Depression

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					                  Kent and Medway
           NHS and Social Care Partnership Trust




Depression
Psychological strategies to manage
depression




What is Depression?
Depression is a common complaint, characterised
by low mood, feelings of sadness and,
sometimes, lack of motivation.

As many as one in four people will suffer with
depression and it can occur at any time in life and
can affect anyone. Depression can range in
severity from mild and limited to one episode, to
enduring or recurrent episodes.

There are also different types of depression such
as bipolar disorder, postnatal depression and
Seasonal Affective Disorder (SAD).




                                   Better Together
Depression




Symptoms of Depression
As well as feeling low and sad, there may be
other symptoms that you are experiencing,
without realising the connection to depression.
These can be divided into four categories:

Mood (emotions and feelings)
• Feeling sad or upset
• Loss of interest and enjoyment in things
• Crying a lot or inability to cry at sad events
• Feelings of isolation
• Feelings of anger or irritability at small things

Physical Symptoms
• Disturbed sleep
• Changes in appetite or weight
• Tiredness or restlessness

Thoughts
• Loss of confidence or self esteem
• Poor memory or concentration
• Thinking that everything is hopeless
• Thinking you hate yourself
• Thinking about suicide

Behaviour
• Difficulty in making decisions
• Can’t be bothered with everyday tasks
• Avoiding social interaction
• Using more tobacco, alcohol or other drugs
  than usual
Causes of Depression
You may be experiencing some of these
symptoms and wondering why they are occurring
and whether it was something you’ve done or
something you didn’t do. In fact there is no one
cause of depression and it is thought to be a
combination of a number of things.

Genetics/Biology
When people are depressed, there are differences
in the level of some brain chemicals and also in
the level of brain activity, compared to when they
are not depressed. Some research has suggested
that this is the result of our genes. However, it is
unclear whether depression causes the changes
or whether the changes cause depression.

Social Aspects
Many people feel that their past experiences
contribute to their current depression. This can be
due to the negative effects of abuse, neglect,
bullying at school or not fitting in with others.
Major life changes may also trigger depression,
for example, bereavement or coming to terms
with a chronic or terminal illness. Many other
events include: financial or relationship problems,
moving house, getting married, having children
or divorce. Any of these things may impact on
how you feel now and may allow depression in.
Depression




What Can I do to Manage
Depression?
There are a number of things you can do to
combat depression, but first there are a few facts
about depression that will help you along the way.
• Depression is nothing to be ashamed of nor a
  sign of weakness. Rather, you can look on it as
  something that is attacking you (and those
  you care about).
• Depression is a liar. It tells you things such as
  “You’re useless, weak, lazy, and a failure.” This
  information will help you overcome the lies.
• Depression takes away your motivation,
  concentration, energy and self-esteem.
• Overcoming depression is likely to take time.
  Be patient with yourself.

Manage Your Activities
• It is helpful to “externalise” it for a start.
  Again, look on it as something that is
  attacking you and your family. This way it is
  less easy to blame yourself (another lie
  depression hits you with), and easier to be
  energised into overcoming it.
• Give yourself a series of small, achievable,
  daily goals. They must be of your own
  choosing. They may simply be along the lines
  of “today I will get dressed/have a
  shower/take the children to school”. Gradually
  build them up at your own pace.
• Try to establish a good routine. Set the alarm
  for the same time each day whether you’re
  going to work/studies or not. Have breakfast –
   try not to miss this because breaking your fast
   really does affect mood and energy levels.
• Avoid sleeping during the day. This is so
  important if you want to get into a good sleep
  pattern.
• Avoid alcohol where possible. Alcohol
  depresses the central nervous system and is
  likely to make you feel worse. Non-prescribed
  drugs will have the same effect.
• If you find yourself being attacked by negative
  thoughts, remind yourself that it’s the
  depression having a go again and find ways of
  distracting yourself. Depression hates you
  being active.
• Tot up your achievements. Review your day
  and pat yourself on the back for things you’ve
  been pleased about. These can be anything
  like preparing a meal, laughing at a comedy
  programme or chatting to another person on
  the phone. Remember that these are the
  occasions when you have managed to resist
  depression’s lies.
• Dare to dream. Think about some realistic
  goals (not winning the lottery or learning a
  language by the end of the month). Perhaps
  there are skills you’d like to learn, places you’d
  love to visit. Think about what you can do
  today to help yourself towards that goal.
• Increase your pleasure. Give yourself things to
  look forward to as often as possible. Social
  events, a good book, favourite programme,
  CD, etc. Depression usually tells you that you
  don’t deserve treats. Tell it to get lost as you
  reach for the remote control, phone, or book!
Depression




• De-clutter! There is little more satisfying than
  having a good clear out and a visit to the
  dump! Get rid of all the stuff that’s cluttering
  up your life and home. Then have a cup of tea
  as you survey bits of the house you haven’t
  seen for years!
• Plant something. If you have a garden watch
  the fruits of your labour grow outside your
  window. It could be in memory of someone
  you’ve lost, or simply because you want to see
  something beautiful grow. If you live in a flat,
  grow some herbs on a window sill, or see if
  you can produce something from a fruit stone.
  Either way, try and research what is easily
  grown. It won’t help if you take on a plant
  that needs special conditions. Remember –
  you’re looking for a success!
• Get some exercise. It is well known that
  exercise is beneficial to our mood. Some
  processes take place that make us feel better.
  Don’t overdo it. Be advised by your GP first if
  you have any concerns.
• Act “as if” – or “fake it to make it!” Acting as
  if you are feeling okay can make a significant
  difference. Don’t forget depression will lie and
  say “what a phoney” but practice walking
  with your head up, shoulders back, and look
  the world in the eye. You certainly won't look
  depressed, and it can rub off on how you feel.
  You’ll probably find you do this already around
  children.
• Start challenging some of the old myths you
  carry around about yourself. “I have to be the
  perfect mum/dad/wife/husband/employee,
  etc”. “I must get my way”, “My children need
  me to do everything for them”. Lighten up on
   yourself. If you persistently have these
   thoughts, talk about them to someone. Don’t
   bottle them up.
• Recruit your partner, best friend, or parents in
  your battle with the depression that attacks
  you. Mobilise your resources together and
  work out strategies for what they can do to
  help if they sense you retreating again. Ban
  the phrase “pull yourself together”.
  Note: It is not usually helpful to involve
  children in this.
• Be creative. Try some drawing, painting or
  craftwork if you can. Some people like to try
  poetry. If none of these things appeal, don’t
  worry. You can express your creativity in many
  ways.

Manage Your Thoughts
Everyone has days when nothing seems to go
right, but if we examine such a typical bad day,
we will find that some things do go right and
some things do go wrong.
If you are depressed you may focus on the
negative aspects of everyday life without thinking
about positive aspects. This is a common
symptom of depression and it may be difficult to
realise this without careful management of your
thoughts.

Below are some examples of common negative
thoughts that the depression will tell you and
underneath are different or alternative ways to
think.
 “It’s all my fault.”
“Am I being too quick to blame myself and not
consider if the blame could partly be due
to other factors?”
Depression




“I must be a terrible mother for sometimes
getting frustrated at my baby.”
“All parents get frustrated at their children - it
does not make me a bad person.”

“Nobody talked to me at work today they
must all hate me.”
 “The receptionist said good morning to me, but I
shut myself away in my office – perhaps my
colleagues thought I was too busy to be
interrupted.”

“I can’t tell anyone, no-one will understand.”
“Everyone finds it difficult to talk about
depression, but there are people who will
understand me.”

“My life is hopeless.”
“My life is not hopeless, there are some things I
can change and some things I can’t. I will focus
on the things I can change.”

“If I hadn’t been made redundant, I wouldn’t
feel so useless.”
“It’s not the end of the world, I must remind
myself of what I still have. This could be an
opportunity for me to try something else.”

“I failed my test, I can’t do anything right.”
“I can do some things right, and I don’t always
fail. Maybe I’ll give this another try another time.”

“I can’t cope with my baby, it’s all my fault.”
“I’m not coping very well, I wonder if other new
mums feel this way. There must be something I
can do.”
“I’ve tried before but nothing ever changes.”
“I tried before, but gave up when it was hard, this
time I’ll keep trying. Some things take longer to
change than other things.”

See if you can think of similar thought patterns
due to the depression during your day, and write
down the alternative thoughts.

Where can I get more help for
dealing with depression?
There are several options open to you and
ultimately you must choose what you feel would
be best in your circumstances.

Medication: You will need to discuss this with
your GP.

Counselling: Your GP could refer you to the
Primary Care Psychological Therapies service who
could offer you sessions to help you deal with the
depression.

Self-help: This can take the form of a book.
Overcoming Depression by Peter Gilbert
published by Constable and Robinson ISBN:
1841191256

Websites
www.nhsdirect.nhs.uk
www.mind.org.uk Keyword search: Depression
www.livinglifetothefull.com

If you want to ask questions about anything to do
with your care or the Trust, please ask a member
of staff.
Depression




You can find out more about the Trust and its
services online at: www.kmpt.nhs.uk

If you require this leaflet in another format or
language please speak to one of our staff or call
Communications on 01732 520441.

Patient Advice and Liaison Service
(PALS)
You may have some concern about your care and
treatment, but feel unable to speak to our staff
providing your care. You may just want some
information about local health services. You can
contact the confidential Patient Advice and Liaison
Service (PALS). The PALS Team is available to help
you with any health difficulties you may have. The
PALS Team can be contacted by calling free:
0800 587 6757 (Maidstone)
0800 783 9972 (Canterbury)
0800 783 9972 (Thanet
0800 783 9972 (Ashford)
You can also e-mail: pals@kmpt.nhs.uk


Complaints and Compliments
If you are pleased with our service, or unhappy,
please talk to our staff – we welcome your
feedback. If you wish to see your compliments
officially recorded or you wish to make a formal
complaint, you can write to our Chief Executive. All
complaints will be carefully listened to and
thoroughly investigated. Write to: Chief Executive,
Trust HQ, 35 Kings Hill Avenue, Kings Hill, West
Malling, Kent, ME19 4AX. A further leaflet, Your
Right to Complain, is also available to help explain
this process.
Comments on this leaflet
If you wish to comment on this leaflet call
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or e-mail communications@kmpt.nhs.uk
Obsessions


Notes




  With thanks to the Primary Care Psychological
  Therapies Service in Medway for their help in
            producing these leaflets.


      Leaflet Reference Number: KMPT.PI.leaf065
                                            66

              Published Date: March ‘09