Transcript of
Depression and low mood (BSL version)
Depression is a very common illness.
People feel down, depressed and hopeless.
They take less pleasure and interest in doing normal things
that they find interesting and pleasurable than they would normally.
It goes on for more than two weeks.
We all have bad days when we feel a bit low.
If that goes on for a day or two, that's unfortunate, but it's life.
But if you have those feelings and they go on for more than two weeks,
that's probably depression.
We tend to divide depression up into mild, moderate and severe.
Mild depression is very common.
People can have mild depression
and will often recover with some self-help measures
that they can institute themselves over a couple of weeks.
It's very common in general practice to see someone who's depressed.
If you give them simple measures to look after themselves, they will recover.
When they come back in a couple of weeks, they're much better.
Someone who's moderately depressed may recover with those measures
or may need some help with either medication or talking treatment
whereas someone who is severely depressed
almost certainly will need both medication and talking treatment
to help them get better and stay better.
I think, first of all, self-help is very important
and applies to any sort of depression, mild, moderate or severe.
You can help yourself
and there are common things to do that are very sensible.
If you're smoking too much, don't smoke or try and reduce your smoking.
Don't use alcohol as a drug because it's a very bad drug
and doesn't necessarily help your mood at all.
You want to reduce your alcohol intake
down to or below the recommended maximums
of about 21 units a week for a man or about 14 units a week for a woman.
You shouldn't use street drugs to try and help yourself feel better.
People can smoke cannabis thinking it will help them feel better.
In fact, it tends to make depression worse.
It isn't a good idea at all.
Eating plenty of fresh fruit and vegetables,
eating well will tend to make you feel better
and exercising is absolutely vital.
Exercise is a good way of feeling better about yourself and it gets you out.
In general practice, about seven out of ten people with depression
actually come and see their GP with physical symptoms.
They might have headaches, backache, tummy aches.
They may have alterations in their appetite,
be losing weight or gaining weight.
They may have difficulty sleeping and see that as a physical symptom
rather than something that's psychological.
Other physical symptoms people can have can be loss
of the normal physical appetites that we all have, like for food or for sex.
People can lose those completely
and lose a lot of weight when they're depressed.
To be worried about whether you might be depressed or not,
you can reflect on how you're doing at work
or whether you're maintaining your friendships or not.
Are you ringing your friends or are you waiting for them to ring you?
Are you taking an interest in your family?
When did you last do something special with your kids?
Often, people who are depressed will do none of those things. That's very sad.
If someone hasn't responded to those self-help measures after a few weeks,
if they're mildly depressed or if they've got moderate depression,
then you need to have a discussion with your GP about active treatment.
There are two sorts of treatment.
You can either have medication or talking treatment.
Traditionally, medication was the main treatment that was available.
It's easily available in the GP's surgery.
I just have to write a prescription
and the patient can start the treatment right away.
Talking treatment used not to be available so widely.
But with the Improving Access to Psychological Therapies programme
that's being rolled out across the country,
there's more talking therapy, especially cognitive behaviour therapy,
available quite rapidly in more and more places in the country.
Sometimes, people can feel absolutely desperate when they're depressed.
They can have thoughts of harming themselves.
Thoughts of self-harm are very common when you're depressed.
Occasionally, people make plans or start taking actions to harm themselves,
perhaps kill themselves even.
It's a good idea to plan with your doctor
what you might do if you ever get those feelings.
You could write down on a piece of paper
the phone numbers of the five people you're going to telephone
if things get really bad and you feel desperate.
Usually, three of them will be out.
You need five numbers to make sure that you catch somebody who's in.
You could also put down on the list your GP's phone number
and also the phone number of the Samaritans
so that if you feel absolutely desperate,
you know what you're going to do before you get there.
