What Is Depression?
Studies show that one in five people will experience depression at some point in their life. So what is the reality of living with depression? It’s not just about feeling ‘sad’ or ‘down’ – everyone gets that at some point. Depression is a lot deeper and more insidious. It disrupts your every day life and you can’t just ‘snap out of it.’ This is your trigger warning, this article will discuss suicide and suicidal ideation. Please take care of your mental health if this topic will be too much for you.
People living with depression will experience a lot of symptoms and difficulties. They lose interest in things they used to enjoy, have changes in weight, difficulties with sleeping, a lack of energy (fatigue) and negative self beliefs and self talk. I am not a mental health professional, I am a person with experience of living with depression. I cannot diagnose or treat and would recommend seeking professional advice.
Serotonin
I discussed the neurotransmitters in a previous post. Serotonin is the one most people focus on when we are talking about depression. Low serotonin is common in depression but is more likely to be a symptom than the cause. That said, serotonin is still the basis of pharmaceutical treatment of depression, for example SSRIs, Selective Serotonin Reuptake Inhibitors. A licensed medical professional can advise on appropriate options for treatment.
Distorted Thinking In Depression
One of the hallmarks of depression is distorted thinking. Thoughts and emotions that occur that continue the cycle of negativity and the feelings of worthlessness and hopelessness that depression brings. Things like making predictions about the future that are extremely negative. Assuming what other people think of you, and assuming the worst. Telling yourself that everyone hates you, they find you annoying and they only tolerate you because they have to.
Catastrophising means treating everything that happens as a huge deal, even minor things that go wrong feel like the end of the world. Blaming yourself for everything that goes wrong and obsessing about what you should have done. Even when it isn’t your fault.
Ignoring the positives and assuming everything will go wrong. Depressed people will often ignore, or not even notice, when something good happens. They only focus on the negative things. They will often self-label as worthless, a failure, useless, all kinds of things that indicate poor self-worth and self-esteem.
Please understand that none of these things are true and experiencing depression is not your fault, it’s not because you are weak. It is your brain lying to you, in a way. It’s not easy to live with but you can find help and support.
The Reality of Living With Depression
People with depression tend to self-isolate and spend excessive time alone. They avoid social engagements and will often make plans then ‘flake out’ at the last minute. They then feel guilty for letting people down and spend their time thinking the worst of themselves.
Sleep disturbances are common in depression. Either insomnia develops where the person can’t sleep or can’t stay asleep. This makes it harder to break the negative thought cycles as well as worsening fatigue. Other people will sleep too much, spending excessive amounts of time in bed, perhaps even having an inability to get themselves out of bed.
Appetite can be affected too, either not eating enough or seeking comfort by excessive eating. This can lead to weight loss or gain, which can factor in to more of the negative thought cycles. Emotional dysregulation is very common. Either they are emotionally detached and numb, or experience negative emotions in a very pronounced way. Not just sadness, some people will experience irritability or anger that may seem irrational.
People will lose interest in things like their hobbies and interests, work and social life. Poor libido is common too. They will stop doing things they enjoy. They will also stop taking care of themselves and their home including hygiene, cleaning the home, making food and that kind of thing. I’ve experienced this and at my worst last year I was showering twice a week and did not care for myself properly.
People with depression also don’t believe they are worthy of love, care, friendship, respect or consideration from others. They may reject support and avoid reaching out because they believe they are a burden and don’t want to drag other people down with them.
Living with depression is hard, you are constantly battling your own mind. A lot of people will start self-medicating with substances like alcohol and illegal drugs. This could also be a factor in self-harm behaviours. It’s a coping mechanism, but not a healthy one and long term it will make the situation worse.
Suicidal Ideation
This is the most difficult part of depression, both to experience and to talk about. Depression can lead to thoughts of death, self-harm and suicidal ideation. This stems from the belief that the person is worthless, a burden to their friends and family and a belief that everyone around them will be better off without them.
They may think about ending their life, imagining how to do it and thinking of plans. They may begin making preparations like giving away possessions and that kind of thing. These thoughts are dark and distressing but with depression it can feel like there’s no other way out of the situation.
If someone admits to feeling this way, please take them seriously and do not judge them. It’s hard to hear when someone you care about wants to end their life, but it is very important that you do not make it about you. Do not call them selfish or tell them how much it will hurt you or other people. They already feel guilty enough, adding more guilt to that will NOT help the situation. Do not dismiss them as dramatic or stupid. If they are in immediate danger, don’t leave them alone and seek professional help for them.
I think this point bears repeating. Don’t tell a person who has trusted you enough to admit to these feelings, that they will hurt you by taking their own life. No matter how upsetting it is for you to hear, it is also very difficult for them and if you focus on your own feelings instead, you’re manipulating them into feeling guilty about it. Unintentionally, perhaps, but it does not help the person.
Beware if someone who has depression suddenly seems happy and content. This might not be a sign of them feeling better, it could be that they have made the decision to end their life and they feel good because they know the end is in sight and it is a relief. Especially if they start giving possessions away. Reach out and make sure they know you care.
How To Help Someone Living With Depression
There are a lot of things you can do to help someone you know that is living with depression. A lot of it comes down to simply being there for them, show up and support them. Listen to them and don’t dismiss their feelings. Try to avoid offering solutions unless they ask, don’t tell them they’re wrong or that they need to ‘snap out of it.’ Encourage them to seek professional support, help them do this if you can. Remind them that you care and they deserve to be cared about. Gentle encouragement with self-care like nutrition and exercise.
How To Help Yourself
Remember that it is not ‘all in your head’, you have an illness, a real illness and it is not your fault. You did nothing to deserve this, you are not lazy and you are not weak. Reach out for help, there are people who want to help you, I promise. Seeing your doctor is an important step to get the help you need.
Medication can help and it is worth considering, your doctor can help you decide what to try. Talking therapies, counselling and CBT are all options that can help as well. If one thing doesn’t work, that’s okay, you can try something else. Different treatments work better for different people.
Try not to isolate yourself, you have people around you that care and want to help you. It’s hard to admit when you need help, I know that. But those of us with mental health issues are good at masking, so people might not know what’s going on. It’s okay to not be okay, but it’s okay to put yourself first as well.
If you need help, Mind has a list of useful contacts. They are there to help. You can find the list here. For those outside the UK, you can easily find helplines via Google that cover where you live. You deserve hope, you deserve help and things can get better. It’s hard to see when you’re in the dark place, but I promise there’s space for you and you are worth helping.
