Everyone feels low from time to time, so it’s not always easy to know when it is part-and-parcel of daily life, and when it’s time to seek help. In most cases, it is short-term and self-correcting, but for a significant minority this is not the case. For those individuals, it is important to seek treatment just as you would any other health condition. Here we discuss six warning signs which, together, might indicate that it’s time to seek professional help.
What are the signs?
1. You’ve been feeling low or irritable for most of the day, every day for two weeks or more. You might have found yourself worrying about past or future events for long periods of time, or simply feeling sad, cross or tearful. Sometimes it’s hard to recognize a gradual change – have others noticed that you don’t seem your usual self?
2. You’ve lost interest in activities that you used to enjoy. Perhaps you have been seeing less of your friends or family recently, have stopped going to the gym, or cooking balanced meals. This is really about recognizing changes in what’s normal for you – no one is saying you have to exercise five times a week or eat your greens, but changes in your routine can offer concrete indications that your mood is changing.
3. You are struggling to concentrate. You might notice that you struggle to focus when reading or watching television, for example, or to follow the thread of a spoken conversation. This could be affecting your performance at work, or limiting your ability to perform routine tasks such as food shopping. Again, we are looking for a change in what’s normal for you, so if concentration has always been something you find tricky, there is little cause for concern.
4. Your energy levels are depleted. Feeling exhausted is one of the most debilitating effects of depression. Summoning the energy to do anything – even getting out of bed – can be a huge effort, and you might find yourself feeling frustrated at not being able to do things that used to be seemingly effortless.
5. Your sleeping and/or eating patterns have changed. Often, it is said that a reduced appetite is a sign of depression. In fact, eating more than usual can be just as indicative of low mood as eating less. The same goes for sleeping: both sleeping more and sleeping less are warning signs that you might have depression. Early morning waking – that is, waking several hours before you would normally expect to, and struggling to get back to sleep – is another common sign.
6. You’ve been preoccupied with feelings of guilt or worthlessness. This might be a case of feeling like you’re in the wrong or that you’ve let people down, or that you are a burden on those who are close to you. Often, these ideas are disproportionate to the event that has triggered them. A good way to test whether these ideas might be out of proportion is to ask a trusted friend or family member whether they would feel the same way in your shoes.
Bear in mind that no one of these signs is in itself indicative of depression, and there are other, perfectly good reasons for each of these symptoms occurring. It’s also important to know that there are several types of depression and each can present in different ways – read more about types of depression.
If you recognize yourself in most or all of these signs, then it is probably time to seek a professional opinion.
A GP is always a good first port of call, as they can signpost you towards more specialist services if necessary. Otherwise, if you are sure you’d like to see a mental health professional, consider making an appointment to see a psychiatrist who will be able to give you a diagnosis and advise you on which treatment might work best for you (read more about therapies that can help with depression), or even a clinical psychologist. To learn more about who’s who in mental health, click here.
What else causes the symptoms of depression?
Life events
A general rule of thumb to ask is: is my mood a reaction to something? It’s very normal for our mood to dip in response to difficult life events: a bereavement, loss of a job, a relationship breakdown, and so on. In these cases, low mood is a pre-programmed response to an environmental trigger. It might still be advisable to talk to a mental health professional, for example, to develop coping strategies, but the good news is that, except in very severe cases, the brain chemistry should rebalance over time without the need for medication.
However, for some, an incident like a death in the family can be a situation that ‘pushes’ the person over the edge and spirals them into a deep depression – so if you have any worrying thoughts or behaviours or if the symptoms persist for several weeks it is always advisable to seek medical help.
Substances/ medications
Depressive symptoms can also be a reaction to a substance: regular and/or heavy alcohol use is often associated with low mood, as are certain recreational drugs, and even some prescription medications, such as the contraceptive pill. If you are worried that the medications you are taking might be affecting your mood, do not stop taking your medication but do talk to your prescribing doctor as soon as possible.
Physical health
Depression is also frequently associated with physical health problems. If this could be the case for you, it is important to see your GP who can take a holistic view of your healthcare. Often, getting on top of pain, sleep difficulties or inactivity can directly improve your mood without the need for specific mental health input.
Mental health
There are other mental health problems that can be associated with the above symptoms. Bipolar disorder is characterized by bouts of low mood, followed by periods of elation. Schizoaffective disorder is characterized by low mood accompanied by symptoms of psychosis, such as hearing voices, seeing things that others’ cannot see, and/or having ideas that are not shared by your social groups. If you think that your symptoms might be indicative of either of these conditions, it is important to seek professional help to ensure that you get the most effective care, as these are unlikely to go away by themselves.
Can depression be cured?
Depression, like many mental health conditions, follows ‘the rule of thirds: One-third of sufferers will fully recover, one-third will partially respond to treatment, and one-third will not benefit from treatment at all. Your age, the duration of your symptoms, having a family history of depression, and co-occurring mental or physical health difficulties might all affect your prognosis.
Some researchers believe that there is evidence for a ‘scarring’ effect, where the likelihood of suffering from a relapse in depression increases with the number of episodes you have already had. There is also an increased risk of suicide associated with severe depression. This is why it is advisable to seek treatment as soon as possible if you think you might have depression.
The good news is that both medical and psychological treatments for depression have a strong evidence base, and new treatments are being developed all the time. In fact, one of the best predictors of treatment success is how closely you follow your treatment plan. To learn more about antidepressant medication or to learn which psychological therapy is for you, follow the links provided or browse our ‘news’ section.