What is depression and low mood?
The terms depression and low mood are often used interchangeably. However, while depression is a diagnosable mental illness; low mood describes an emotional state which we all experience from time to time.
What qualifies for a diagnosis of depression?
Depression is diagnosed If you have experienced 1 of the following symptoms, most of the time, for over 2 weeks:
- Low mood or sadness
- Loss of interest or pleasure in your usual activities
And at least 4 of the following symptoms:
- Sleep disturbance – either falling asleep or waking very early
- Either a loss or increase in appetite
- Difficulty concentrating
- Slowed functioning (either thinking, talking or acting slower than usual) or agitation
- Lower sex drive
- Less energy
- Loss of self-confidence or self-esteem
- Thoughts of death or suicide
- Feelings of guilt
Throughout our lives we all experience sadness. This is a normal, healthy emotional reaction to events and our thoughts about these events. For many people, these feelings usually pass quite quickly. However when these feelings last more than a few days, keep coming back quite frequently, or start to affect your work, interests and/or feelings towards your family and friends, then it could be a sign of depression.
Low mood and depression in its mildest form does not stop you from leading your normal life, but it makes everything seem harder and less worthwhile. In the most severe form of depressions, it can seriously affect your ability to function on a daily basis, and some people feel so bad that they find themselves feeling that life is not worth living or that other people would be better off without you. Whilst these thoughts can feel very frightening it is important to remember that they are quite common. However, it is very important that you seek help from your GP or if you feel that you are in imminent danger, the emergency crisis support services such as your local mental health crisis team, the Samaritans, or the Accident and Emergency department at your local hospital.
How depression can affect us
Depression and low mood affects us in four ways:
The way we think
Difficulty in making decisions
Difficulties in concentration and memory
Ruminating (keep going over the same thoughts in your mind)
Thoughts of death
The way we feel emotionally
The way we feel physically
Sleep disturbances (e.g. early morning waking, mid sleep waking, and difficulty getting to sleep)
Never feeling 100%
Aches and pains
Decreased or increased appetite
Loss of energy/always feeling tired
Restlessness and agitation
The things that we do
Losing interest and enjoyment in activities you previously enjoyed
Difficulty doing everyday tasks
Withdrawal from friends/family or life in general
Letting people walk over you
Just as we are all different, each of us will respond to depression and low mood in different ways. For example some, particularly men, will not feel sad or tearful, but instead their main symptom may be physical or feeling angry or frustrated.
What causes depression / low in mood?
The causes of these problems can be biological, or environmental:
Biological – Biological changes in the brain happen when we are depressed; changes in chemicals and electrical activity here are particularly responsible for the more physical symptoms of depression and low mood. Physical health problems can be both a cause of and symptom of depression, such as poor sleep, being run down, physical illness, underactive thyroid, poor diet, etc.
Genetics – It is not clear if there is a genetic link. The chances of being depressed are higher if other members of your family have been depressed. However, this may be caused by other factors such as learnt ways of reacting to/coping with situations or events. If a family member has depression it does not mean that it is inevitable that you will get it.
Life events – Our reaction to major life events can be a factor in developing symptoms of depression. Especially, if the feelings we experience in response to these events are not expressed or explored.
On-going stress – Issues that seem to go on and on or seem to have no solution in sight can lead to negative thinking and feeling helpless.
Traumatic experiences – this can result from abuse or neglect, bullying, or death/near death of a loved one for example.
Often low mood and depression are caused by a combination of factors. The importance of each factor varies from individual to individual.
How to treat depression and low mood?
Medication does not cure depression but it can help to relieve symptoms. Some patients may benefit from medication while they are undergoing psychotherapy.
Cognitive Behavioural Therapy (CBT) is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to depression inducing feelings and situations. It can be conducted individually or with a group of people who have similar problems. CBT is administered in high and low intensity formats but for best results with reduced chance of relapse, high intensity is far more effective.