From ancient Greece to today’s modern world, depression has always been with us. So how do we identify it and move forward? Depression, has a long history and attracts a wide range of theories about its origins and purpose. 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. 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.
How to identify depression
Identifying depression 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 things that they previously enjoyed and find making decisions a problem.
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, which may mean they use up lots of their vital mental energy.
Of course, these are psychological manifestations. Walk down the street and you will be unable to identify a single person who is depressed, depression can affect people differently and may not always be noticeable.
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. 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.
If someone is struggling to cope or self help is not working then this information might be useful - NHS - Low mood, sadness and depression
Or someone needs more urgent help visit - NHS - Where to get urgent help for mental health
