How depression starts
Losses, disappointments and setbacks
When we experience setbacks in our relationships, working lives, health, or losses such as bereavement, it is completely normal to feel down for a while as we adjust to these changes before finding a new way forward. Sometimes, however, these feelings last longer and begin to affect our confidence and ability to cope with everyday life. This is when depression may begin to set in.
Build-up of stress
Depression may also result from a build-up of stress and worry over a period of time, for example, ongoing worries about money, housing, health, work, or family. Again, after a while, this can affect our confidence and ability to cope.
Smaller losses, disappointments and setbacks
Sometimes, however, the triggers for an episode of depression can be harder to identify. This may mean that relatively small setbacks can lead to self-doubt, loss of confidence and feelings of hopelessness, which are characteristic of depression.
How to recognise depression
Depression is associated with temporary changes in the way we may think, act, and feel.
You may find that you are not enjoying the things you used to enjoy. You might feel emotionally numb, as if your normal feelings have been turned down or even switched off. Or you might feel vulnerable and weak, or sad, noticing that you cry easily. Feelings of guilt and shame are also common in depression. You might notice you are more irritable than usual, perhaps getting angry easily. You may also experience elevated levels of fear and anxiety.
If you are depressed you may find that your thinking seems slowed down, that it is difficult to think clearly, or that your mind is foggy. You may also forget things more often than you usually would. It may be difficult to make decisions. You may find that you are dwelling on problems and difficulties, perhaps going over and over things that you feel have gone wrong in the past. Thoughts of death and suicide are also common in depression.
Sleeping, eating, energy
Depression often affects sleep. It may take a long time to fall asleep at night, and then you may wake up early and are not able to get back to sleep again. Sometimes, however, people find that they sleep more than usual when they are depressed. You might lose your appetite or you might find yourself eating more than usual. It is common in depression to feel very tired so that even the smallest tasks can feel overwhelmingly difficult. Sometimes depression is also associated with feeling agitated and restless making it impossible to relax. As a result of changes in appetite and activity, you may find that you lose or gain weight.
Depression is often associated with a desire to isolate from other people and withdraw from the demands of everyday life. Although a very understandable response to feeling down, this has a tendency to make things worse in the longer run.
Treatment for depression
IAPT services offer talking therapies for depression that have been recommended by the National Institute for Clinical Exellence (NICE). This means they have been researched and have evidence to support them.
One of the main talking therapies recommended is CBT. This approach helps us understand the links between emotions, thinking, body responses, and behaviour as described above. This in turn leads to effective strategies for breaking out of the vicious cycles of depression.
You can read more about treatments for depression, including CBT, on the Depression Alliance website.