Reilly's Therapy Blog


What’s Depression? First week back and this seems to be the general feel in the room. A New year tends to bring these emotions up, it’s a realisation for many along with relief to know they are not alone and with help can get through. So with this in mind I thought I’d write about the basic’s symptoms and diagnosis. Depression is described in the dictionary as being ‘low in spirit; downcast’. What it actually feels like is that a cloud of lead particles has settled on the soul. It is the heaviest weight we are ever going to feel. It is also the most stubborn of feelings and it can drive a person to despair. It sears our very essence and dirties our vision. It has the lightness of a gas but the weight of a concrete overcoat. It seeps into every crevice of our being. When we are depressed we can’t be bothered with our own potential. We cannot lift our heads enough to see that we have true value in the world. We cannot give ourselves in close relationships because we become absent in the company of those we love. We care less about how we look, or else we overdo it when we go out to act as a mask to the world. We stumble through the day trying to find some meaning to the feelings that ravage us. We lose our motivation to pursue our true vocation and, in so doing, compromise our soul. We feel like victims – buffeted by the rough winds of life. We cannot grasp onto anything that is solid in order to pull ourselves out of the storm. Either we see nothing but unfairness or we stoop to self-loathing and believe we deserve nothing better. We lose our sense of reason and we are unable to take an objective view on our circumstances and address what is fact and what is fiction. The problem with depression is that it does not allow us to stand still. We either get worse or we get better. One common symptom of depression is mood swings. We can go from feeling ecstatic to feeling suicidal in minutes. We are used to the highs and lows; we thrive on them to give meaning to the day. But this thinking exacerbates the depression by keeping us in a state of anxiety. When the process of recovery from depression begins, it can seem as though nothing is happening, but this may be because we have stopped the backward drag. SOME SYMPTOMS OF DEPRESSION: • Overwhelming tiredness • Insomnia• Self-loathing • Rage • Immense sadness • Inability to do anything worth while • Feeling stuck • Feeling isolated • Harming ourselves • Feeling lonely • Thoughts of suicide • Not caring whether others like us or not • Having no feelings – numbed • Eating junk • Smoking • Sabotaging friendships • Behaving violently • Stealing • Drug and alcohol abuse • Gambling to excess • Being obsessive about sex • Losing all interest in sex • Abusing children • Compulsively cleaning • Self harm HOW A DOCTOR DIAGNOSES DEPRESSION When we ask for help from our doctor they wont take any of these concerns into account. They have a black and white view of depression which is abstract and doesn’t often relate to how we’re feeling. It’s important to know this and for this reason, here’s what the doctor will ask us to ascertain if we’re clinically depressed (depression that’s diagnosed by a clinician) or we’re just having a bad day. Current National Institute for Health and Care Excellence (NICE) guidance uses the Diagnostic and Statistical Manual Fourth Edition (DSM-IV) classification. THE SYMPTOMS A DOCTOR WILL LOOK FOR To diagnose major depression, this requires at least one of the core symptoms: Persistent sadness or low mood nearly every day. Loss of interests or pleasure in most activities. Plus some of the following symptoms: Fatigue or loss of energy. Worthlessness, excessive or inappropriate guilt. Recurrent thoughts of death, suicidal thoughts, or actual suicide attempts. Diminished ability to think/concentrate or increased indecision. Psychomotor agitation or retardation. Insomnia/hypersomnia. Changes in appetite and/or weight loss. Symptoms should have been present persistently for at least two weeks and must have caused clinically significant distress and impairment. They should not be due to a physical/organic factor (e.g., substance abuse) or illness (although illness and depression commonly co-exist). Severity is based on the extent of symptoms and their functional impact: Sub threshold depressive symptoms – up to 5 symptoms Mild depression - few, if any, symptoms in excess of the 5 required to make the diagnosis, with symptoms resulting only in minor functional impairment. Moderate depression - symptoms or functional impairment are between 'mild' and 'severe'. Severe depression - most symptoms present and the symptoms markedly interfere with normal function. It can occur with or without psychotic symptoms. Normal sadness exists along a continuum from clinically significant depression: differentiation is based on the severity, persistence and the degree of functional impairment and disability associated with the low mood. Only we really know how bad our depression is. It is very important to make this clear to a doctor. They cannot help us if they are not made aware of how serious the depression is. If we've reached out to our doctor then we are probably struggling. There is no shame in admitting you may need help the shame is in not seeking it. Things will get better just ask. As with all these blogs, please pass them on, someone, somewhere may well be grateful. Happy Sunday.

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