Depression
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Important contact details
Mental health crisis support :
- Get advice by calling 111 and selecting the mental health option or using 111 online.
- Ask your GP for an urgent appointment, a GP can advise you about helpful treatments and also help you access mental health services.
Access listening services:
- Call 116 123 for Samaritans or email jo@samaritans.org
- Text ‘SHOUT’ to 85258 to contact Shout Crisis Text Line or text YM to 85258 if you are under 19
- You can also contact Childline on 0800 1111 if you are under 19
Understanding depression
Depression is a mental health illness that includes symptoms like having a low mood or losing interest in things you usually enjoy. It affects around 1 in 10 people. Anyone can have depression, regardless of your gender or age.
How does your brain change if you have depression?
Depression is often thought of as just having emotional symptoms, but it can cause physical changes to your brain. In the brain of someone who doesn’t have depression, there is increased brain activity, shown in the picture as the blue, orange and yellow patches. In the brain of someone who has depression, there is less brain activity.
Depression has also been linked to having a chemical imbalance in the brain. Studies have suggested that depression could be caused by low levels of brain chemicals like serotonin, dopamine and noradrenaline.
Symptoms
There are many symptoms of depression, both physical and psychological. It’s important to know that everyone’s experiences of depression will vary. Symptoms of depression can affect your work, social life and family life.
Doctors describe depression in three ways, depending on how serious it is; mild depression has some impact on your daily life, moderate depression has a significant impact on your daily life and severe depression, can make it almost impossible to get through your day.
- Tired all the time
- Hopeless and in despair
- Down, upset or tearful all the time
- Guilty and down on yourself
- Empty and numb
- Isolated
- Like you can’t relate to other people
- Like there’s no pleasure in life or things you usually enjoy
- Frustrated or angry over minor things
- Suicidal
- Like you’re living in a sense of unreality
- Like you have no self-confidence or self-esteem
People experiencing depression may feel:
- Avoid social events and activities that you’d usually enjoy
- Have difficulty speaking, making decisions or thinking clearly
- Lose interest in having sex
- Have difficulty remembering things or concentrating
- Use recreational drugs like tobacco or alcohol
- Have trouble with sleep - this might be too much or not enough
- Have no appetite and lose weight
- Eat more than usual and gain weight
- Have pain and aches with no obvious physical cause
- Move slowly
- Be restless and agitated
Those with depression might experience changes in their behaviour such as:
If any of these thoughts, feelings or behaviours begin to affect your daily life, it could be a sign that you or a loved one may be experiencing depression.
If someone you care about is experiencing any of the above symptoms, it can be upsetting for you. Don’t be afraid to get help for yourself too.
Depression in children & teenagers
- Providing emotional support
- Working with them on practical strategies
- Finding suitable professional support if they need it
Studies have shown that around 4% of children in the UK between the ages of 5 and 16 have depression or anxiety.
Going through different emotions is part of growing up. While this can be worrying as a parent or carer, it can be normal for children and teenagers to feel low sometimes. Time and support from loved ones can help them to feel better again.
If your child or teenager is feeling depressed, the sadness and low feelings can become more overwhelming, lasting longer periods of time and making it difficult for them to go about their regular activities.
It’s important to get help if you think your child or teenager might be depressed. Addressing it early can prevent potential disruptions and reduce the chance of it turning into a long-term problem. There are things you can do to help them, including:
- Avoiding or withdrawing from friends or social situations
- Losing interest in their schoolwork
- Finding it hard to concentrate
- Losing interest in the things that they previously enjoyed doing
- Feelings of irritation, anger or frustration
- Feeling tearful, lonely or hopeless
- Feeling empty or numb
- Disruptions with sleep – this could be sleeping more or sleeping less than normal
- Disruptions with eating – this could be eating more or eating less than normal
- Being very self-critical of themselves or feeling less confident
- Feeling tired or not having energy
- Having less or no interest in self-care like brushing their teeth and washing
- Wanting to harm themselves
- Experiencing suicidal thoughts
If your child has any of the above symptoms, it doesn’t mean they have depression, but it’s important to speak to your GP so that you and your child can understand what is happening and get any appropriate help.
It’s useful to be able to tell the difference between your child or teenager feeling low and feeling depressed. This can help with getting them the type of support they need. While every young person is different and their feelings can also be expressed differently at different ages, some signs that they might be feeling depressed include:
If you’re worried that your child may be struggling with depression, there are some things you can do to help them:
- Try to talk to them about what’s happening – you can let them know that you’ve spotted that they aren’t very happy. It’s important to try and voice this in a non-judgmental way
- Listen to them and provide support – try not to ask too many questions or find quick solutions. Empathise with how they feel
- If they don’t want to talk at the moment, encourage them to speak to someone else, but let them know you’ll still be there for them. Try again another day
- Think with them to try and find out if there’s anything in particular making them feel low
- Help them with daily things that support their wellbeing, like self-care
- Reassure them
- Encourage them to think about who they have for support
- Encourage them to think about activities they enjoy doing
Causes
Depression doesn’t have a single cause & there are many things that can trigger it including a mixture of different causes combined.
Some people can develop depression after a stressful or upsetting life event like going through a divorce or relationship challenges, losing a loved one or going through redundancy.
It's common for people to need time to process difficult events like loss or relationship challenges. If you find yourself facing such situations, remember that reaching out to friends and family for support can help to reduce the risk of depression.
If you have certain personality traits like low self-esteem or being overly self-critical, it's important to understand that you're not alone. These may stem from inherited genes or early life experiences.
If a family member, like a parent, sister, or brother, has experienced depression before, it's natural to feel concerned about your own risk. While there may be a genetic component, it's essential to remember that depression often happens because of a mix of factors, including life events. Having a family history doesn't guarantee you'll develop it.
It's important to recognise that some people may be more vulnerable to depression after pregnancy. The hormonal shifts, physical changes, and the adjustment to the responsibilities of caring for a newborn can contribute to postnatal depression.
It's also worth knowing that depression can also begin during pregnancy – this is called antenatal depression.
Menopause is when your periods stop due to lower hormone levels. It can be common for menopause to trigger feelings of depression, especially during the initial years.
Alongside this, symptoms like sadness and mood fluctuations may also happen due to hormonal shifts. It's important to understand that while these symptoms may be like depression, they are distinct and can be a part of going through the menopause.
Experiencing loneliness, which can start from things like being disconnected from loved ones, may increase the risk of depression. However, recognising this and taking steps to reconnect or seek support can help with feelings of isolation.
During challenging times, some people may turn to drinking too much alcohol or using recreational drugs, but this can make feelings of depression worse, leading to a downward spiral.
While substances like cannabis might initially make you feel relaxed, research suggests they could contribute to depression, especially among teenagers. Similarly, using alcohol to "drown your sorrows" isn't advisable, as it can disrupt brain chemistry and increase the risk of depression.
If you're dealing with a long-term illness like coronary heart disease, cancer, or a condition causing persistent pain, it's understandable to have concerns about depression. It's also important to know hypothyroidism can also cause feelings of depression in some people.
Some people talk about a ‘downward spiral’ of events that leads to depression. An example of this may be, if your relationship with your partner breaks down, you might feel low. As a result of feeling low, you might isolate yourself and stop seeing friends and family. This might make you drink more alcohol, making you feel worse and triggering depression.
Some studies have also shown that as you get older, your likelihood of getting depression increases, and depression is more common in people who live in difficult situations socially and economically.
Research has also shown that getting severe depression may be somewhat affected by inherited genes.
Are there different types of depression?
There are different types of depression. This can depend on the severity of your symptoms or when your symptoms happen. The severity of your symptoms can change over time. Depression isn’t a one-size-fits-all diagnosis. It can be an umbrella term for many types. We’ve put together an article to take you through the types of depression.
Some of the types of depression can include:
Major depressive disorder
you might hear of depression being called this sometimes
Seasonal affective disorder
SAD – this can happen at a particular time of the year, for example, a particular season
Antenatal depression
can happen while you’re pregnant. Sometimes it’s called prenatal depression
Persistent depressive disorder
is depression that lasts for two years or more. You might hear of this being called dysthymia or chronic depression.
Postnatal depression
PND – this can happen in the first year after having a baby. You might hear of it being called postpartum depression. It can also affect dads and partners.
Supporting your wellbeing
Treating depression usually involves a combination of self-help, talking therapies and medicines.
Any treatment recommended by a GP will be based on the type of depression you have.
- Wait and see – your GP might suggest that you wait to see if it gets better. Your GP will see you again after two to four weeks to check on your progress. This is also called watchful waiting
- Guided self-help – this might be working through a workbook or online course with support from a therapist. It could be in person, by phone or online. Guided self-help is usually based on the principles of cognitive behavioural therapy (CBT). This is to help you change the way you think and behave.
- Exercise – there’s evidence to suggest that exercise can help with managing symptoms of depression (it’s even one of the main treatments for mild depression)
- Talking therapies can be useful if your mild depression isn’t improving. A GP can refer you for talking therapy, or you can refer yourself directly to an NHS talking therapy service.
If your symptoms are mild, you may be recommended to:
- Antidepressants– medicines to treat the symptoms of depression. These have to be prescribed by a doctor, usually for moderate or severe depression. Most people with moderate or severe depression can benefit from antidepressants, but not everyone does
- Combination therapy – this involves a course of antidepressants combined with talking therapy, especially if your depression is quite severe. A combination usually works better than having just one treatment
If your depression is more severe, you may be recommended the following:
Talking therapies are psychological treatments that involve working with a trained therapist. It could be one-to-one, in groups, online, over the phone or in person. Different talking therapies suit different people and for some people and some conditions, one type of talking therapy might be better than the other.
Types of talking therapy include:
- CBT
- Interpersonal therapy (IPT) – this focuses on your relationships with other people and problems you might be having in your relationships
- Behavioural activation – this focuses on identifying links between your activities and your mood, instead of focusing on what you think and how you feel
- Individual problem solving – this focuses on identifying problems and then developing plans to solve them. This is normally only recommended for severe depression
- Psychodynamic psychotherapy – this is to encourage you to say whatever is going through your mind. It can help you to become aware of difficult feelings in your relationships and situations
- Counselling – this is to help you think about the problems you’re facing in life so you can find new ways to deal with them
- Behavioural couples therapy – this can be useful if your relationship problems could be contributing to your depression
Other treatments include:
- Mindfulness – which involves paying attention to the present moment and focusing on your thoughts and feelings
- Brain stimulation – this can be recommended for severe depression that hasn’t responded to other treatments. Electromagnetic currents can be used to stimulate certain areas of the brain to try to help improve symptoms of depression
If you’ve been diagnosed with depression by your GP or a psychiatrist and you’re over 18, you can try the Flow tDCS headset. It uses a non-invasive brain stimulation method called tDCS or transcranial Direct Current Stimulation. You must speak to your GP before using Flow and always before making changes to your current treatment for depression.
You can also access treatment for depression through Boot Online Doctor2. You can have a consultation with medical professionals and plan tailored treatment and support to help you feel like yourself again.
Looking after your mental wellbeing
There are steps you can take to help to lift your mood and help with your symptoms.
If you’ve been prescribed antidepressants, it’s important to take them as prescribed, even if you start to feel better. If you stop too soon or suddenly, your depression could come back or you might increase your risk of withdrawal side effects.
If you have any questions or concerns about your medicine, speak to your doctor or pharmacist. As some over-the-counter medicines like pain relief or supplements can interfere with antidepressants, make sure to check with your doctor before you take any other medication alongside your antidepressants.
- Improving your mood
- Reducing everyday stress and feelings of anxiousness
- Encouraging the release of your body’s feel-good chemicals (endorphins)
- Improving self-esteem
- Distracting from negative thoughts
- Improving social interaction
Exercise and eating a healthy diet can make a difference in not just how you feel, but your general health as well.
Eating a healthy diet can help improve your mood. Eating healthily is seen to be just as important for looking after your mental health as it is for preventing problems with physical health.
Being physically active can help with:
The National Institute for Health and Care Excellence (NICE) recommends group mindfulness and meditation as a treatment for less severe depression.
It’s understandable to get caught up in the hustle and bustle of life without stopping to notice much. Mindfulness helps you to keep in tune with what’s happening in the present. It can help to relieve stress as you learn to connect deeper with your emotions. You can learn more about mindfulness in our how-to guide.
Talking about your problems can help give you support. You might not feel comfortable speaking about your mental health with other people. If you don’t, you can express how you feel through poetry or art.
If you have depression, you might be tempted to smoke or drink to help you feel better. Smoking or drinking can worsen symptoms. If you find yourself smoking, drinking too much or using recreational drugs, your GP can give you advice and support.
It isn’t just the person with depression who’s affected. Their loved ones and people close to them are also affected.
If you care for someone with depression, your relationship with them and your family life can become strained. If you feel unsure on what to do, finding a support group and speaking to other people in a similar situation might help.
If you’re struggling with your other relationships or having difficulties with your marriage, it might help to speak to a relationship counsellor who can help with talking things through with you and your partner.
If you’re experiencing a mental health crisis or are at risk of harming yourself or others, please call 111 now, speak to the Samaritans on 116 123, text Shout on 85258, or speak to your GP.
Inspiration & advice
Frequently asked questions
The symptoms of depression vary widely between different people. If you have depression, you might feel sad, hopeless and lose interest in things you used to enjoy, but there are other symptoms you might also have. We’ve explored the symptoms of depression in the ‘What are the symptoms of depression?’ section of the page.
*In order to use Flow you must be over 18 years of age and diagnosed with depression, which is usually done by your GP or a psychiatrist. You must speak to your GP before using Flow and always before making changes to your current treatment for depression.
2Access to prescription-only treatment is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.
