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What is the difference between feeling down and depression?
Types of depression
Who gets depressed and why?
The cycle of depression
What can I do about it?
Information for friends and family
Resources
We can all feel down from time to time. Feeling depressed is a bit different in that it tends to last longer than a couple of weeks, and is marked by low mood, significant decrease in enjoyment or interest in activities, feeling worthless or guilty, memory and concentration problems, and changes to your appetite, sleeping patterns, or libido.
If you are concerned you may be depressed it's a good idea to talk it over with someone. Maybe a friend you feel comfortable talking with as a first step. We also suggest speaking with a counsellor if you are worried or concerned about yourself and how you've been feeling.
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There are a few different types of depression, and the amount of disruption they can cause to your life depends a lot on your personal circumstances and how long you have been feeling this way. The following case studies* illustrate this. There is currently some debate about exactly what these different types of depression are and how they are different, but we will use the most current and widely agreed upon categories of depression for now.
* all of these case studies are composites of people who have presented to the Counselling Service, and all names have been changed
Tina
Tina presented to the counselling service because she'd been feeling down. She had been having difficulty motivating herself to go to lectures and couldn't understand her course materials. She had recently been arguing a lot with her family and was worried that her boyfriend was going to break up with her.
After talking to a counsellor it became apparent that Tina was suffering from mild depression due to the different stressors in her life. With counselling she was able to reassess her degree program and Tina began to feel more assertive in talking to her family and boyfriend
Tina is displaying what is commonly known as 'reactive depression'. This is when the depression seems to be a reaction to life events and situations that can be identified.
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There are clear and recent stressors in Tina's life that are causing her to doubt herself and her abilities, producing what is sometimes called 'low mood' or feeling down. Many different events and situations can lead to reactive depression, but a common theme linking them all tends to centre around loss of some kind (real or perceived) and the associated grief.
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Peter
Peter presented with a very different picture from Tina. He reported having problems meeting people on campus, poor sleeping patterns and energy, low mood and strong self doubts. Whereas Tina had appeared tearful and anxious, Peter seemed quite flat in mood and was slumped in the chair. It seemed that he did not think that anything would help him to feel better as he had 'always been this way'.
When we spoke to Peter, it became apparent that he had suffered from depression for many years. He was also a generally shy person who tended to avoid social contact of all kinds. He had come to believe that he would always feel like this and that he would never really do very well in his studies.
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Peter is presenting with a more enduring and more severe form of depression. In Peters' case the depression and social shyness went hand in hand. In helping Peter to overcome feeling down, we had to work on two things: 1) helping him to see that he could learn to have an impact on his mood and have control over how he thought and felt about himself, and 2) helping him to address the social fears and anxieties that were holding him back and contributing to his unhappiness.
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Depression can often co-occur with other problems, such as shyness and other interpersonal difficulties, stress, anxiety, and self esteem problems. Many people at university suffering from depression will also have procrastination and motivation problems and this will of course impact upon their ability to successfully complete their studies.
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Recent research suggests that 1 in 5 Australian adults will suffer from depression at some stage in their lives. Currently, young females in the 18-24 year old group will have emotional or mood problems (like depression) more often than at any other stage in their life. Young men of the same age are more likely to have alcohol or drug related problems, although this can often co-occur with depression or low mood.
There are many theories as to why depression is so common, ranging from the fast paced, highly competitive life in the new millennium to the breakdown of traditional community and family relationships and social connections. Evolutionary theorists propose that depression is an adaptive response to force people to slow down and re-evaluate their lives in order to bring about healthy change.
Research is currently focusing on the different causes of various types of depression as well as prevention and early intervention strategies. Although we already have a lot of good information, we are still investigating such questions as: What are the most useful forms of treatment for the different kinds of depression?
We still have a lot to learn about depression.
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You may already know that people who are experiencing depression show characteristic patterns of low self esteem, pessimism, feelings of hopelessness and disinterest in most things. Unfortunately, these things tend to feed on each other and intensify the depression, creating a vicious cycle of depression. Here are some of the common thinking patterns and behaviours in depression which contribute to this.
Thoughts
Often people who are experiencing low mood or depression will think negatively about themselves, their future and the world in general.
Many people lose hope that things will ever get better and develop a pessimistic view of the world. People can often feel that there is no point in seeking help because they believe that 'nothing will change how I am feeling!' This is a really common belief and often prevents people from seeking help. Fortunately, when people do present for help there are lots of different treatments that can assist with improving their mood and general outlook on life and helping them recover from depression.
There are other 'distortions' to our thinking that commonly occur when depressed, or for some people even when they're not depressed! Some of these unhelpful thinking habits include black and white (all or nothing) thinking - that is, no shades of grey (eg. something's either fantastic or it's terrible); making mountains out of molehills; catastrophising, etc. Fortunately, there are ways of learning to challenge these thinking habits if you feel they are making things worse for you.
Behaviour
If you are feeling low you are probably also avoiding doing many things. Not only do you not feel like doing anything, people who are feeling down tend to avoid seeing their friends - 'what's the point, I have nothing to say anyway'. They also avoid going out to things they usually enjoy (mostly because they feel they can't enjoy anything) and will often spend a lot of time alone, feeling down. This can quickly become a vicious cycle as the less you do, and the less people you see, the worse you tend to feel, which then drains away your motivation to do anything! The cycle of depression can be pretty hard to break...
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One of the hardest things about recovering from depression is getting yourself to the point of believing that things can and will actually improve. And the other really hard thing is getting the motivation to seek help or do something to help yourself. Here are some strategies for increasing this motivation and getting into action. But first, let's look briefly at how you got depressed - and stayed there.
Triggers vs Maintaining factors
Triggers are the things (events, situations, relationships) which cause you to become depressed in the first place. Often there is a combination of these and not just one.
Maintaining factors are the things which keep the depression going or make it hard to get out of the rut. These can be things like the neurochemical changes which occur in the brain once you become depressed, or the negative thinking patterns that dominate the depressed mind. They can also include destructive relationships, personality traits, and many others.
It is important to realise that even though the things which triggered the depression for you may no longer be a problem any more, you might still remain depressed because the maintaining factors are keeping you that way. You may need to start using some strategies which overcome these maintaining factors before you can start feeling better. You may also want to look at your triggering factors and work out how you can avoid them in future where possible. If you decide you need help with any of these strategies don't forget there are counsellors here on campus who can help you work it out. Below are some ideas you can try yourself.
Get HAPPIA
There are lots of different strategies you can use to help yourself start feeling better.
For an easy-to-remember yet effective guide to recovering from mild to moderate levels of depression try using our 'Get HAPPIA' strategy:
Hope
Achievement
People connections
Pleasure
Inspiration
Active
Hope
Loss of hope is one of the biggest signs of depression. Finding things and people which give you a sense of hope for the future can help to lift you out of a low mood and help to give you the energy to motivate yourself to get better and embrace life again. Finding some hope again is one of the surest paths to recovery.
What inspires you to have some hope? One thing people often find gives them hope is when they actually have some influence over their situation - when they can make a difference and have some impact. One way of getting more influence and control over your life is to start making plans, and then carrying them out. Whether it be planning something big for the future that has always been one of your dreams (like travelling), or making short-term plans for the coming week or even today (including some of the suggestions below), planning and doing things which make you feel satisfied or feel like you've achieved something can definitely help to regain your sense of hope. In giving yourself hope it is important to remember that you have felt better in the past, (even if it doesn't feel like that now!) and that you are likely to feel better again in the future.
Achievement
Do things which give you a sense of achievement or satisfaction, no matter how small. You can build on the feeling and try something a bit harder next time, and so build up your confidence and self esteem in the process. Whether it be starting an assignment or cleaning out your wardrobe, or helping out a friend, do something which you can look back on and say 'I did that today' and feel good about it. It also helps to build your sense of self-efficacy, which is that feeling of 'I can do it'.
People connections
Stay connected with other people even if you don't feel like it. And if you've isolated yourself and withdrawn from everybody and everything then get connected again somehow. Reach out. Talk to somebody. Write an email. Make a phone call. This is one of the most overlooked and yet most valuable strategies for starting to feel part of life again. Human beings are social animals - we need each other, that's all there is to it.
Pleasure
This is one of the first things to go when you become depressed - you find that you don't get any pleasure or enjoyment out of anything anymore. Or the things you once used to enjoy are now of no interest to you at all. Well, the good news is that your sense of pleasure will again return, but not all at once. Bit by bit, you need to build up your ability to enjoy things again. Think of it like exercising an unused muscle. You need to start small by doing things which still give you some little trace of enjoyment or pleasure. Don't think of it like something which you absolutely used to LOVE doing - think of it more like 'Oh yeah, I found myself kind of enjoying that for a minute,' and then you'll be on the right track. And if you can't think of anything, get some help.
Inspiration
Find things or people which inspire you in some way. Look for inspiration in the small things, in the moment. If it also makes you remember something about what life means to you, all the better. Finding inspiration is sometimes easier when we shift our focus outwards, to others, rather than being focused inwards on ourselves. Why not practice being on the lookout for even the tiniest bits of inspiration in everyday life? It's amazing what you notice when you become attuned to it. Inspiration can be a strong force against the negativity and pessimism that goes with depression.
Active
Get physically active if you aren't already. Most people who become depressed find themselves feeling less and less like doing anything active at all. Unfortunately this contributes to the physiological side of the vicious cycle of depression and you become more depressed. So get out there! Getting out of bed is a good start. Seriously. Go for a walk, play some soccer with a friend, go for a swim or a surf, get out the old tennis racket, take the dog to the park… anything! Getting physically active will help re-balance your body and brain chemistry and actually help you start feeling better sooner. Even a 20 min walk each day has been shown to lift some of the symptoms of depression. If you're finding it super-hard to break through the lethargy, talk to someone about it and get some help.
And if you can remind yourself of these strategies everyday and get some help with the ones you are still finding hard, you will probably find that things begin to improve…
However if there are issues or problems in your life which were causing you to become depressed in the first place and which still haven't been dealt with, you are probably facing an uphill battle! Because the things which trigger depression are not always the same things which maintain the momentum of depression, you usually find that you need to deal with both if you are to recover fully.
All of the above suggestions can be helpful to give you a different perspective on your current problems, re-engage you with the things you enjoy and help you to see that your mood does not have to dominate everything you do. This may just be enough to help lift you out of the depression cycle.
These strategies are all based on clinical research and have been shown to be effective for mild to moderate levels of depression. If you are suffering from severe depression we strongly advise you to talk to a qualified professional as soon as possible, or to tell someone you trust and let them find you the appropriate help. Please do not stay suffering in silence - reach out to someone.
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Talking to friends and family about how you feel can be difficult. Talking to a friend or family member can also be difficult. At the Beyond Blue website there is a useful factsheet on how to help someone with depression which you can link to here.
For information for friends and family about suicide and how to help someone whom you think is at risk of self-harming, click here.
Centre for Clinical Intervention
Clinical Research Unit for Anxiety and Depression (CRUfAD)
Acceptance and Commitment Therapy
The Black Dog Institute
The Black Dog Institute conducts research and provides therapy for major depression and bipolar disorder. On this website you will be able to learn more about depression and also to participate in research trials in the treatment of depression.
Beyond Blue
The Beyond Blue website provides information about depression, bipolar disorder, and postnatal depression. You can log on to this website to complete an interactive checklist to see if you are experiencing depression.
Reach Out!
Contains information on the types, causes, symptoms, and treatment of depression, how to help a friend who is depressed, and also living with someone who is experiencing depression.
SANE Australia
Contains useful fact sheets on depression, bipolar disorder, schizophrenia, related drug use, and effective therapies. Information is also available in different languages, including Chinese, Vietnamese, Arabic, Greek, Italian, and Turkish.
Self-paced modules or workbooks
MoodGYM
On-line step-by-step cognitive behaviour therapy program for depression. The MoodGYM program has been validated in scientific studies.
Centre for Clinical Intervention
The Back from the Bluez program by the Centre for Clinical Intervention provides information about depression as well as looking at the link between thoughts and feelings and how to manage depression by using cognitive behaviour techniques.
Just Ask Us
A national website for university students run by Turning Point Alcohol and Drug Centre. The Just Ask Us website is aimed at university students who are seeking information or help in relation to a wide range of health issues, including alcohol, drugs, mental health and well-being. The website provides information on a variety of health topics and links to support services offered by university campus counselling services and key treatment and support services nationally.
Self-help books
Taming the black dog by Bev Aisbett
Feeling good – The new mood therapy by David Burns
Beating the blues by Susan Tanner and Jillian Ball
A new guide to rational living by Albert Ellis and Robert Harper
Back from the brink by Graeme Cowan
Breaking the patterns of depression by Michael Yapko
Dealing with depression by Gordon Parker
How to heal depression by Harold Bloomfield and Peter McWilliams
I had a black dog by Matthew Johnstone
Journeys with the Black Dog by Tessa Wigney, Kerrie Eyers, and Gordon Parker
Mind over mood by Dennis Greenberger and Christine Padesky
This book is an excellent introduction to cognitive behaviour therapy for depression. It is easy to read and provides exercises that you can follow. Learn to identify and modify unhelpful thoughts and thinking styles that maintain your depression.
The SANE guide to depression by SANE Australia
The SANE guide to Staying Alive by SANE Australia
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