What Is Depression?

Depression: Symptoms, What It Feels Like, Types, Causes, And Where To Get The Help You Need

What Is Depression?

It is normal to feel sad and hopeless at times. However, for people with depression, these feelings are more intense and last longer. So much so that these feelings impact their ability to carry out daily activities.

In this guide, we will explore different aspects of depression, specifically:

• how it differs from anxiety
• its symptoms
• how having depression feels like
• types of depression
• cause(s) of depression
• when to get help
• where to get help
• how to support someone with depression
• how a counsellor or psychologist can help

How Is Depression Different From Anxiety?

It is common to experience depression and anxiety at the same time. As they have some overlapping symptoms, it can be difficult to distinguish between them. These symptoms include fatigue, sleeping difficulties, irritability, appetite changes, concentration issues, muscle tension and headaches.

However, depression and anxiety are different conditions:

• anxiety is characterised by excessive worry and fear
• depression is characterised by low mood and loss of interest or enjoyment in activities.

“Anxiety and depression often occur simultaneously so it may be confusing trying to figure out which you have. It’s normal to feel worried or sad at times. However, if you’re experiencing prolonged symptoms which are affecting your daily life, please speak to a professional. They will be able to provide a diagnosis, treatment options and ongoing support. Remember, it’s possible to recover from both anxiety and depression, so it’s important to seek help as soon as you can,” Tania Rugiero, Psychologist at New Vision Psychology

What Are The Symptoms Of Depression?

Are you just feeling down or could you be depressed?

Depression affects the way people feel, think and behave. It has mental and physical symptoms which affect each person differently.

Symptoms include:

• Sadness, low mood, tearfulness
• Emptiness, hopelessness, disappointment
• Loss of interest in activities that were previously enjoyable
• Inability to perform at work or school
• Restlessness, irritability, anger
• Fatigue, low energy levels
• Guilt, worthlessness, self-blame
• Concentration problems
• Lowered confidence and self-esteem
• Reduced social contact
• Sleep disturbances
• Appetite changes
• Weight gain or loss
• Lowered sex drive
• Headaches, muscle aches
• Suicidal thinking

What Does Depression Feel Like?

“I feel worthless. I can’t bring myself to do basic tasks like getting out of bed, brushing my teeth or having a shower.”

“I feel empty. I don’t look forward to anything. I am stuck. I want to sleep and never wake up.”

“I can’t sleep. I can’t fall asleep or stay asleep. I can’t concentrate in school. I’m always having headaches. My body aches for no reason.”

“I don’t want to do anything. I don’t want to be anything. I wish I don’t have to exist. It would’ve been better if I was never born.”

Everyone experiences depression differently. Let’s take a look at David and Candice who are both suffering from depression.

David is a 46-year-old man who has started staying in a lot more than usual. He has stopped catching up with friends and attending his weekly soccer games. He’s also been drinking more alcohol and getting into more fights with his partner Lucy. Lucy is getting stressed out as everything she does seems to annoy him. She’s also afraid he’s no longer attracted to her as they haven’t had sex for months.

Candice is a 14-year-old girl who feels like everything wrong in her life is her fault. She feels like a burden to her parents and often thinks, “Everyone would be better off without me.” While she used to be a straight-A student, she’s started struggling with her schoolwork. She has frequent headaches and feels lethargic all the time. Her teachers have expressed concern and her parents are getting worried.

Depression affects people of all ages and genders. It also affects their loved ones. If you have been experiencing symptoms for two weeks or more, or are dealing with someone who is experiencing depression, it is important to seek professional help. It is possible to recover from depression with the right treatment.

Types Of Depression

Major Depressive Disorder

Also known as: clinical depression; major depression; unipolar depression; depression

Major depressive disorder is mainly characterised by low mood and loss of interest in previously enjoyable activities. It can be mild, moderate or severe. Symptoms typically occur on most days and persist for at least two weeks. It affects all areas of a person’s life including daily activities, work and relationships.

Subtypes of major depression include melancholic depression (which includes physical as well as emotional symptoms) and psychotic depression (which includes hallucinations, delusions and/or paranoia).

Bipolar Disorder

Also known as: manic depression

Bipolar disorder is characterised by extreme mood changes. People with bipolar disorder have manic and depressive episodes. Manic episodes involve extremely high levels of energy and a reduced need for sleep. In contrast, depressive episodes involve very low moods like in major depression. People with bipolar disorder may also experience episodes of psychosis.

Cyclothymic Disorder

Also known as: cyclothymia

Cyclothymia is characterised by emotional highs and lows, although less extreme than bipolar disorder. People with cyclothymia have mild to moderate hypomanic and depressive episodes. Between episodes, they may feel stable and fine.

Persistent Depressive Disorder

Also known as: chronic depression, dysthymia or dysthymic disorder

Persistent depressive disorder is depression that lasts for two years or longer, with milder but longer-lasting symptoms. People who suffer from this may forget what it’s like to feel good and assume it’s normal to constantly feel mildly depressed.

Double depression is a condition where someone experiences a major depressive episode on top of their dysthymia.

Seasonal Affective Disorder

Also known as: seasonal depression

Seasonal affective disorder (SAD) is a period of depression that often happens during winter. It is triggered by changes in light exposure. Depressive symptoms tend to start in winter when there’s less sunlight and disappear in spring and summer.

Perinatal Depression

Also known as: peripartum depression; antenatal depression; postpartum depression

Perinatal depression occurs during pregnancy or after childbirth. It is associated with hormone changes and the new challenges of parenthood. It affects up to 1 in 5 women and approximately 1 in 10 men.

What Are The Causes Of Depression?

Depression is often due to a combination of factors, rather than being caused by a specific issue or single event. It is not always possible to identify the cause of depression; sometimes it happens without an obvious cause or reason.

For your reference, we’ve detailed a few common causes of depression in the following section.

Life circumstances and events

Ongoing difficulties such as unemployment, financial problems, abusive relationships, long-term isolation, work stress or lack of support are more likely to cause depression than recent life stressors. However, specific events can trigger depression if a person is already at risk due to previous circumstances or personal factors.

Personal factors

• Family history – Depression can run in families and some people will be at an increased genetic risk.
• Personality – Certain personalities are more at risk of depression – for instance, those who are worriers, perfectionists, have low self-esteem and/or are self-critical.
• Childhood problems – People with childhood trauma are more likely to develop depression.
• Medical conditions – The stress and worry of coping with long-term illnesses like chronic pain can lead to depression.
• Drug and alcohol use – This both leads to and results from depression. Many people with depression also have substance use disorder simultaneously.

Brain structure and changes

A person’s brain circuits and nerve pathways can affect their mood, thinking, sleep, appetite, and behaviour. Factors such as genetic risk, severe life stressors, medications, substances and medical conditions can affect the way a person’s brain regulates their moods. This is a complex area that researchers still don’t have answers for.

When To Seek Help For Depression

• You have exceptionally low moods most of the time
• You are experiencing depressive symptoms
• Your daily life, relationships, work and/or school are being affected.

If you have been experiencing the above for two weeks or more, it is time to seek professional help. It is possible to recover from depression. You don’t have to feel like this all the time.

Where To Get Help

We understand it can be hard to ask for help. Here are a few resources to guide you in the right direction.

Start by talking to your General Practitioner (GP)

GPs often treat problems like depression and can help you find the best ways to move forward. Your doctor can listen to your concerns, explain treatment types, check for other health issues, prescribe antidepressants and suggest lifestyle changes.

Get a referral to a mental health professional

Mental health professionals include psychiatrists, psychologists, counsellors, social workers, occupational therapists and mental health nurses. You may want to ask your GP to refer you to a psychologist experienced in treating depression. They can also prepare a mental health treatment plan to help you get Medicare rebates for your psychology sessions.

Get therapy (give counselling a go)

You may choose to participate in individual, couples, group and/or family therapy, depending on your needs. Your psychologist will tailor your treatment plan to suit your symptoms and overall health. Therapeutic approaches proven to treat depression include Cognitive Behavioural Therapy, Interpersonal Therapy, Psychodynamic Therapy, Acceptance and Commitment Therapy and more.

Medications

Depending on your specific condition, your doctor or psychiatrist may prescribe medications to be used in conjunction with psychotherapy.

Family and friends

Try not to isolate yourself. Reach out to your loved ones if you’re able to. They can lend a listening ear and help you get help.

Support groups

Consider joining a support group for depression. By being in a safe space with others who can relate to your experiences, you will realise you’re not alone. These meetings will provide resources, practical advice and coping strategies.

Digital mental health tools

Consider online self-help tools which can be accessed anywhere, anytime.

Here are some tools to help you get started:

• myCompass – A free online self-help program developed by the Black Dog Institute which has been proven to relieve symptoms in people experiencing mild-to-moderate anxiety and depression.
• MoodGYM – A free online cognitive behaviour therapy program for preventing and coping with depression, provided by the Centre for Mental Health Research.
• THIS WAY UP – A not-for-profit initiative by St Vincent’s Hospital and UNSW Faculty of Medicine offering online learning programs, education and research in anxiety and depression.

Mental health websites

Gain a better understanding of what you’re experiencing. Empower yourself with knowledge and eliminate myths and misconceptions. By reading about depression, you can learn about treatment options and gain hope knowing that it’s treatable.

These websites offer insights, mental health programs and support services.

• Head to Health – Mental health resources from Australia’s leading health organisations, funded by the government
• Beyond Blue – National organisation offering useful depression resources with a 24-hour telephone information service
• WayAhead – Mental health information and education seminars by the Mental Health Association of NSW
• BluePages – Information on depression treatments by Australian National University and CSIRO

How To Support Someone With Depression

It’s not easy supporting a loved one with depression. Every person’s experience with depression is unique and there isn’t a one-size-fits-all approach. Here are a few ideas to help you get started.

Show your support – ask and listen

A person experiencing depression may be afraid or embarrassed to ask for help.

Show your support to them by:

• Offering your support and presence to let them know they are not alone.
• Showing them you care and want to help by listening with an open mind to help them feel supported.
• Comforting them by providing a shoulder to cry on.
• Being patient and making time to check in on them.

Here are three effective ways to ask “Are you ok?”:

• “You’re not alone in this. I care about you and I’m here for you. Is there anything you want to talk about?”
• “This is not your fault. What can I do to support you?”
• “I’ve noticed that you’re having a difficult time. Have you considered talking to your doctor about this?”

Do not say things like:

• “I understand exactly how you feel.”
• “Don’t be so negative. Focus on the positives.”
• “Don’t be sad. There’s no reason to be depressed.”
• “Be strong. This will pass.”

This is because talking about depression is rarely easy and these statements, though well-intentioned, are dismissive, invalidating and may add to the guilt and shame that they already feel.

Help them get help

Depression is treatable, so it is important to encourage them to get help and/or assist them in doing so. You may help them find a professional who they’ll be comfortable with, make an appointment for them and even take them to the appointment.

Sometimes, people with depression may not want to seek help. You could try to explain why it would be helpful for them to speak to a professional. Refer to information and research to show them that it is possible to recover with the right treatment. For example, this PDF by Beyond Blue is a good starting point.

Do not leave them alone if you’re worried for their safety. If they are showing signs of suicidal ideation or self-harm, call an ambulance on 000 or Lifeline on 13 11 14.

Avoid judgement and blame

If they are unable to perform regular tasks and activities like before, this isn’t because they’re lazy. Depression makes the simplest tasks feel overwhelming or impossible. Try not to get frustrated or blame them or yourself. It is perfectly alright to ask for additional help if you need it. If you do get discouraged, be sure to reassure them that you’re not frustrated with them but their illness.

Offer hope and love

Offer them hope – whether it is their faith in a higher power, their children, their pets, or whatever makes life worth living for them – and find ways to remind them of it. Let them know that you love them unconditionally. This could help with their feelings of guilt and worthlessness.

Take care of yourself

To help someone else, you need to be able to support yourself. This journey can be stressful and demanding. Here are some important self-care tips:

• Acknowledge your feelings – Your feelings are a valid response to a challenging situation. Whether you join a caregivers’ support group, confide in a close friend, or see a therapist, it is important to acknowledge and process your emotions rather than letting them build up.
• Remember that it’s not personal – If the person seems withdrawn or angry, it is often not a reflection of their feelings towards you. In fact, it is probably not related to you at all. Depression affects a person’s social skills and anger management skills. Do not take this personally.

How Can A Psychologist, Counsellor Or Psychotherapist Help You?

Numerous studies have shown that psychological therapies are effective in the treatment of depression:

• Cuijpers, P., Quero, S., Dowrick, C. et al. Psychological Treatment of Depression in Primary Care: Recent Developments. Curr Psychiatry Rep 21, 129 (2019).
• Pim Cuijpers (2020) Measuring success in the treatment of depression: what is most important to patients?, Expert Review of Neurotherapeutics, 20:2, 123-125.
• Oud, M., De Winter, L., Vermeulen-Smit, E., Bodden, D., Nauta, M., Stone, L., . . . Stikkelbroek, Y. (2019). Effectiveness of CBT for children and adolescents with depression: A systematic review and meta-regression analysis. European Psychiatry, 57, 33-45. doi:10.1016/j.eurpsy.2018.12.008

Whether you are experiencing depression or are concerned about a loved one, therapy can help. It is possible to recover from depression with the right psychological treatment.

New Vision Psychology has a team of professional psychologists (meet our psychologists) who are experienced in treating depression in a warm and empathetic manner. They will help you alleviate your symptoms, create a personalised treatment plan and guide you on your journey to recovery.
We understand that asking for help may seem a difficult task, especially if therapy is a completely new experience for you. This is why our psychologists have prepared this guide ‘How To Find The Right Therapist For You’ where you can get a sense of what the first session will look and feel like.