HEALTH Depressed? Help is out there

SEEK SUPPORT Asking for help with depression could be the best thing you have ever done for yourself. 

Depressed? Help is out there


Doctors insight
Dr Ronan Clancy

The lull of January often leaves people feeling a little blue. A vacuum in the wake of Christmas, the blues of over indulgence, dark cold weather with little natural sunlight and for many the daunting realisation of unemployment, mounting bills and financial stresses early in a new year all contribute.
These feelings should be short lived and manageable, disappearing as the year progresses. For some, however, they are part of a continuum of chronically low mood.
Depression is a mood disorder in which the predominant feelings are of sadness. It can occur as a consequence of adverse life events, such as bereavement, ageing and loneliness, financial and social stresses, and also due to drug or alcohol misuse. In this context it can be termed reactive depression and generally resolves after a period of time and the right support.
In the absence of such conditions or life events it is referred to as endogenous depression and is believed to be due to reduced levels of certain chemicals called neuro-transmitters produced in the brain. They are responsible for all aspects of brain function, including mood control.
Unlike a reactive depression, endogenous depression occurs on a continuous basis and tends to be potentially much more severe. Common patterns of endogenous depression include recurrent depressive disorder, persistent affective disorder and bipolar affective disorder.
Recurrent depressive disorder describes the tendency of an individual to suffer recurrent episodes of depressed mood with intervening periods of recovery. Depressive periods may range from mildly low mood with sad feelings and negative thoughts to severe feelings of worthlessness, guilt, futility of the future, suicidality and sometimes even psychotic behaviour (delusions, extreme paranoia or hallucinations).
In other instances, persistent affective disorder, such as cyclothymia and dysthymia, occur. In these a person will experience cyclical or constant mild depressive symptoms on a cyclical or constant basis respectively. The important difference with such conditions is that they generally don’t significantly affect the person’s quality of life or day to day functioning.
Depressive symptoms also occur in bipolar affective disorders, which I will discuss in more detail in a subsequent article. Briefly, in bipolar affective disorder, depressive symptoms will predominate, but there are periodic swings to elevated, high, elated or manic mood symptoms.
The accompanying table summarises the principal mood and physical symptoms of a depressive disorder.
Unfortunately in Ireland, depression and sadly suicide is highly prevalent at around 500 suicides per year. Alarmingly, male suicides, particularly young males, outnumber female suicides by a ratio of four to one.

The broad screening questions I use to detect possible depression are:
•    During the last month, have you often been bothered by feeling down, depressed or hopeless?
•    Have you lost interest or pleasure in doing everyday things and does coping with everyday life seem more difficult now?
•    Do you feel yourself withdrawing into yourself?
•    Are you having difficulties sleeping?

If the answer is yes, or if you are experiencing some of the  symptoms listed in the table, you may be suffering from a depressive disorder and you should contact your doctor, who will assess the cause, severity and treatment options available. These include psychological treatments, counselling, education and support as well as medication.
Obviously, if you are or someone you know is experiencing suicidal thoughts or plans, or is severely affected by some of the above symptoms, urgent assessment by a doctor is required due to the immediate risk of harm to self or others.
Depression is a common and treatable human condition that many of us will suffer during the course of our lifetime. It is an illness just like any other, and no shame or stigma should be attached to it.
GPs are highly trained and readily available to assess, advise, support and initiate a treatment if you are suffering from a mood disorder in an environment of absolute privacy and confidentiality. The help and supports are out there, it’s a matter of asking for it.

For more information on depression, visit www.aware.ie or www.yourmentalhealth.ie.

Dr Ronan Clancy is a GP at the newly opened Clancy Medical Practice, James street, Westport
(www.westportgp.ie). He is in practice with Sarah Kavanagh, chartered physiotherapist.