Low mood > depression > and how to tackle it
One in five people reading this feature will be suffering from some form of depression. Here's how to spot the signs and help yourself and those you love.
To say the pandemic has not been great for our collective mental health is an understatement. As we while away the hours in our lonely bubbles, eating and drinking more, sleeping and exercising less (yep, four ticks here), cut off from friends and family, it’s scant wonder many of us are losing our footing and falling into a mental health mire.
The number of adults with depression in Britain has doubled during the pandemic to almost 20%, with female, younger and disabled adults most affected, according to the Office of National Statistics. Women are bearing the brunt of homeschooling and chores whether they’re working or not. In fact, almost one in five people reading this right now will be experiencing some level of depression.
Children’s mental health is also vulnerable, predominantly due to reduced peer interaction. The proportion of children experiencing a probable mental disorder has increased from one in nine in 2017 to one in six in 2020. And finding solace at the bottom of a prescription bottle has also risen. In the three months to September last year according to the NHS, more than six million people in England received antidepressants – the highest ever on record.
HOW TO SPOT DEPRESSION IN OURSELVES AND OTHERS
Having a low mood is undeniably a 2021 baseline setting for us all. But what if that slump shifts into something more serious, something that starts to affect everything you do, and your ability to function?
Dr Alka Patel is a lifestyle physician, GP, author and podcaster of The Lifestyle First Method® says signs of depression are not just related to your mood but can also show up as physical effects. Here she gives her insights on what to look out for, in yourself and others.
Increased agitation and restlessness or the opposite can both indicate depression. Exhaustion and tiredness are both not to be ignored. Your doctor may do tests to rule out other conditions such as an underactive thyroid.1
Listlessness at things that usually give you pleasure is called anhedonia and is a symptom of depression. It’s helpful to spot, because it also means you can feel relief knowing that your joy will return when you get to the other side of depression (and you will).2
Loss of appetite or increased eating can both signal depression. If your weight starts to change in parallel with your mood, this is a sign to seek help. If your child has become fussier about food, or is over-eating, try a gentle conversation to find out if there is anything else on their mind.3
A change in sleep patterns can be an indicator of depression in children and adults. One of the commonest reasons for waking too early, having difficulty falling asleep or waking through the night is worry. This psychological activity wakes up your amygdala, your emotion centre, and floods your body with wakeful arousal hormones – cortisol, adrenaline and noradrenaline. This increases your heart rate and body temperature and makes it harder to sleep.4
Self-harming is often a hidden feature of depression – and includes use of drugs, alcohol and tobacco. If you are self-harming, learn the triggers that give you the urge to hurt yourself and learn ways to distract yourself. If you have had thoughts that you want to die keep a suicide safety plan accessible. Help is available 24/7 (see below).5
HOW TO TACKLE DEPRESSION
The first thing to make sure you do if you are feeling down or depressed is to see your doctor. If you experience symptoms for most of the day for more than two weeks, seek help from a GP. Take that first step and every other step after that you will have someone to support you.1
What you eat can have a significant impact on your mood. The SMILE trial showed depression can be reduced or reversed by increasing the amount of fibre you eat. Fruit, vegetables, whole grains – these all increase diversity in your gut bacteria and increase serotonin, our mood-lifting neurotransmitter.2
Relaxation techniques can help switch off the body’s stress response and activate the relaxation response to increase feelings of calm and control. Deep breathing exercises have been shown to reduce negative thinking, so often linked to depression.3
Exercise is very beneficial if you have depression. It helps with concentration and memory which are often impaired in depression, and reduces muscle tension. It can be very hard to find the motivation to exercise when you are feeling low. The thought of a half hour run can be daunting. So instead, think about the smallest thing you can do. Can you take 60 seconds to stretch your neck and back? Can you take three minutes to do squats in the kitchen waiting for the kettle to boil? Can you go up and down the stairs five times? With time you’ll notice your exercise levels naturally increase as you see benefits to your mood through the endorphins which are released.4
Losing interest in things you used to enjoy generally is a common sign of depression. What’s important is to restart them anyway. You’ll develop a sense of achievement and over time the enjoyment will return. Aim for small, increases in meaningful enjoyable activities rather than a boom-and-bust approach. Try out new things – painting, drawing, writing a song.5
Changing the focus of your thoughts can help create a positive, calm mind, allowing your activation centres to switch off. To do this, start a gratitude journal. Last thing at night write down 3 things you noticed that day that made you happy, that you felt grateful for – even a small thing like the warmth of a coffee cup in your hands or the freshness of the air on a walk.6
If you are worried about someone you think is self-harming, ask them about it. Talking about self-harm doesn’t mean you’re going to cause it to happen and it may be a relief for your friend or child to have someone to talk to.
Spending time with a pet, letting yourself cry, listening to music or looking at a positivity book filled with things that have made you happy can all help reduce self-harm.
Notice, Name and Neutralise – this is a useful technique to help recognise your thoughts are not who you are. Notice what thoughts are popping up, then name the thought and distance yourself from it. ‘I’m worthless’ becomes ‘I am thinking that I am worthless’ which becomes ‘I am noticing that I am thinking that I am worthless.’ You can then neutralise the unhelpful thought by pulling yourself away from it. Be open to all your thoughts and emotions. The trick is to not let them dominate. Use mindfulness techniques such as focusing on your 5 senses – what are 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. This re-focuses on what’s important to you instead.8
If you are experiencing symptoms of depression seek help from your GP, or, ring the Samaritans on 116 123 or Childline on 0800 1111 for children and young people under 19. If you don’t want to talk to someone, send a text to the Shout Crisis Text Line on 85258. Contact CALM (with webchat support from 5pm to midnight) or get in touch with MIND who offer lots of numbers for support with depression.