It might not be immediately obvious, but depression and anxiety can have huge effects on your career choices and are the most common mental health disorders among teens and adults in New Zealand.

People often use the word ‘depression’ when they’re actually talking about a time where they felt sad or down. When life gets full-on and you’re dealing with stress, disappointments or grief, it’s common and normal to go through patches of sadness. Let’s say you get dumped or someone you love dies – you’ll probably want to curl up in a corner and cry forever. But usually, in time, as you talk about it and good things start to happen again, the sadness starts to reduce.

What doctors call ‘major depressive disorder’ or ‘clinical depression’ doesn’t work like that, however – this is when the feelings last for a really long time and get in the way of everyday life.

Symptoms of depression

A person may be depressed if they have felt sad, down or miserable most of the time for more than two weeks… OR lost interest or pleasure in most of their usual activities… AND they’ve experienced depressive symptoms in at least three of the following four categories:

Behaviours

  • Not going out anymore.
  • Not getting things done (like work or study).
  • Withdrawing from close family and friends.
  • Being grumpy and irritable.
  • Relying on alcohol and sedatives.
  • No longer doing things previously enjoyed.
  • Crying a lot.
  • Unable to concentrate.

Thoughts

  • ‘I’m a failure.’
  • ‘It’s my fault.’
  • ‘Nothing good ever happens to me.’
  • ‘I’m worthless.’
  • ‘Life’s not worth living.’

Feelings

  • Being overwhelmed, sad, empty, restless and frustrated.
  • Having no confidence, feeling indecisive, worthless and miserable.

Physical

  • Feeling tired, nauseous and run down all the time, with headaches, muscle pains and a churning gut.
  • Having sleep problems, a loss or change of appetite and significant weight changes (losing or gaining weight).

What makes a person more at risk of depression?

There’s no clear-cut reason why a person may be depressed and sometimes it just comes out of the blue. But some of the factors that can increase your risk are:

  • family conflict or violence
  • bullying or abuse
  • the loss of someone close
  • stress, including loneliness, relationship problems
  • unemployment
  • drug and alcohol use
  • physical illness or long-term health problems
  • a family history of depression
  • pregnancy or post-childbirth, especially with any of the risk factors above.

Getting help

Most people recover from depression and enjoy life again. But delaying treatments may delay recovery, so it’s important to take that first step.

Self-help strategies

If you have mild or moderate depression, there are some simple things you can try.

  • A regular routine of physical exercise has been found to be the most helpful. Getting fresh air and sunlight every day is good for improving sleep problems as well.
  • Other natural therapies that help you to relax include yoga, meditation/breathing exercises, massage therapy and acupuncture.
  • There are some good self-help books available on coping with depression. Check out your library or bookstore, or see what people have recommended on The Lowdown message board.
  • Remember to avoid alcohol or recreational drugs, as these can make depression worse.

Talking therapies

In general, psychological and family therapies (counselling) are the main treatment for depression in children and young people. Psychological treatments are also known as ‘talking therapies’. They work by changing negative patterns of thinking or sorting out relationship problems.

Psychological treatments can help to:

  • speed your recovery
  • prevent depression from recurring
  • identify ways to manage the illness and stay well.

Different types of talking therapies are provided by counsellors (sometimes also called ‘therapists’), psychologists, psychiatrists and other health professionals. Two therapies that are known to work for depression are:

Cognitive behaviour therapy (CBT) – a programme of counselling that helps to change negative thought patterns. It works on the basis that the way we think affects the way we feel.

Interpersonal therapy (IPT) – this focuses on improving relationships by looking at how we relate to other people.

Medications

People who are depressed often feel physically unwell. Antidepressant drug treatments can relieve the physical symptoms of depression.

If you have depression, your doctor may think it is useful to start you on antidepressant medication. This may happen if your depression is severe, or other treatments haven’t worked or are not available in your area.

Your doctor will provide you with information about the medicine, how to take it, and the possible side effects. Drug treatments for depression are not addictive, but like any drug they can have side effects (such as nausea and headaches).

Antidepressant medications can only be prescribed by a GP or health professional.

Some things to remember about treatment:

  • Depression is a very common medical condition.
  • Effective treatments are available, and it’s important to get help as soon as possible.
  • Counselling therapies are the recommended first line of treatment for children and young people. In some cases, a doctor may think an antidepressant is also necessary.
  • Your doctor should provide you (and your family, if you are under 18) with clear information about the pros and cons of taking antidepressants, and the steps to take in a crisis situation or emergency.
  • Regular check-ups are important.
  • With the right treatment, the vast majority of young people make a full recovery from depression.

How to help yourself feel better:

  • Start by writing down the things you always do (get up, have a shower, eat breakfast, get to school/uni/work, etc). Then try to fill in the gaps.
  • Try each day to put into your plan one thing that you enjoy and one that makes you feel like you’ve achieved something.
  • During early morning and/or late afternoon, build in some exercise (such as going for a walk or playing sports with friends). Physical activity can help prevent depression.
  • If you find it hard to get up in the morning, it’s a good to plan to walk to school or university with someone, or meet them for breakfast over the weekend.

Try to stick to your plan, but don’t get stressed if you don’t get around to some things. We all get stressed or anxious sometimes; worried or afraid of something happening, or obsessed about something happening in a certain way – so you’re no exception.

A bit of stress is fine – sometimes it can help get things done. What’s not okay is when the anxiety gets so absolutely overwhelming that it stops you from doing things and makes you feel totally miserable. Having an anxiety disorder means that this response is giving you more problems than benefits.

For many people with an anxiety disorder, a common symptom is having worrying thoughts in your head that you know are unhelpful (or even silly) but are hard to stop. These thoughts, which are often negative, keep replaying in your mind and worsen the anxiety or fear. An anxiety disorder can also make you react quicker or more intensely to situations. It even causes physical symptoms so strong people feel like they might have a heart attack.

Anxiety disorders

An anxiety disorder is different from depression because the feelings:

  • are quite intense
  • last for weeks, months or more
  • negatively affect your thoughts, behaviour, and general health
  • leave you feeling distressed and not enjoying life.

It can impact on other areas of your life, such as how you’re doing at school or work, or your relationships with friends and family. People with anxiety disorders often become worried or upset about their problems. This may lead to them becoming depressed as well.

Types of anxiety disorders

There are a number of anxiety disorders, but the most common are:

generalised anxiety disorder – where the person feels anxious on most days over a long period of time – six months or more.

phobia – when a person feels very fearful about a particular object or situation. Examples are fear of attending social events, driving over bridges, or travelling on planes.

obsessive compulsive disorder (OCD) – people with OCD have ongoing intrusive thoughts and fears that cause anxiety (obsessions). These obsessions lead to the person carrying out behaviours or rituals (compulsions). An example is a fear of germs, which leads to constant washing of hands and clothes.

post-traumatic stress disorder – this can occur at any time after a person has experienced a traumatic event, such as an assault or serious accident. The symptoms can include difficulty in relaxing, bad dreams or flashbacks of the incident, and the avoidance of anything related to the event.

panic disorder – a person with a panic disorder has panic attacks, which are intense feelings of anxiety and the type of physical symptoms you would have if in great danger. During a panic attack, you can feel like you’ve lost control of your body and emotions. You may feel sick, dizzy and short of breath. Panic attacks can be managed and beaten, with help.

Symptoms of an anxiety disorder

Behaviours

  • Avoid socialising or going out.
  • Wanting someone with you all the time.
  • Avoiding eye contact with others.
  • Using alcohol or drugs to calm down.

Thoughts

  • ’I’m going crazy.’
  • ’I won’t have anything interesting to say.’
  • ’I can’t control my worry.’
  • ’I have a serious illness that the doctors can’t detect.’
  • ’What if germs get on my hands and I get sick?’

Feelings

  • Confused, anxious, tense all the time.
  • Constantly nervous, panicky, terrified,
    on edge.

Physical

  • Blushing, trembling, racing heart, numbness.
  • Tingling, nausea, sweating, shaking, shortness of breath, dizziness.

What can I do about my anxiety?

The good news is that anxiety disorders can be managed and overcome. It’s important to recognise anxiety problems and treat them as soon as possible as this can avoid a lifetime of battling with anxiety and maybe depression.

Most people need to seek professional help – either from a GP, or a counsellor or psychologist. Some forms of ‘talking therapy’, such as CBT, are very effective for some people.

For many people, talking therapy is the first choice in treating anxiety disorders because it helps people change their thought patterns and the way they react to certain situations. This can also prevent further problems. Learning some relaxation techniques can also be helpful.

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