about the future
- Eating significantly less or more than usual most days
- Difficulty concentrating or making decisions
- Thoughts of harming yourself
If you are wondering if what you are experiencing could meet criteria for perinatal depression, you may wish to see the Edinburgh Postnatal Depression Scale which asks you to consider how intense your symptoms have been across ten areas.
It is estimated that perinatal depression is experienced by one in seven mothers in Australia, and is also experienced by fathers. Sometimes the symptoms can develop during pregnancy (antenatal). The symptoms of depression can make it hard to function every day, and we might find that we struggle to take care of ourselves or others.
Practical and emotional support from family and friends can be a great help in this period, however these may not be sufficient in reducing the symptoms. Seeking treatment early can help to reduce the negative impact on the person and those around them. Evidence-based treatments include psychological therapy and antidepressant medication.
What is Bipolar Disorder?
While it is completely normal to experience highs and lows in response to life events, for individuals with a Bipolar disorder, these fluctuations are significantly more intense. Bipolar disorder is characterised by extreme “highs” (referred to as mania) and extreme “lows” (referred to as depression).
Symptoms of mania include feeling euphoric or invincible, high levels of creativity, decreased need for sleep, racing and tangential thoughts, increased irritability, risk-taking behaviours, impulsivity, poor concentration, delusions, hallucinations and grand/unrealistic plans.
Symptoms of depression include feeling sad or hopeless, losing interest in pleasurable activities, withdrawing from friends or family, changes in sleep, loss of energy, poor concentration and feelings of guilt. Suicidal thoughts may also be present.
There are two types of Bipolar disorder:
Bipolar I Disorder
An individual with Bipolar I disorder will have experienced at least one manic and one depressive episode.
Bipolar II Disorder
An individual with Bipolar II disorder will have experienced at least one hypomanic and one depressive episode. Hypomanic episodes share the same features as manic episodes, except that symptoms are typically shorter lasting and less intense.
What is Major Depressive Disorder?
Major depressive involves experiencing a depressed (or low) mood and loss of interest, on more days than not, for at least two weeks. Other symptoms may include changes in sleep or energy levels, changes in appetite, feelings of worthlessness or guilt, difficulty concentrating and thoughts of death or suicide.
Major depressive disorder is the most common depressive disorder diagnosed in Australia, and is thought to affect 1 in 7 Australians at some point in their life.
What is Dysthymia?
Individuals who have been diagnosed with dysthymia typically experience depressed mood for most days for durations of at least two years. They may experience symptoms similar to those associated with Major Depression, including reduced self-esteem and concentration and changes in appetite, eating, and energy. The primary difference is that these symptoms have lasted for a very long time (i.e. two years or more).
Making lifestyle changes and learning new techniques may help us to improve our mood and keep it steadier. Some of the most commonly recommended strategies that can positively affect our mood include:
- Getting enough sleep
- Keeping socially connected
- Being physically active most days
- Reducing alcohol and non-prescribed drug intake
- Maintaining a daily routine
- Talking about difficulties we’re having with someone that we trust
- Continuing to do things that used to give us feelings of pleasure and achievement
- Learning and practise relaxation techniques
- Expressing ourselves through writing or another creative outlet
- Practicing mindfulness
You may also find the following national organisations helpful in learning more about depression and accessing further resources:
- Centre for Clinical Interventions – a range of informational resources available including coping with depression series
- Moodjuice – education and techniques for managing depression
- Black Dog Institute
- Beyond Blue
- Headspace – information resources for ages 12-25
- Mind Spot – free online courses
Getting professional help
If you or someone that you know needs additional assistance, the best person to speak to is your GP. They may refer you to a mental health professional, such as a psychologist or psychiatrist.
Services available include:
In case of emergency, the following services are available: