Depression and Suicide

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About 10% of the population experience depression at any one time, most commonly together with anxiety [1]. Depression affects everyone from top CEOs and rock stars to blue collar workers and students. Depression isn’t limited by age, location, or economic status – it can affect anyone.

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For people with a dental phobia, the combination of dental fears and depression can feel overwhelming. You are not alone and you are not unusual! Both depression and dental phobias are very common. If your depression is due mainly to dental phobia, you may find it disappears once you have tackled the phobia. Also, 4 out of 5 people who experience depression recover without treatment within 2 years (though therapy or treatment can help prevent relapses and make the duration shorter).

Even if you don’t fully recover – many people very successfully live life with depression, and depression need not stop you from doing things that are fulfilling and meaningful. It can also be an opportunity for personal growth. It’s not something to be feared – accepting it and developing strategies to live with it are important and can be very empowering.

Depression or Unhappiness?

In today’s society, sometimes feelings which used to be interpreted as unhappiness are now labeled as a medical condition of sorts – under the umbrella term of “depression”. If you feel down because you are unhappy with certain aspects of your life (or even all aspects of your life), then trying to make changes to the things you are unhappy with can help. Sometimes, it feels as if change is impossible. It can help to enlist the help of a counselling psychologist if this is the case, and together figure out whether there are things that you can change, and whether making these changes would make you happier. Sometimes there is not much you can change about your situation because of circumstances outside your control, but circumstances can and do change and you may find a much brighter future lying ahead.

Am I Depressed?

The following are some of the signs that you may be depressed:

  • Inability to sleep or sleeping too much
  • Loss of interest in things that used to excite you
  • The desire to isolate from other people
  • Sudden loss or increase in appetite
  • Overwhelming and persistent feelings of guilt, sorrow, worthlessness and/or self-loathing
  • Feeling tired or fatigued almost every day
  • Persistent feelings of hopelessness
  • Persistent thoughts of self-harm
  • Recurrent or frequent thoughts of death and/or suicide (whether specific and planned or non-specific) and/or suicide attempts
  • Difficulty concentrating or making decisions

Of course, some of these feelings are part of everyday life and experiencing them does not necessarily mean that you are depressed. They can be a normal reaction to difficult circumstances.

I think I am depressed. Now what?

There are several steps you can take:

Self-Help

Confiding in friends or significant others about how you feel is a great first step. Having someone who supports you can ease the burden of depression tremendously. Who knows, you may be able to someday repay the favour!

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If you do not have anyone you can confide in, the internet can also be a good place to get social support (for example, the Mental Health Forum). Make sure that the internet community or communities you choose make you feel welcome and safe, and protect your identity by using a fake name.

Exercise has been shown to help alleviate symptoms of depression. If possible and if it’s safe for you to do so (from a health perspective), aim for half an hour’s exercise a day (e.g. fast walking, jogging, cycling, gym, swimming, or anything you might enjoy). A beginners’ yoga class can be very relaxing and can also be done if you are unable to do more vigorous sports. You can find more information in the booklet Up and Running – How Exercise can Help Beat Depression by the Mental Health Foundation.

Engaging in activities which help others or which benefit the public can be a huge help, too, and is often overlooked. Being part of something bigger thanĀ  yourself, while still feeling the impact that you can make personally in the world, can greatly help with alleviating some forms of depression or unhappiness. There may be various volunteering opportunities in your area, or you can try and find novel ways of making a difference yourself.

Professional Help

If you are experiencing signs of depression on an ongoing basis, contact your doctor. Depression can be due to various physical causes, for example an underactive thyroid, low blood sugar, celiac disease, or sleep apnea. If you don’t know what is causing you to feel depressed, your doctor can check if there is a medical reason.

Depending on your symptoms, the severity of the depression and the circumstances (external causes or sad feelings that come “out of the blue”), your doctor may suggest some form of talking therapy, antidepressant tablets, or both.

Some people don’t like the idea of medication, some don’t like the idea of psychotherapy. So, there is obviously a degree of personal choice.

Talking therapies include:

  • Cognitive Behavioural Therapy (CBT): This can help you deal with negative thoughts and behaviours which are often a feature of depression.
  • Psychotherapy/Counselling: Talking freely about your feelings to someone who is non-judgmental can be very helpful.
  • Mindfulness/Acceptance and Commitment Therapy (ACT): ACT emphasizes identifying what is important to us and living our lives in accordance with our values. ACT is a relatively new form of therapy and not widely available. However, the principles behind it have been adopted by many psychotherapists, who integrate them into their practice. A central component of ACT is mindfulness, which is also used in Yoga and some forms of meditation. Mindfulness is the practice of simply being aware of thoughts and emotions, rather than getting caught up in them or analyzing their meaning. Read more about mindfulness-based cognitive therapy here.

The following links may help make it easier for you to talk to your doctor:

  • Talking to your Doctor about Depression – discusses depression from your doctor’s point of view. Did you know that depression is one of the most common reasons people see their doctor? In fact, most doctors treat at least one case of depression every day. This link provides an overview of how your doctor can help you to feel better.
  • Questions to Ask Your Doctor – provides a list of questions to ask your doctor.

If your doctor is not as helpful as you would like, or his ideas are at odds with your own outlook and philosophy (and s/he’s not open to discussion), find another doctor!

If you are in the UK, you can go to your local Mind office. They may be able to provide support directly or at least steer you in the right direction.

You may also want to check out this link on finding the right therapist.

Where can I look for further information on depression on the internet?

You may find some of the following resources on depression to be helpful:

  • The Royal College of Psychiatrists (UK) Leaflet on Depression – this leaflet describes what it feels like to be depressed, how you can help yourself, how to help someone else who is depressed, and what help you can get from professionals. It also provides a range of links to organisations which can help you in the UK.
  • Depression and Bipolar Support Alliance – This site provides a range of solid information specifically focused on these two mood disorders.
  • All About Depression – General coverage of depression issues.
  • The Depression Center – An interactive website dedicated to helping those who suffer from Major Depressive Disorder. Features “The Depression Diary” (a software application that helps track your mood) and a professionally moderated online support group.
  • MoodGYM – Excellent (and free) web-based programme of CBT addressing depression and anxiety. Heavy use of Flash means it will be more accessible to those on higher-speed connections.

I am thinking about harming myself or taking my life

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Thoughts of suicide or imagining suicide don’t necessarily mean that you want to die. Sometimes it’s just a question of considering all the options. We often weigh up a lot of different factors in making decisions but that doesn’t mean that we would act upon some of them. For example, if we are in debt we would consider taking advice, buying a lottery ticket, running away, facing up to the problem. Running away and buying a lottery ticket aren’t good options but we’d still probably think of them.

Although things seem bleak, there will be a way through. Hotlines are available all over the world and are staffed with people who want to talk to you – people who care. The people staffing the hotlines understand what you are going through and they will not judge you. Whether you feel like you just need someone to talk to or you are in danger of harming yourself, the hotlines and resources below can provide help and support:

UK and Ireland
  • Samaritans – a hotline available to residents of the UK and Ireland. Call 08457 909090 in the UK, 1850 609090 in the Rebublic of Ireland or email mailto:jo@samaritans.org
  • In England and Wales, you can phone NHS Direct and NHS Direct Wales on 0845 4647 for any concerns that you have about your health that are not an emergency. In Scotland, call NHS 24 on 08454 242424. These are 24-hour services
  • If your life is in danger, go to your local accident and emergency department or call 999
US
  • National Suicide Prevention Lifeline – hotline service for residents of the US. Call 1-800-273-TALK (8255)
  • Look for “Crisis Prevention Centers” or “Suicide Prevention Centers” in your yellow pages
  • If your life is in danger, visit an emergency room or call 911
Canada
  • Suicide Prevention Canada – Click on a province for a listing of crisis centers in your area
  • Look for “Crisis Prevention Centers” or “Suicide Prevention Centers” in your yellow pages
  • If your life is in danger, visit an emergency room or call 911
Australia
  • Lifeline – Offers 24-hour telephone counselling – you can call Lifeline from most parts of the country for the cost of a local call on 131 114
  • If your life is in danger, visit an emergency department or call 000 (112 on cell phone)
New Zealand
  • Lifeline New Zealand – Offers free 24-hour telephone counselling on 0800 543 354.
  • If your life is in danger, visit an emergency department or call 111
International
  • Befrienders Worldwide – An affiliate of the Samaritans. Provides resources and hotlines around the world.
  • If your life is in danger, visit your local hospital or call emergency services
Book recommendations:

Mind Over Mood: Change How You Feel by Changing the Way You Think by Dennis Greenberger, Christine Padesky

Undoing Depression by Richard O’Connor

The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by J. Mark G. Williams, John D. Teasdale, Zindel V. Segal, Jon Kabat-Zinn

Other resources which might be of help:
  • Depression Alliance (UK) – This UK-based charity offers a wealth of information as well as a supportive pen pal service.
  • Relate (UK) – Relate is the leading UK organization for relationship counselling. If you are depressed because of relationship problems, check out their website.
  • Victim Support (UK) – Victim Support is the independent charity which helps people cope with the effects of crime. They provide free and confidential support and information to help you deal with your experience.