From ancient Greece to today’s modern world, depression has always been with us. So how do we identify it and move forward?
Depression, or more specifically clinical depression, has a long history and attracts a wide range of theories about its origins and purpose. Although depression doesn’t appear to serve an evolutionary objective – it can decrease sexual desire and therefore human reproduction – some psychologists believe that it has a hidden purpose, as an aid to creativity in different fields.
This isn’t a modern theory, because the ancient Greeks identified it in the fourth century BC, when Aristotle noted that: ‘all men who have attained excellence in philosophy, in poetry, in art and in politics, even Socrates and Plato, had a melancholic habitus; indeed some suffered even from melancholic disease.’
Moving forward in time, Dr Samuel Johnson, the 18th century’s most distinguished English poet, essayist and lexicographer would probably agree with this, coining the term ‘black dog’ to describe his bouts of clinical depression. The same term was frequently used by Winston Churchill to express his periods of gloom when dealing with important matters throughout the 20th century. So there you have it: melancholia; the ‘black dog’; the doldrums; and ‘blue funk’. Whatever you call it, it’s as real today as it ever has been, particularly in times of crisis, such as the current pandemic.
How to identify depression
Identifying depression as distinct from stress and anxiety also needs considerable care. In very simple terms, it’s the time element that’s different. People who are depressed experience continuous periods of low mood or sadness, combined with feelings of helplessness. The individual may lack the motivation to do anything and find making decisions a problem. The spark has simply gone out of them in a big way, and there can also be of suicide in more severe cases.
One trait that psychologists have identified is rumination, which is a negative thought process that repeats itself, digging a bigger hole each time. Depressed people can fixate on their perceived problems, wasting huge amounts of mental energy to the detriment of everything else.
Of course, these are psychological manifestations. Walk down the street and you will be unable to identify a single person who is depressed; it’s not like a they have a leg in plaster. So when we know people a little better, are there any physical signs to look out for?
Physical signs and symptoms
The physical signs of depression can include noticeable changes in weight, and not exclusively weight loss. People may also move or speak more slowly than you are used to. The depressed person may also suffer from a lack of energy and libido. In addition, there can be changes to the menstrual cycle, as well as disturbed sleep.
You might also notice that they have closed down their circle of friends, reduced their social calendars and put previously important hobbies on hold, creating a dark, lonely place where there once was sunshine and light. And if you don’t see someone that often, these tell-tale signs can be easier to spot. If you interact with someone every day, you might not notice the gradual onset of depression.
Degrees of depression and their treatment
There are three degrees of depression, and medical professionals classify them as follows. First, mild depression will have some impact on your daily life. Next, moderate depression will have a significant impact.
Finally, severe depression makes it almost impossible to get by, and it’s here where intervention is needed most. Treatment usually consists of self-help, talking therapies and medication. For mild depression, your GP might suggest strategies such as exercise.
Self-help could include a combination of exercise, apps and online tools. For moderate depression, you may need to talk to a professional. A GP can refer you for talking treatment, or you can refer yourself directly to an NHS psychological therapies service without a referral from a GP.
For severe depression, antidepressants may be prescribed, combined with talking therapy. If things don’t improve, you may be referred to a mental health team composed of psychologists, psychiatrists, specialist nurses and occupational therapists. Of course, in the current pandemic, many of these services may be conducted online.
