What is Depression?
Depression is a complex condition, which is affected by many different factors. It varies greatly from person to person. It is based in our brain chemistry, most notably in the availability of the neurotransmitter serotonin. Depressed brains have been shown to have lower levels of available serotonin.
Depressed brains have also been shown to have lower levels of emotional activity all over. Depression is not about feeling sad; it is about feeling nothing. Just emptiness. And emptiness feels rubbish.
So why does depression exist? One theory is that it was actually beneficial for survival in the days of the early humans. The reduced serotonin can be a result of too much stress, over long periods. In those early days, when we first evolved, the types of stress we might have encountered would be things like scarcity of food, or abundance of predators. In such situations it was a good survival strategy to shut down a bit, hang about at home, not feeling like doing much, thus conserving energy and keeping safely hidden.
As with any condition, some people are more prone to depression than others. There are various factors which influence whether an individual is prone: genetics, early experiences, circumstances, but none of it is about weakness. Depressed people are not weak. Every day they are fighting a battle. I am continually inspired by what people can achieve in spite of this daily battle. Depression does not have to define you, it does not have to limit you. You can achieve what you want to achieve.
How can I help myself?
There are many ways you can help yourself to be well:
1. Firstly, try to make sure you have a good nutritious diet. Depression may cause you to have a reduced appetite or it may make you feel like eating more than you need to. But do your best to get your five-fruit-and-veg-a-day, eat things like oily fish, seeds and nuts, eat complex carbs for slow release of energy rather than the sharp spike then slump that you get if you eat sugary snacks! Protein is also important to get enough of, and especially those proteins which contain high levels of the amino acid tryptophan. That is because tryptophan is a precursor of serotonin! Foods rich in tryptophan include game-meats, egg, soya protein, seaweed and spinach.game-meats, egg, soya protein, seaweed and spinach.
2. Exercise is very helpful for depression. It brings about the release of those feel-good hormones endorphins, and raises your metabolism which makes you feel more energised. Depression can make it hard to get out of bed let alone run some Ks but find a goal that is achievable and right for you.
3. Investigate what factors may be causing you psychological stress. These may be experiences from your past, which are staying to haunt you, and it may help to talk to someone, such as a counsellor. Present-day stressors may also be affecting you, so have a think about your life and whether there is anything you would like to change. Not having enough to stimulate you can be just as much a stressor as having too much, so it isn’t all about quitting your job! But think about what is right for you and what changes are achievable.
4. Reach out. Depression can make you feel very isolated. Projects like The Beacon are great because they bring people together to try to combat this.
5. Medication. It is not compulsory to be on antidepressants if you have depression, but there is no shame in it either. They can help take the edge off so that you feel more able to help yourself in the other ways listed above. Antidepressants need to be prescribed by a GP.
How Do Antidepressants Work?
There are many different antidepressants, but they tend to belong to two main types: SSRIs (selective serotonin reuptake inhibitors) and TCAs (tri-cyclic antidepressants). SSRIs work by doing just what it sounds like they do; they inhibit the reuptake of serotonin, so it stays available in the brain. Common SSRIs are Citalopram, Escitalopram, Sertraline and Fluoxitine. TCAs work by inhibiting the reuptake of both serotonin and another neurotransmitter: noradrenalin (this is called norepinephrine in the USA). Elavil is the most commonly-used TCA.
Lithium-based drugs may be prescribed for major depression. These interact with the neurotransmitters in various ways, including boosting the synthesis of serotonin.
If you have been prescribed antidepressants, they take a couple of weeks to kick in, and maybe five weeks to feel the full benefit. Those early weeks tend to be the worst for side effects too, like nausea, dizziness and a general weird feeling. This period can be tough but hang in there and hopefully you will be feeling better very soon. Sometimes it can be a bit of trial and error, finding a medicine and a dosage to suit each person. If after five weeks you are not seeing a difference or the side effects are too awful, your GP may alter the drug or the dosage.