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Everyone gets "down" sometimes. Life has natural ups and downs, when we just feel fed up or things don't go right. People often say they are "depressed" when they are really referring to these normal low periods in life. If we suffer a major loss or trauma, we may have emotions which are similar to those associated with depression, but working through these can be a healing process, although it will take time. Depression is more of a long term problem which doesn't get better by itself. The difference between feeling "down" and being depressed is one of both intensity of feeling and duration. It affects people of all ages and backgrounds and is one of the most common reasons for seeking help from a counsellor or GP.
- Feelings and symptoms
- Some possible reasons why people get depressed
- Things you can do which may help
- Advice & support
- Helping someone you are concerned about
- What to do in a crisis
- Getting help/useful telephone numbers
Feelings and symptoms
Depression is characterised by a feeling of all pervasive gloom and loss of interest or pleasure in life. It also commonly involves:
- a change in eating, weight and/or sleep patterns;
- a change in concentration and working;
- feeling irritable and short tempered, or tearful, without being able to pinpoint the causes;
- loss of energy, listless, and feeling you "can't be bothered"; loss of interest in sex;
- feeling worthless or powerless;
- feelings of hopelessness and thoughts of self harm or suicide;
- negative thoughts about yourself, your situation and/or about the future.
We all experience some of these feelings or symptoms at times, but someone who is depressed will experience a number of them for quite some time.
Some possible reasons why people get depressed
There is no simple answer to this – there are usually several factors. Depression can be a response to something distressing or a change of circumstances – particularly those involving loss of some kind – which seem to threaten our sense of identity or our very existence. These include: leaving home/country, bereavement, being isolated, or the break-up of a relationship.
However, often people become depressed for no immediately obvious reason. Sometimes a particular set of circumstances allow feelings that belong to something which hurt deeply in the past, to come to the surface. Sometimes it can be caused by a chemical/hormonal change which affects our body chemistry, or other physical conditions.
Things you can do which may help
When you are depressed it is easy to get stuck in patterns of behaviour or thoughts, which then make you feel more depressed, and powerless to find a way out. However, there are things you can try which have been shown to help ease depression. These could involve challenging your negative thoughts and trying to change your behaviour. This may seem difficult in your current state of mind, but may be possible in cases of mild depression.
A good first step is to try to think about why you feel like this now. Give yourself time to understand your feelings. Encourage yourself to start doing things again and questioning some of your negative thoughts.
Break tasks down into small manageable chunks, doing one thing at a time, starting with easier things and progressing to more difficult ones. Be realistic – there probably are things you've achieved, and recognising these will help you to regain your confidence.
- Try to spend time with people who are supportive and with whom you can be honest about yourself; isolating yourself increases depression, while social support helps lift a low mood.
- Try to challenge your negative thoughts no matter how strong they feel at the time; accept that there may be a number of explanations for your current situation and state of mind – avoid blaming yourself all the time.
- If you feel it is appropriate, try talking to other people to help you get a balanced perspective on which are the most likely explanations.
- Many depressed people "dose" themselves with excessive quantities of alcohol or other drugs to blot out the painful feelings – try not to do this as it will make you feel worse in the long run.
Advice & support
If you continue to feel isolated, powerless to do anything or you cannot get on with your life, work or relationships, then you should consider seeking further help.
If you find it hard to talk to friends and family, it may help to talk to a counsellor.
You could speak to a college nurse or GP if you are having difficulties with eating or sleeping. You can discuss with your GP the range of treatments available to you, which could include counselling and/or medication. Many people worry about getting dependent on medication. It may not be a cure in itself but it may help, along with counselling, to help you find the resources to address the circumstances contributing to your depression.
If you have strong feelings of hopelessness or are having suicidal thoughts and feelings, you should contact someone for help as soon as possible.
Outside normal working hours, you can telephone your GP practice to see what arrangements are in place for emergencies, or go to your nearest hospital with an accident and emergency department. You can also telephone the Samaritans on 0345 909090.
Helping someone you are concerned about
You may find this section useful if you are worried about the emotional or mental health of someone you know. It offers practical guidelines for students as to what you can do in this situation and how you can get help, both for the person concerned and yourself. There are also some suggestions as to how to get help in a real emergency.
What's causing you to worry?
- Has he or she told you there is a problem?
- Have there been any dramatic changes in your friend's appearance (for example, weight loss/gain, decline in personal hygiene)?
- Are they drinking alcohol or taking drugs to a degree that worries you? Do you notice changes in, or heightened, mood – for example, more sad, withdrawn, hyperactive, aggressive? Have other people expressed concern about this person?
- Have there been changes in behaviour or attitudes, for example towards work, friends or other commitments?
What to do if you are concerned
It can be very difficult or even embarrassing to raise these issues with the person concerned. You may be worried about being dismissed or rejected, or that your friend will get angry with you. However, try not to avoid the situation or pretend that nothing is wrong. If everyone does this, the problem is likely to persist for longer. Remember that people in distress ultimately respond to people being straightforward and honest with them.
Try to talk to them and tell them you're concerned about them – this may open up the way for them to begin talking to you. However, asking too many questions just makes most people feel like clamming up. If they don't want to talk, you have to respect their privacy.
Be prepared to listen, sympathetically and without offering advice. But also try to be aware of what you can take – being with someone in a personal or emotional crisis is exhausting and time-consuming. Don't jeopardise your own health and well-being.
Express concern but remember you're not their therapist or counsellor. You may feel there's very little you can do, but just being able to talk to someone is often very important to someone with a problem. You don't have to come up with a solution.
If you think it's appropriate, encourage them to seek professional help – see below for ideas as to whom you might suggest they contact.
If you are seriously worried and feel you need to tell someone else, try to get your friend's consent. Explain what is making you so concerned and how you think telling someone could help. Be honest about this – it will help to gain your friend's trust.
If your friend refuses help and you're still worried, speak to someone in a specialist support service or someone else you trust. If you don't have your friend's permission to divulge details, you can still get support for yourself without breaking your friend's confidence – you do not need to mention their name.
However, in exceptional circumstances, where you feel your friend's personal safety, or that of others, is at risk, you may need to act without their consent. Do look after yourself and get appropriate help and support from others.
What to do in a crisis
A situation becomes a crisis when someone's feelings are outside their control, and they behave unpredictably and dangerously. They might be suicidal or harming themselves, or incapable of ensuring their own safety, or you might be worried they will hurt someone else.
Crisis situations are very rare, and it's difficult to give firm guidelines – it is in the nature of crises to be unpredictable. The course of action you take will depend on the circumstances: what is happening with the person concerned, how you think the situation is likely to develop, and where you are (what help is available).
In all crisis situations, ensuring your own safety and that of others is paramount.
The following suggestions may help, when you encounter a situation where someone is on the verge of harming themselves or others.
- Try to remain calm and adopt a non threatening approach. Don't approach the student from behind or stare at them – this feels threatening to the person concerned. Give them room to breathe; do not touch them unless you're sure they are not frightened of you.
- Be very straightforward, tell them you know they're upset and that you're going to make sure they get help. Be reassuring. Often people in a crisis are very frightened of what they might do and find it helpful when someone takes charge of the situation.
- It may be that this will result in the person calming down enough to be able to think with you what help would be useful – you can suggest they consult a counsellor, nurse, GP, or Accident and Emergency Department of a local hospital. Then help them to access these services.
- If the person continues to behave in a way that threatens their own safety or that of others, you need to contact the emergency services. This will normally be the ambulance service, or in extreme cases of violent behaviour, the police. Dial 999. If you are in college, get a member of the College staff to help you do this. Explain what has happened and get them to call for help. Otherwise, dial 999 and ask for the ambulance service.
- In the event of a suspected overdose, or someone being unconscious from too much alcohol or drugs, call an ambulance immediately. Don't leave them to sleep it off alone.
After the crisis has passed, it may help to talk over what has happened with a member of the student support team such as a counsellor. These situations can be very shocking and upsetting – you may need support for yourself, or just a chance to reflect on what has happened.
Getting help/useful telephone numbers
08457 678000 (for advice on mental health