By Julian Jooste

An aspect of human life is that we will all experience ups and downs – with feelings of sadness touching all of us at some time. If these feelings take over and have started to impact on your functioning, you may have depression. Depression impacts our lives in several ways, and makes it difficult to merely get through the day. This article will look at clarifying some of the signs and symptoms of depression, what factors impact on/cause depression, as well as some of the possible treatment options available.

1. What is depression?

Depression is different from person to person. There are, however certain key symptoms to look out for.

  • Depressed mood most of the day, nearly every day. You may experience feeling sad or empty.
  • Feelings of helplessness and hopelessness. Having a pessimistic outlook on life.
  • Loss of interest. You will find that you have no interest in things you might normally enjoy (hobbies, social activities, or sex).
  • Suicidal thoughts. This may be either an active plan, or merely thoughts about suicide.
  • Sleep changes. Either insomnia, especially waking up during the night or early hours, or over sleeping .
  • Anger or irritability. You feel restless and agitated. You have a low frustration tolerance where your temper is short, and everything and everyone gets on your nerves.
  • Loss of energy. You feel fatigued through the day, and everything seems to take a great amount of effort. Some people will struggle to even get out of bed.
  • Appetite or weight changes. Significant weight loss or weight gain.
  • Self-loathing. A critical inner voice is present where you blame yourself for everything.
  • Reckless behavior. You engage in escapist behaviour (substance abuse, excessive gambling, reckless driving).
  • Concentration problems. You have difficulty focusing on things, or even with making decisions.
  • Unexplained aches and pains. An increase in physical complaints (headaches, back pain, aching muscles, and stomach pains)

Significantly, these symptoms would have had a detrimental impact on one or more important areas of your life (such as social or work life).

Depression and suicide

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. Thoughts of death or suicide are a serious symptom of depression, so take any talk of suicide seriously.

Warning signs of suicide include:

  • Talking about killing or harming yourself
  • Expressing strong feelings of being trapped and having no way out
  • Being overly pre-occupied with death or dying
  • Acting recklessly, as if drive by a death wish(e.g. speeding through red lights)
  • Calling or visiting people to say goodbye
  • Getting affairs in order (giving away prized possessions, tying up loose ends)
  • Saying things like “Everyone would be better off without me”.
  • A sudden switch from being extremely depressed to acting calm and happy

If you think a someone close to you  is considering suicide, express your concern and seek professional help immediately. Talking openly about suicidal thoughts and feelings can save a life!

2. Causes and risk factor of depression

The causes of depression are complex. Depression is not just the result of a chemical imbalance in the brain – the solution therefore cannot be medication alone. Depression is caused by and influenced by a combination of biological, environmental, and social factors. Therefore, our past as well as current situations put us at greater risk for depression. We talk about predisposing and precipitating factors. Predisposing factors would be aspects of my life that cause/underlie a depression whereas precipitating factors would be situations in life that ‘trigger’ someone’s depressive episodes.

Predisposing and precipitating factors:

  • Family history of depression (Genetic)
  • Early childhood trauma (loss of a parent)
  • Early childhood abuse (sexual or emotional)
  • Loneliness
  • Lack of social support (feeling like I have nobody to understand and help me)
  • Recent stressful life experiences (failing an exam)
  • Marital or relationship problems (fearing being alone)
  • Financial strain
  • Alcohol or drug abuse
  • Unemployment
  • Health problems or chronic pain

It is important to better understand the factors playing into your depression, as then you can better evaluate what options are available to you, and which solutions are likely to make your life more meaningful and satisfying

3. Dealing with depression

There are many options available and steps to be taken. The important thing is to realise that the change will only happen once you have made the first step, rather than thinking that you will make the change only once you feel better.

Reaching out to support structures helps to feel like the load is being shared, and helps you to gain different perspectives.

Seeking professional counselling. Speaking to a psychologist to help gain a perspective that helps you to unpack unhealthy thinking patterns, or to gain insight into yourself can be crucial. Having a safe space in which to explore your emotions and where you can work out a more balanced approach to life can be empowering.

Medication. Consulting a psychiatrist can be an option if other routes have yielded little results. Although medication on its own is not necessarily the full answer, it can lessen the impact of the depression to an extent that you are more capable to face the challenges that lay ahead. There is no single medication that solves everybody’s problems, although there are many antidepressants that act on different receptors in the brain. The challenge is finding one that works for you. Much research show that the best treatment combines psychotherapy with medication.

Adopting lifestyle changes Getting into a healthier routine, setting small goals for yourself to achieve on a daily basis, engaging in exercise, eating healthily (a deficiency in omega-3 fatty acids, which are found in fish, including salmon, albacore tuna, and herring has been linked with mood swings and depression), addressing your sleep cycle.

Acupuncture. There is a handful of research that suggests it might help.

Meditation. Promising research suggests mindfulness-based meditation helps with depression.

Support groups. These groups provide education on depression, a community of support, and the opportunity to learn from people dealing with similar issues.

Natural Remedies: St John’s Wort. There seems to be mixed research findings, although if you do choose to use it, be sure do your own investigations and consult with your doctor.

Contact a helpline: Helplines such as the South African Depression and Anxiety group (SADAG) provide telephonic counselling and referral sources for psychologists and resources in your area. They are a national helpline and you can contact them on either SADAG Mental Health Line: 011 262 6396 or their Suicide Crisis Line: 0800 567 567 or SMS 31393.