My name is Dr Cosmo Hallstrom. I'm a consultant psychiatrist
and a fellow of the Royal College of Psychiatrists.
If you have depression or you feel unwell,
you should go and see your GP.
He should be your first port of call.
The GP is very skilled in assessing patients with depression.
Depression is a very broad-spectrum condition.
At one end of the spectrum is manic depression,
a severe mental illness.
At the other end is unhappiness.
There are often what we call biological symptoms present in depression,
such as, classically, poor sleep,
waking up in the morning in the early hours
and ruminating on all your past misdeeds.
There's a diurnal variation in mood
where people feel terrible in the mornings,
but tend to lighten up and brighten up through the day.
Loss of weight, loss of appetite, loss of libido.
Generally not coping.
Lots of physical symptoms, including anxiety.
If you have lots of symptoms,
then it's more likely that you have a depressive illness,
than if you simply have a feeling of low self-esteem, long-term low mood.
If you have a family history,
that makes it more likely that there's a biological element.
These are the main symptoms they'll be looking for.
It is common that depressive illnesses are caused or triggered
by what we call life events.
Bereavement is one thing, loss of employment.
Some people are highly vulnerable and it takes very little to trigger it.
Other people are robust, but become depressed
in the presence of an overwhelming stress.
Depression is very treatable.
The most appropriate treatment is to take antidepressants
together with some form of counselling and therapy.
Very few people with depression are referred on to a psychiatrist.
Community psychiatric nurses get involved, practice counsellors,
but depression is generally treated in primary care.
There may be a case for starting off with counselling first
and seeing how it goes, and if that's not enough,
then an antidepressant may be an appropriate treatment.
Medication has an important part to play in the treatment of depression.
Antidepressants undoubtedly help the majority of patients who are given them
in improving their mood.
They may not be curative, they might not make you completely well,
but they have a strong part in lifting symptoms and making people better.
You probably need to take them for a number of months
to stop the depression coming back.
People take antidepressants, they feel better,
stop taking them and slip back,
and then blame the antidepressants for not being effective.
So I think it's important to take a proper course of antidepressants,
like it is to take a proper course of antibiotics.
Often, people think they can't be helped, but there is help available,
and it's certainly worth seeking help because a lot can be done.