Coming to terms with Depression

Depression is an illness that if left untreated, can lead to serious physical, psychological and emotional damage and potentially death.

Most people assume that depression is caused simply by recent personal difficulties. While depression can be triggered by stressful events such as separation, divorce, death of a loved one, changing schools or jobs, moving house, trauma or abuse, other long-term risk factors also play a part.

Depression is more than just a low mood – it’s a serious illness. While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time and often without reason. People with depression find it hard to function every day and may be reluctant to participate in activities they once enjoyed.

Depression is one of the most common of all mental health problems. One in five people experience depression at some stage of their lives.

Taking drugs and drinking heavily has been found to be common in people with depression. Almost 50 per cent of women and 25 per cent of men with a substance-use disorder also have a mood disorder.

It’s hard to know which comes first – the substance use or depression. On the one hand, taking drugs and drinking alcohol can bring on symptoms of depression, however studies have found that having depression can also make it more likely for someone to use substances. In the short term, some of the symptoms of depression are temporarily relieved by using drugs which can make continued drug use tempting. However, long-term use can make symptoms worse and treating the illness harder, as it can reduce the effectiveness of treatments.

From puberty onwards, women are twice as likely to experience depression as men. Depression is more common in younger rather than older women. Women who are likely to develop depression will usually experience their first episode during their reproductive years between the ages of 15 and 45 years.

Men are less likely than women to seek help for depression. As a result, depression in men often goes unrecognised and untreated. This is reflected in the statistics for suicide rates. Four times more young men than young women commit suicide and in the past 30 years, the suicide rate for males aged 15 to 24 years has tripled.

Men are also more likely to have other risk factors for depression including cardiovascular disease and diabetes. They are also more likely to turn to alcohol or other drugs when they are depressed. This can mask the symptoms of depression for a while, but in the long term it can make the illness worse.

Sexual Orientation

People who are bisexual or homosexual are at greater risk of having depression than people who are heterosexual. This is reflected in suicide statistics which have found that bisexual and homosexual people are six times more likely to attempt suicide than people who are heterosexual. This may relate to people who are homosexual and bisexual being more likely to struggle with their sexual identity and/or being discriminated against or bullied because of their sexuality.

Indigenous people

Depression is a major health problem in Indigenous communities. While exact figures on the prevalence of depression among Indigenous people are not available, the use of mental health services and rates of suicide suggest that depression is high.

Between 1999-2003, deaths resulting from mental and behavioural disorders were found to be around four times higher for Indigenous people than for the general Australian population.

Also, Indigenous people are hospitalised for mental health problems twice as often as non-Indigenous people.

Living in a rural or remote area

People living in rural and remote areas face special challenges managing depression. Research shows that people living in these areas are less likely to get help from mental health specialists (psychiatrists and psychologists) than people living in cities. This may be because there are fewer trained specialist staff available in country areas, services are further away and people may feel they should handle their problems themselves. Recent figures show that suicide is also more common in rural and remote areas than in the city, especially among men.

While much has been learnt about depression in recent years, a great deal of stigma still exists, which can deter people from seeking treatment. However, one thing is clear, seeking treatment is one of the most important steps in recovery and substantially increases the prospects of long term recovery.

More information about the symptoms and treatment for depression can be found here

*Information in this post has been sourced from the Beyond Blue Initiative.

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43 Responses

  1. Very important issue that needs much more understanding and compassion. I know I’ve posted my letter that was published in SMH previously, but it’s the best way I know how to describe my concerns:

    The danger of denying that men suffer depression
    http://www.smh.com.au/news/letters/the-danger-of-denying-that-men-suffer-depression/2006/01/09/1136771496816.html
    January 10, 2006

    We must address the issue of depression and suicide that afflicts too many men. This doesn’t discount the problem among females but look at the ratios – males are more successful than females in finding ways to end their lives; this is tragic.

    You would hardly know it if you met me, but I hide my depression well. That is what I have been taught to do. Numerous visits to various specialists confirm my condition, which has become progressively worse with time.

    Recently it was revealed that Steve Rogers suffered from it; John Brogden suffered a bout of it, and so did Rene Rivkin. Many of us at various stages in our lives may be overcome by it.

    My cycle started as a reaction to adverse work circumstances; Mr Rogers’s may have begun with the death of his first wife; Mr Brogden’s possibly as a result of revelations in the media about his inappropriate behaviour; and Mr Rivkin’s seems to have been a combination of an existing illness and circumstances surrounding his criminal charges.

    Whether circumstances surrounding this troubling problem are situational or an inherent part of a person’s make-up, the stigma and shame remain the same.

    After two years of seeking support for the crippling problem I faced, the insurer in my worker’s compensation case has finally accepted that my despair runs deep.

    Unfortunately, the denial by others and myself that there was indeed a problem has only exacerbated my troubles.

    Have I contemplated suicide? Unfortunately, yes. However, I have been fortunate enough to have support that at times, in spite of my pride, I’ve begrudgingly accepted and which has helped me overcome some really dark episodes.

    Do we really accept and understand that males, in particular, can and do suffer as deeply on an emotional level as females, and are males really any better-equipped to deal with their pain than females? I would suggest not. The great shame in many cases is that if you’re not bleeding, you’re fine. And if you do express your pain, it is seen as a sign of weakness. This seems to be a uniquely male thing – take the pain, brush yourself off and get on with it.

    There really is no such thing as “superman”. We need to make it more socially acceptable for males to reach out for help, without making them feel defective.”

  2. I have a number of family and friends suffering from this illness and my heart goes out to all affected by this illness in some form or another and their families.

    I cannot attempt to understand how they feel as my body does not seem to let me get to the depression level no matter how bad my situation becomes.

    I do know that counsellors and those treating the illness need to provide more information to those looking after the sufferer as they seem to keep everything away from the carers even if there is written permission or request that the carer know what is happening.

    While I understand and respect privacy a carer needs to know what the sufferer is thinking and how they are thinking, to be able to look for signs or indications that may trigger a deeper level of depression (and attempt to circumvent it) which leads to suicide attempts. This is speaking from my own experience as a carer of a depression sufferer.

    There needs to be much more support for those suffering depression.

  3. Shane

    Bloody good point that carers need more information. As many know here I refer to my depression as the black dog and my friends even tell the dog to behave when they see I have the dog with me. By that simple action (telling the dog to behave) they are showing compassion and respect to what I am feeling.

    So – in my case – letting people know what is wrong with me can help with how I deal with it, because I am not ashamed to say that I need help. Others I know are not so lucky and will internalise the condition.

    Saying that – I have been free of blackie for nearly two years now.

  4. joni

    Yes many bottle it inside and the only way a carer can know what is happening is to be briefed by the counsellor as to the way the sufferer is thinking yet they refuse to divulge this information making it impossble to know. I now know many of the subtle signs and take remedial action to turn the situation around.

    It is wonderful that you are willing to let people know and also seek help. Congratulations on being free of blackie for nearly two years, what an achievement.

    The one I care for has not attempted suicide for over 12 months now, nor have I been called to the hospital in over 12 months out of the blue to collect them after they were found inflicting bodily harm on themsleves on roads or other public areas while being oblivious to their surroundings.

  5. Shane

    Just thinking about this, and I actually do still hold some stigma over this. I have not told my parents – even though all my siblings know of it. I guess I do not want my parents to feel like they “gave” it too me – does that make sense?

  6. joni

    It makes perfect sense as some of my family that are suffering have not told their parents either. Who the person chooses to tell should be up to them, but remember if you were the parent would you like to know ?.

    Only you can imagine how your parents would react and if you believe witholding it from them would be better than telling them. The big question is if it was any other illness would you tell them and if so why are you treating this illness differently.

    To be honest if I was the parent I would want to know to be able to support and also read the signs, not to be in their hip pocket but to rather understand why they act and react at times the way they do. Having said that I would never tell the parents of a sufferer. I believe this is not my right to do so.

  7. Tim ran a few interesting posts on the subject

    Beyond Blue
    http://blogs.news.com.au/news/blogocracy/index.php/news/comments/beyond_blue/

    Tim Dunlop
    Wednesday, May 02, 2007 at 12:17pm

    This is really just a plug for Jeff Kennett’s good work at the beyondblue organisation. Well, not a plug so much as a reminder of the work that they do. It’s prompted by a number of requests from readers to post something on the topic, as well as a response to the recent spate of stories about the topic of depression in Australia. I’ll go through some of those stories, but treat this as an open thread on the topic.

    I guess the first piece I noticed was the story about the suicide of some soldiers returned from Iraq:

    FAMILIES, war veterans and MPs are demanding an independent inquiry into the mental health of soldiers returning from Iraq and Afghanistan after suicides believed to be caused by post-traumatic stress.

    The Federal Government acknowledges two soldiers took their own lives after returning from the Middle East, but veteran activists say there could have been as many as five suicides – and they fear more will come.

    To date 121 soldiers returned from the Middle East have been discharged for mental illness. About two dozen have serious psychological problems, including post-traumatic stress disorder (PTSD). Families say the soldiers who commit suicide on their return are the hidden casualties of war.

    Then there was the report about depression in the work place:

    The research, by mental health group beyondblue and management consultancy firm Beaton Consulting, found that 15 per cent of legal professionals experienced moderate or severe depressive symptoms, a rate 2½ times that of the general population.

    And I was also struck by this report:

    About 20.7 million prescriptions for mental-health related medication were filled under the Pharmaceutical Benefits Scheme (PBS) in the year ending June 2006, compared to 18.5 million five years earlier.

    Overall, the number of prescriptions increased 2.2 per cent per year between 2000-01 and 2005-06, the Australian Institute of Health and Welfare data revealed.

    But the use of some drugs increased much faster – about 6.8 per cent for antipsychotics and a 4.6 per cent per year for antidepressants.

    We have also seen former NSW Liberal leader John Brogden go on the record about his fight with depression, and the AFL launch an initiative to deal with the problem amongst footballers. Depression also seems to be an issue in two recent incidents involving police officers, this one where an officer was involved in a seige, and the death of ACT police boss, Audrey Fagan.

    The value of Kennett’s work seems to be that he brings the issue out of the closet, normalising discussion of it so that it can be dealt with openly. But that’s just an amateur observation, feel free to correct me in comments. And as I say, treat this as an open-thread on the topic. It really is a problem that affects families all over the country.

  8. Forgive me for pasting my earlier comment from the frolykz thread here, but this is where it belongs…

    …my partner is (on & off) a long time endurer of the black dog; going on a decade now. I sympathise mate, it tests her out & consequently it tests me & our daughter; it is very real & hard to watch someone you love suffering from despair.
    Even though it’s under control it still surfaces on occasion & must be beaten back with understanding.
    For me in particular it has been a long road to reconcile it because I don’t ever feel close to rock bottom & generally look for the positives in the day to day grind rather than feeling flat & consumed by the negatives. I realise that it is not that simple however.
    To anyone with the black dog I’d like to express my solidarity with what is commonly an ongoing wrestle.

    I guess I’d also add that it’s important to recognise that it is clinically treatable & there is definitely hope. An important step towards treatment is certainly acknowledgement. Accept it, it is not something to be hidden, let somebody know.

  9. I thought i was dealing with this to a reasonable point also combined with meds, But this hit and run victim triggered something that has kept me so low since that night. I have taught myself so much about the human body incase, but a brain injury made me feel like i knew nothing.
    My wife and i are going to dinner in a few minutes so this was just a quick post.
    I’ll get a chance to read peoples posts when i get back.

  10. What I have also learned as a carer and through professional advice is to get the person up early and have them exercise, go for a walk for about 4 or 5 kms this releases positive endorphins into the blood stream and starts the day off positively. If this is done then the day is much better and able to be handled, however if it is not done then the day is clouded.

    Amazing what a simple thing can achieve. I now ensure this routine is adhered to as much as possible.

  11. hexx… just remember you are not alone.

  12. Shane@10

    You are right. A parallel I can certainly draw is the correlation between being “unoccupied” or “idol” & a tendency to have the black dog sneak back in.
    I find that if my wife has a purpose & a place to reach (so to speak) then the mongrel is kept at bay. The unfortunate thing seems to be that it is always circling the campfire, looking for an opening, & vigilance & tolerance is essential.

  13. joni@11

    Amen to that! I enjoy Hexx’s comments & even if all else fails he should keep his “fans” abreast of things.
    I think it’s easy to overlook the fact that lots of people care about us.
    I wonder how Wolf is doing?

  14. HDTB @ 8

    I agree, HD. Even having a partner go through this takes its toll on the entire family.

    My husband battled with depression a year or so ago – was given meds which he routinely failed to take because according to him they made him drowsy – as if the solution was to “sleep it off”

    Under the circumstances, any positives you point out to them can turn into negatives. It took a lot of understanding and letting go to see him through the phase.

    One thing I can vouch for is, if a person is successful in overcoming this malady, they emerge from it more enthused for life and living. Our daughter helped more than an medication – for him and me….

  15. “…was given meds which he routinely failed to take …”lekhni

    At risk of sounding like a doctor’s son I think it is important to emphasise that if you’re instructed to take meds a certain way, & to a certain schedule, then it isn’t open to personal interpretation if you want the meds to work as they were designed.
    My partner used to miss ’em here & there or take the wrong ones & almost without fail the difference in mood/outlook was tangible.
    To me it’s not a huge difference to a diabetic or a patient recovering from cardiac issues, it MUST become a strictly adhered to part of the daily routine if it is to be given an realistic chance of working. Once upon a time, many moons ago, I may have cynically believed that this was all in the mind; & consequently could be defeated in the mind. Lifes experiences have taught me different.

  16. One thing that irks me about how depression is treated is the quick fix of medication. Many prescribing such do so without ever asking about a persons diet, in particular consumption of processed or sugar saturated foods/drinks etc.

    Meds can cause as many problems as they solve. I would recommend anyone suffering from such to visit a reputable holistic healer and counsellor.

    NB: Cutting out sugar and processed foods can actually cause withdrawal symptoms similar to drug withdrawal – but once this is passed you will be amazed at the difference. If you do this make sure you have a supportive person nearby.

  17. just changed avatr, chkng…

  18. It worked Lehkni!

  19. HD, don’t get me wrong -i understand the importance of prescribed medication – i am a diabetic who has been on insuling during both pregnancies and medication otherwise.

    what i meant was that in the case of depression, either it is brushed away (by orthodix doxtors) as “one of those thing, it’ll pass… or by the new generation doctors with medication as a first resort rather than a last resort.

    i think bfore medication is prescribed (in the first consult in this case!) some couselling should b undertaken to at least find the caue or trigger.

  20. joni – yay!

  21. “i think bfore medication is prescribed (in the first consult in this case!) some couselling should b undertaken to at least find the caue or trigger”lekhni

    Totally agree, there is no such thing as a magic bullet.
    Tracie is also right about diet etc..
    Such complex issues can’t be solved solely by “pills”. I have however seen them work.

  22. agreed – it must be a whole of life solution:

    – exercise
    – talking to someone
    – medication (if required)
    – diet

    But definitely NOT by finding solace in a bottle.

  23. Thats why i hang out here, your a great bunch.
    Thanks Joni, Toiletboss likewise i enjoy your posts also

    I guess im not feeling like i did last night. when it hits its like someone has control of the emotions. Its hard to justify hanging around, the feeling of being unworthy, then i go diving and people say you have the best life .

    My best mate died two years ago around christmas, he was 30 years older then myself. The only person i could trust with all issues. He taught me to bloody grow up, what i mean is he taught me to see myself through others eyes.

    I recovered dead bodies/parts for most of my diving career, i enter caves and tunnels for courts to examine what took place if somthing tragic occures. I also map out underground mines and disused fresh water shafts. After a mishap im finding it hard to complete some of these tasks.

    This has to be my longest post but it was nice to unload some crap and say things i cant talk about to others.
    I’m not going to reread this before i post or i wont send it so i hope it makes a little sence. Thankyou (bows and runs off)

  24. ” it must be a whole of life solution”joni

    It is very hard to change another individual’s attitude to life, no matter how clearly the “answers” may be staring you in the face.
    The only complete solution is ultimately up to the individual, you just gotta be there for them…& make sure that they KNOW that you’re there for them.

  25. “…Many prescribing such do so without ever asking about a persons diet, in particular consumption of processed or sugar saturated foods/drinks etc…”TracieofFNQ

    Good doctors will ask.

  26. Good doctors can sometimes be hard to find though Toiletboss. One doctor we went to was obsessed with viagra, and offered samples to our male family members no matter what condition they were actually consulting him about.

  27. Tracie@26

    Definitely, they are in short supply in this country, particularly in regional areas such as where I live. I can only base my opinions on what I have lived & learned.
    I would say that the doctor I am best placed to “judge” (my mother) is a bit out of the ordinary in that she nursed for many years until she began medicine at 45yo (not to mention raising a family & working on the farm until my bro & I were at uni). I think her “life experience” is what makes her good at what she does. It isn’t about the money or prestige. Bedside manner can’t be overstated if you want a “good” doctor. The majority are “professionally sound” but you can’t make ’em care.

  28. All of you have some wonderful comments, and they mean a lot to me as I have a long history of depression.

    Toiletboss’s suggestion that episodes of depression should be beaten back with understanding is absolutely spot on. As a depression sufferer, “understanding” is the one drug that is not freely available. I’m sick of hearing people say “get over it”, “deal with it”, or “you’re gutless”.

    It is hard for me to write this, but fifteen years ago I was hospitalised for some length following a suicide attempt. What followed was 7 years of rehabilitation.

    I’m sorry, but I don’t want to say anything else about this episode. But I do want to say thankyou for the above comments.

  29. What an amazing bunch the blogocrats are.

  30. Solidarity in this people. It is much more widespread than most would imagine.

    Life is never futile.

    The thing that really strikes me is that you can’t tell this about someone by looking at them or even seeing them day to day as there is usually a strong front. It goes on behind the eyes, some of the people I have respected the most have an achilles heel when it comes to their perceived self worth.

  31. I hope my comment at 29 did not come out wrong.

    I meant that for a bunch of people that gravitated together we really support each other.

  32. I believe comment 29 came out just right Joni

  33. Wonderful comments from everyone and some real good suggestions. What it proves is that many people really do care about others and are mostly supportive as this illness gets greater coverage through tragically cut short lives of celebrities, sometimes it takes this to get the community to wake up.

    It is imperative that we not tell people to “Wake up to yourself” or “Get over it” It is an illness. Do we tell those things to people suffering others illnesses No. This simply leads to further withdrawal as there is no instant way to snap out of an illness.

    If I get negative somments I always point out the positives in life and why it is better to be here than not. This seems to work along with the exercise and keeping busy. The exercise needs to be a long walk not just a few minutes but at least an hour as it takes time for the gloom to subside and the good endorphins to take over however I see the change after around 20 mins and it gets better from there.

    To anyone suffering, while you may not think it, please remember people love you and want to be supportive in any way they can. It is amazing the stength true friends and family find in times like this.

  34. “Good doctors are hard to find”

    True. However there is a list of medical practioners on the the beyond blue web site with expertise in treating anxiety/depression. I’d suggest that is a good place to start.

    It’s where I found my current GP. I’m currently taking antidepressants daily and have been for almost ten years. I don’t feel any stigma about it, because it makes a remarkable difference to my quality of life.

    I thought I’d give them away after the first two years, and took the following two years off. It wan’t long before my quality of life started to suffer. So I went back on them.

    I’ve also being seeing a psychiatrist one and off during the past ten years also, which has helped to some extent.

    Lekhni, you mentioned your husband stopped taking them cos he felt sleepy. this is a common side effect which I also encountered – I used to have to go the library at lunchtime and would have a snooze on their lounge chairs.

    It’s called somnolence, and usually passes after the first 2-3 weeks.

    My experience is not so much depression, but anxiety, which often goes hand in hand with depression.

    The medication makes a huge difference. I’ve come to terms with the fact that it’s just a chemical thing going on with my brain and read up a lot about how the SSRI meds work.

    So to me, it’s no different from someone taking insulin.

    Some people have accused me of avoiding ‘reality’ because the meds do give you a kind of sense of ‘unreality’.

    But f**k it. It’s my life, and if the meds make me feel better, then I’ll just keep taking them…

  35. By the way,

    I have been refused life insurance cover because I’m taking anti-depressants for anxiety/depression, yet I’ve been told by the insurance company that if I were to stop taking them I would qualify for insurance cover.

    Their position is that by taking antidepressants, this confirms that you suffer from anxiety/depression, but if you’re not taking them this confirms that you no longer have the condition.

    Talk about viewing things from the completely wrong perspective…

  36. reb

    My Life Insurance is OK, but they refuse Income Protection. But then again – my medical history is pretty unusual and scares them off.

  37. Life insurance! Forget it. Try getting insurance when you suffer from depression, diabetes, and lupus.

    It’s their way of telling you that they don’t think you’re going to live much longer.

    How very comforting.

  38. reb

    I have had anxiety at times during stressful years in the Bank. I was wathcing TV and they said one of the worst things for anxiety is coffee. Therefore for 8 years I have given up coffee and now find if I do have a cup of coffee I suffer terrible headaches and a type of withdrawal overnight. My anxiety levels dropped dramatically after giving up coffee.

  39. Shane,

    That’s interesting about coffee. I don’t drink a lot of it – maybe 1 or 2 a day..

  40. reb

    I suggest anyone who suffers depression or anxiety not drink coffee at all.

  41. I have been told i havnt found god and when i do things will be so different and Joy will come on that day for me. Im possitive that was the first time i thought i hurting myself.
    Seriously good advise has been given above, Keep fit walk a lot. One cycle that happens a lot is i stress and then i cant eat. Then i stay stressed cause i havnt eaten.

  42. Aquanut, when someone asked me whether I had accepted the lord Jesus Christ as my lord and saviour, I swear that’s the first time I seriously thought about hurting someone else.

    But yes, eating healthy helps….

  43. lol Reb

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