Depression

Last updated 18 April 2016 — Last reviewed 10 March 2014

Sometimes it is hard to know if what you are experiencing is sadness or depression. The symptoms, causes, management and treatment of depression are discussed along with how to get a mental health care plan from your doctor and tips on what to do if someone you know is depressed. 

What is depression?

Depression is more than feeling sad or blue. It involves persistent and extreme negative thoughts and feelings. It can stop you doing everyday activities including eating and sleeping.

Depression is a serious and common illness that affects one in five Australians. People with depression find it hard to function each day, physically, mentally and emotionally.

sadness or depression?

Sad or depressed?

Depression is different from sadness, stress, anxiety or even grief. It is normal to feel sad or low at times. What distinguishes depression is a combination of factors, including continuously feeling miserable or losing interest in things that you usually enjoy, to the point where you feel you are no longer functioning.

What are the symptoms of depression?

While most people will experience some symptoms of depression at various stages of their life, people who are depressed experience many symptoms, often intensely. Depression significantly affects how people think, feel and act..

If you have some of these symptoms over a period of at least two weeks please see your doctor:

Physical symptoms

  • Sleep disturbance: either not sleeping or ‘over’ sleeping
  • Changes in eating: either not eating or ‘over’ eating
  • Changes in weight: unanticipated loss or gain
  • Headaches
  • Churning stomach
  • Loss of motivation
  • Loss of interest in sex
  • Not wanting to be intimate with others
  • Loss of energy
  • Tired all the time
  • Empty and depressed mood most of the time
  • Continuing feelings of sadness, unhappiness and tearfulness
  • Irritability and/or agitation
  • Tension pains
  • Feelings of anxiety
  • Feelings of heaviness
  • Feelings of isolation

Thoughts

  • "I’m a failure"
  • "Everyone would be better off without me around"
  • "I feel so guilty"
  • ‘"It’s all my fault"
  • "Nothing good ever happens"
  • "I’m worthless"
  • "Life is not worth living"

Behaviours

  • Withdrawal from social situations
  • Less pleasure/interest in activities
  • Loss of interest in personal appearance
  • Drug and alcohol misuse
  • Difficulty concentrating
  • Panic attacks
  • Hopelessness about yourself, the future and the world

What causes depression?

There is no single cause of depression. While there is a lot we don’t know about depression, we do know there are many influencing factors.

Influences How they can lead to depression
Biochemical changes Neurotransmitters (brain chemicals), which carry signals from one part of the brain to the next, can be disrupted and 'dull' how you feel, leading to depression.
Hormones

Oestrogen, progesterone and testosterone may account for mood changes women can experience:

  • with periods and PMS (premenstrual syndrome)
  • with menopause (around 51 years)
  • postnatally

However these are not the same as depression.

The exception to this is women who have a surgical or sudden menopause. The sudden and severe drop in hormones when menopause is induced increases the risk of developing depression.
Genetics A family history of depression increases your risk of having depression. However, it does not automatically mean it will occur.
Stress and anxiety

If you have had high stress and anxiety over a long period of time this may lead to depression.

Personality Some personalities are more prone to depression such as being self-critical, having low self-esteem or worrying excessively.
Traumatic experiences You may not feel depressed immediately after a traumatic event, but depression can build up and develop over time. This is known as post-traumatic stress disorder (PTSD).
Health status Some illnesses and diseases are linked to depression, such as diabetes and cardiovascular disease.
Having an illness or disease such as arthritis, breast cancer or stroke can make depression worse.
Social factors
  • Being lonely, isolated from friends and family, single, divorced or widowed can contribute to the development of depression
  • The experience of depression is often made worse if you are lonely or isolated
  • A ‘cluster effect' means your mood is influenced by the mood of your social network
  • If someone very close to you is depressed for a long time, you are more likely to develop depression
Cultural expectations

Sometimes cultural expectations create added stress and if this continues for a long time, it can lead to depression.

Lack of daylight

During the winter months some people find they are more prone to Seasonal Affective Disorder (SAD) which is a depression caused by the impact on the brain of the lack of day and sunlight. This is more common in countries that experience long and harsh winters like Europe.  

 

How do you know if you might have depression?

For more than two weeks, have you:

  • felt sad or miserable most of the time?
  • lost interest or pleasure in most of your usual activities?

If ‘Yes’ to either of these questions, have you:

  • lost or gained weight or had an increase or decrease in appetite (when not dieting)?
  • experienced sleep disturbances?
  • felt slowed down, restless, or excessively busy?
  • felt tired or had no energy?
  • Felt worthless, excessively guilty about things without a good reason?
  • had poor concentration or had difficulty thinking or been very indecisive?
  • had recurrent thoughts of death?

If you answered yes to four or less of these seven questions:

You are unlikely to be experiencing depression

If you answered yes to five or more of these seven questions:

It is likely that you may be experiencing depression

Management & treatment of depression

Depression is complex and needs time, together with a range of strategies, for it to be managed.

It is important to know you can not just ‘snap’ out of it, nor can you just ‘cheer up’ or ‘get over it’ without help.  Depression will not pass easily if ignored and may get worse, and the longer it continues without help, the more difficult it may be to shift.

The best place to start is a discussion with your doctor to work out the best management and treatment options for you. There are a number of things you can also do for yourself.

Things you can do to help manage depression

Keep a diary

Everyday write down your physical and emotional symptoms to help clarify:

  • whether the symptoms are related to your periods, menopause,  anxiety and/or depression
  • the things that trigger feelings of stress
  • what creates positive or negative thoughts for you
Relaxation techniques Learn relaxation techniques to help you feel more calm through the day and to give you a coping skill in times of stress and distress.
Small tasks Set small tasks so each day you feel you have achieved something
Small achievements Remember the things you achieve each day – even the small ones are worth remembering.
Small good things Do more of the things that make you feel more positive: listen to music, sit outside, sit quietly in the warmth.
Small steps Rather than worrying about what might happen tomorrow or in the future, take one day – or even one hour – at a time.
Exercise Exercise physically to stimulate endorphins (feel good hormones) in the brain because these can improve your mood and help you cope with stress.

Nutritious food

Avoid the highs and lows of sugary and high carbohydrate foods.
Talk

Talk with trusted people if this helps to get things ‘out’ rather than bottling things inside.

Good company Spend time with the friends and family members who are easier to be with and make you feel more positive. It is okay to choose the people you want to spend time with.
Information

Get information about the causes and treatments for depression so you can decide what you need.

Network If you feel cut off from other people, try joining a sport group (e.g. Pilates, tennis, walking) or hobby group (e.g. pottery, bridge), or a book club, use the internet to connect via a reliable system such as email or Facebook or LinkedIn, volunteer with a local charity.
Herbs and natural remedies Ask an accredited naturopath about some of the herbs and natural remedies that can help with depressive symptoms – these might include St John’s wort, lavender, lemon balm or oat straw
A doctor and/or psychologist See a doctor and/or psychologist who can assess your symptoms and then discuss possible treatments such as talking, therapies and/or medication. Choose a doctor and/or psychologist who makes you feel comfortable

How health professionals can help

Some doctors are trained in therapies to help with depression and some will refer you on to other health professionals such as a psychologist or psychiatrist. 

There are a number of medications used to treat depression. Your doctor can advise you.

Medicare rebates are available for up to 10 counselling sessions with a psychologist under a Mental Health Care Plan. Talk to your doctor about how to access these.

How to help someone close to you who is depressed

If you know someone who has depression, there are a few simple things you can do to help:

  • Start a general conversation
  • Ask open-ended questions e.g. "Tell me what you have been doing lately?"
  • Give them time to open up to you
  • Don’t push them if they are not ready to talk
  • Offer to listen
  • Ask how you can help
  • Ring, text or pop in
  • Be a presence
  • Encourage them to see a doctor
  • Follow up with them
  • Reinforce any positive things they do
  • Try not to preach or lecture
  • Look after your own wellbeing
  • Try to keep your own emotions in check – it can be easy to get overwhelmed; If you find you are not coping with what they are doing or how they are behaving, seek support for yourself
  • Let them know you care

If you are worried someone is thinking about suicide, or they tell you they have been thinking about suicide, take it seriously. You can call the Suicide Call Back Service on 1300 659 467 for advice and support.

If the person is in immediate danger, or you are concerned for their safety, it is important you do NOT leave them alone. Call emergency services on 000 and request an ambulance.

For urgent help

If you are in need of urgent medical or psychological assistance, contact your local doctor or hospital as soon as possible.

If you need to talk to someone straight away, please call:

Lifeline 24 hours 7 days a week – 131114
SANE mental health information line Mon-Fri 9am-5pm – 1800 18 72 63

MensLine Australia 1300 789 978


Remember

  • Depression is common
  • It is not a sign of weakness
  • It is nothing to be ashamed about
  • It can be treated

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at March 2014.

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