Monday 22 January 2018

Doctor's Orders: Half of us are going to be depressed

Depression - it doesn’t just happen to other people, writes Ciara Kelly

DEPRESSION: The black fog can make you seem cut off from the world around you, isolated in a dark and lonely place
DEPRESSION: The black fog can make you seem cut off from the world around you, isolated in a dark and lonely place

Dr Ciara Kelly

This week, I want to discuss something more sobering than my usual offerings. It’s a sad fact of life that up to 50pc of us will suffer from depression at some point. That sickening black fog descending. Destroying your ability to interact with other people. Tainting your every waking moment with sadness and affecting your ability to function — or even care about functioning. You feel cut off from the world around you. Isolated in a dark and lonely place. Ten pc of us feel that way, at any given time. That’s 450,000 Irish people right now and about 100,000 people reading this article. That’s a lot of people.

In the same way that our physical health can be affected by infection, injury or illness, our mental health — which for many is already fragile — can be affected by bereavement, relationship issues, financial stress or other factors. But equally, many people — ostensibly with no problems whatsoever, still feel depressed.

I think it’s important to point out how common it is, because many people do believe that depression is something that happens to other people. Not true! Every last one of us is vulnerable to it, in the exact same way we’re vulnerable to physical illness. And understanding that is in itself a protection . If you believe that you’re not the sort of person to be affected by depression, then it’s unlikely you’ll recognise it, if and when it becomes a problem. And more likely, it’ll take you longer to seek help. And there is help. The good news is, there’s life and happiness after depression.

Depression, in its mildest form causes early morning wakening, poor concentration and loss of confidence. You feel wrecked, but mightn’t feel depressed’. As it progresses you experience a profound fatigue, sleep disturbance and start to appear depressed to yourself and others. Severe depression causes impaired judgment, abject despair and persistent pessimism and negativity, often with suicidal thoughts or intent. Pretty horrible.

I often tell really depressed patients — who, incidentally, are mostly plagued by guilt about their depression and low self-worth, regarding their inability to snap out of it’ — that they wouldn’t feel any worse if they had a major physical illness, like heart disease or cancer.

So what do you do, if you suspect you’re struggling with depression? Readers of my column will know my great love of lifestyle intervention; and, indeed, adequate sleep, a healthy diet and regular exercise will of course, improve your mood, But for those of you who are beyond that and can barely get out of bed, let alone go for a run, the first thing is to talk to someone.

Your GP is a good place to start and is trained and experienced in treating depression. Sometimes it’s easier to talk to someone who is not a friend, so you don’t have to pretend in any way. It’s often very daunting, admitting how hard things are for you and you may, in fact, find opening up very upsetting. But mostly people find it cathartic and are often slightly relieved and uplifted after they do it — possibly because they’ve taken action.

Every patient is different and there’s no set treatment for depression. It depends on the individual, but broadly speaking, it falls into two categories: talking therapy and medication. For some, talking therapies, such as counselling or CBT, are all that’s required, but equally some need medication as well. What I really hate is seeing people reject treatment because of fear or stigma. For so many years, depressed patients have been let down in this country, by medics and society in general. And the legacy of that, is that people learned to hide their depression and pretend it couldn’t happen to them.

So look after your mental health. Protect it and value it. Recognise when it’s vulnerable and get the help you need.


Sunday Independent

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