Down in the Dumps

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The media constantly bombards us with health ‘issues’ – heart disease is the main cause of death, we are busy fighting cancer so please donate to the cause, ‘change for life’ to avoid diabetes; and the obesity epidemic is certainly never far from the headlines in some form or another. With all of these very valid messages being sent to us every day it would be very easy to believe that one of these conditions takes up most of a GPs time during an average day, and it’s true to say that we are fairly preoccupied with them – but there is one condition that, according to the research at least, takes up more of our time than any other one single health problem, amounting to approximately 40% of our workload, and it may surprise many to know that this is depression.

I am writing this shortly after the media has done its very sad job and brought our attention to the fact that the ‘legend in his own lifetime’ Robin Williams recently lost his own battle with this horrible disease, and every superlative I read attributed to him and every expression of loss and tragedy, however extreme, was (in my humble opinion) entirely deserved. He was certainly not alone – many of our national treasures have been held in the clutches of this all too common ailment, and upon searching the internet for ‘celebrities with depression’ in order to give some examples in this present rambling, the results were so overwhelming that I gave up the battle to select a few names from the vast array before me.
Depression can often be a tricky diagnosis to make. When I say that up to 40% of a GPs time is taken up with depression, this is not always obvious to either the doctor or the patient – as an example, we can look at the women who have gained weight from too many cakes, or the businessmen who have become a little portly from all those corporate ‘jollies’ and deal with only the high blood pressure, diabetes or arthritis that brings them to our door, but often neither the doctor nor the patient digs deeper and unearths the fundamental underlying problem which is essentially comfort eating – because of depression. This is not always the case, of course, and if you just happen to enjoy one too many cakes or eating the wrong thing at a business lunch, please don’t run to your doctor with this article insisting that you must be depressed! Tiredness, memory loss, aches and pains and many other symptoms also often turn out to be ultimately caused by depression and it can take time to discover this.

Sometimes the situation is a lot clearer; someone who has just been through a major life event and isn’t sleeping or eating, doesn’t want to get out of bed and is tearful all the time poses very little problem, in terms of diagnosis at least. But between the two extremes there are some common themes to look out for; the symptoms of depression can be psychological, physical or social and can include any, some or all of:

continuous low mood or sadness
feeling hopeless and helpless
having low self-esteem
feeling tearful
feeling guilt-ridden
feeling irritable and intolerant of others
having no motivation or interest in things
finding it difficult to make decisions
not getting any enjoyment out of life
feeling anxious or worried
having suicidal thoughts or thoughts of harming yourself
moving or speaking more slowly than usual
change in appetite or weight (usually decreased, but sometimes increased)
constipation
unexplained aches and pains
lack of energy or lack of interest in sex (loss of libido)
changes to your menstrual cycle
disturbed sleep (for example, finding it hard to fall asleep at night or waking up very early in the morning)
not doing well at work
taking part in fewer social activities and avoiding contact with friends
neglecting your hobbies and interests
having difficulties in your home and family life

If any of these sound familiar and are present to any significant degree in your life or that of someone you love, there is a possibility that they are depressed. If you are concerned that this may be the case then you could find out more by going through the questionnaire that many doctors use to assess likelihood of depression, known as the PHQ9, you can find it at: http://www.patient.co.uk/doctor/patient-health-questionnaire-phq-9

If this, or any other experience, leads you to believe that you are depressed, please do something about it! This can often be the biggest struggle for someone suffering with depression as lacking motivation and an inability to achieve things can be major features of the condition, so sharing your concerns with someone close to you can be extremely helpful at this point as they can be motivated for you.

As you will have guessed by now, the obvious place to turn is your GP as they spend a huge chunk of their time dealing with people probably just like you – and they absolutely will not think that you are wasting their time. Many people find it very difficult to open up, but your GP will be on very familiar ground, no matter how difficult your own version of the depression story is to tell, and they will be able to guide you to tell them the information that they need in order to help you.

If you do not feel able to approach your GP for whatever reason – and can I please take this opportunity to say that significant depression is a perfectly good reason to request an urgent appointment rather than a routine one – there are a few alternatives. In particular, if you are reading this then there is a high chance that you are involved in a church, and most churches will have a number of people who will be able to help you.

If you do decide to discuss this with your GP they have essentially three things that they can offer you. First, if your depression is caused by , or aggravated by your work, or you just need some time out to deal with whatever it is that is getting you down, your GP can give you a ‘Fit Note’ advising your employer to let you have some time off.

The other things that a GP can typically offer are counselling and medication. I am not going to dwell on counselling here as the options available to you vary widely depending on local arrangements and policies, but counselling is an excellent option in any number of situations that lead to depression – from finding out exactly what is bugging you to dealing with it, or seeing it differently, or learning how to respond differently next time something negative happens to you, counselling has a lot to offer.

Regarding medication, there are many prescription drugs available to you and your GP will be able to advise if any of them are appropriate for you. Many people, Christians in particular, struggle with the idea of popping a pill for their mental health, and indeed it is not always the best option. But over the years I have prescribed antidepressant medication for many Christians – depression essentially occurs when serotonin, one of the body’s ‘happy’ hormones, reaches levels that are too low. If you were dealing with insufficient insulin (diabetes) or thyroxine (underactive thyroid), most people would happily take medical treatment for their condition. Serotonin deficiency (depression) can be helped by the Christian faith, counselling, exercise, support of close friends and family, and many other things, but sometimes medication is necessary – if your doctor recommends pills then please don’t disagree immediately, they may just have a point. And one of the most difficult things about living with depression is that it alters your perception of how you are, so do listen to the advice of trusted health professionals/friends if you are not sure.

In summary, depression is far too common a complaint in our society, and if you think you are affected please don’t fight the fight on your own – there are lots of people out there who can not only help but understand more than you realise as more people than you think have been through it themselves and will be very happy to do their bit to get you through!

Comments

  1. Mrs B Cummins on September 4, 2016 at 2:43 am said:

    can taking Statins increase possibility of depression, if so, what would you suggest I do to lower my cholesterol? thank you so much

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