More than a feeling

Posted on 26 November 2015

Depression is about so much more than feeling sad all the time. It’s a mental illness that affects your mood, body, thoughts and feelings and can have devastating consequences if not treated. The good news? It can be.

Perhaps one of the biggest myths about depression is that it’s just a bunch of sad thoughts – and you can ‘snap out of it’. Depression won’t necessarily occur when something bad or sad happens to you – it can strike even when life is good. Symptoms include feelings of guilt, eating or sleeping more or less than usual, no longer enjoying the things you normally do, feeling irritable, and finding it difficult to concentrate or make decisions that usually come easily. ‘Because we don’t fully understand how depression comes about, there are many myths out there,’ says Dr Irvine Eidelman, a psychiatrist at Mediclinic Constantiaberg. ‘But certain chemicals have been found to be deficient in people with mental illnesses – and we’ve found that by correcting those levels of chemicals in the brain, we can treat depression.’

True or false?
We take a look at some of the popular beliefs about this illness and investigate whether or not they’re true.

Antidepressants change your brain chemistry.
True. Antidepressants are often referred to as ‘happy pills’, which isn’t entirely correct. Although taking them appears to make depressed people ‘happy’, what they actually do is change the brain chemistry to help stabilise and improve patients’ moods over time.

Depression runs in the family. If my mom has it, I’ll have it too.
Partially true. ‘Patients with depression may very well have uncles, aunts or parents who suffer from it – we often find there is a family history,’ says Dr Eidelman. ‘While there does seem to be a tendency towards developing depression, it’s not a genetic illness.’ So if your mom has depression, it doesn’t necessarily mean you’ll get it.

You can just snap out of it.
False. Telling someone with depression to snap out of it is like telling someone with diabetes to lower their sugar levels by simply having sugar-free thoughts.

I’ll have to go to therapy for the rest of my life.
Partially true. Many patients with depression function and recover better if they have psychotherapy, which means going to a therapist regularly to spend time learning skills to help them cope. Therapy can also help the patient recognise what support mechanisms they need. ‘It doesn’t mean, however, that patients have to be in therapy for the rest of their lives,’ Dr Eidelman explains. ‘When patients have their first major depressive episode, they should be treated for a certain period of time. Once they have recovered, we can slowly wean them off the medication. If they relapse or have a strong history of major depression, they may need to be on medication for longer. If patients keep relapsing, they may need to be on medication for the rest of their lives.’ It’s the combination of psychotherapy and medication that often yields the best results in the treatment of depression.

Depression manifests differently in men and women.
False. Symptoms of depression present in the same way, regardless of whether you’re male or female. ‘Women tend to go for treatment earlier than men do,’ says Dr Eidelman. Why? ‘It’s often because of the stigma the illness has. Men don’t want to appear to be weak, which is another myth – depression is not a sign of weakness.’

I can use alternative treatments for depression.
Partially true. ‘If depression isn’t treated correctly, it can result in complications – the most tragic consequence being suicide,’ says Dr Eidelman. ‘I don’t have anything against alternative treatments but I have to practise the medicine I know, and I believe that for patients with true major depression, the best medical intervention is antidepressants and therapy.’

How to support someone with depression
Support is vital when it comes to managing depression. ‘You sometimes need to treat the family too,’ says Dr Eidelman. ‘For example, if a woman who’s in relationship is depressed, it’s a good idea to try to empower her partner so they understand it. In every treatment plan, offering your friend/spouse/partner support by attending group therapy with them, reading up on the subject and making the effort to understand depression as best you can will go a long way in helping the sufferer to cope. It’s also a far better tactic than relying on the stigmatised approach of, “Pull yourself together”, “Chin up” or “Just get over this”.’

When they say: ‘I’m all alone.’
Don’t say ‘You’re not alone – I’m right here, aren’t I?’
Do say ‘I know you feel as though you’re alone. What would you like me to do for you? I’m happy
to just sit here with you – together we’ll get through this lonely feeling.’

When they say: ‘Why should I bother? Life isn’t worth living. I don’t see any point in going on.’
Don’t say ‘How can you say that? You have a good job and you’re surrounded by people who love you. You have everything to live for!’
Do say ‘I know it feels that way to you right now and it will be difficult for both of us – try to remember we’ll get through this together.’

How does it feel to have depression?
‘It’s like living in a constant fog. I feel weighed down. I struggle to concentrate. I’m tired. I have good days and feel like a different person. I have bad days. Sometimes it’s physically impossible to get out of bed. I doubt myself. Calling depression a Black Dog* is a great analogy. Once I began to identify with my illness, my depression started to make sense. It became easier to control. It’s part of my life now. I’ve realised that understanding and educating myself on it has helped.
‘A while back I had a terrible breakdown. It didn’t make sense. I was consumed by disappointment and guilt – I felt like a complete failure. It was completely irrational, but at the time it seemed perfectly logical to me. I had no control over why I felt the way it did. It was terrifying. It was lonely.’
– Mandy Freeman

* What’s with the Black Dog? Winston Churchill used this metaphor to describe his depression. With depression, you have a constant companion – the Black Dog either behaves and you don’t notice it (your mood is stable) or it doesn’t and it becomes unruly (you’re depressed). Fortunately every Black Dog has a collar – which quite simply means that depression is a manageable and treatable mental illness.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.