Depression

Recognition and diagnosis

Some people had-had only one episode of depression, others multiple episodes. For many it had taken years for their depression to be recognised. It was common for people to say the diagnosis was made when they were an adult, yet they believed they had depression as early as childhood. People commonly felt different from other children in ways they could not easily name (e.g. loneliness, feeling an outsider, anger, sadness, mood swings, anxiety, fear), but which they later linked to depression. Such early symptoms of depression were not readily apparent to adults, although one man did say that a teacher realised there was a problem, and suggested he should see a school counsellor.

One difficulty in the recognition and diagnosis of depression is that people often find it hard to articulate their feelings. A number of people described this feeling as if they were 'locked in'. One woman described this locked in experience as 'terrifying because I could not get across to people how I was feeling'. Additionally, unlike a broken leg, outsiders cannot directly see depression. This makes depression hard to spot, unless a health professional is specifically looking for it.

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People frequently tried to appear as if they were coping when depressed. And even when people did try to explain how they felt, friends and family often suggested that it was a temporary response to stress, or due to being physically run down. Although some said they were desperate for someone else to notice how bad things were, others very much wanted to believe their friends and family were right. To get a diagnosis people usually had to 'make the first move' and visit their doctor. People often reported physical ailments associated with their depression (e.g. gastric upsets, sore backs, extreme tiredness), which could make it even harder to diagnose depression.

Not only was it difficult for people to understand that their symptoms meant depression, but doctors sometimes seemed reluctant to make the diagnosis. It was felt that GPs could easily mistake the symptoms of depression for other conditions such as post-exam stress or just trouble sleeping. When the seriousness of their depression was not recognised, people could suffer in silence. Such people were often angry about remaining unheard. They felt that an earlier diagnosis and/or recognition of the severity of their condition could have made a real difference to their lives. One woman (who did get a diagnosis) felt that the seriousness of her condition was not adequately acknowledged. Some people with a diagnosis of depression felt they also suffered from hypo-mania or mania, which their doctors did not recognise.

Resisting the diagnosis of depression was partly about the stigma attached to depression, but also about trying to avoid the implications. One woman who eventually got a diagnosis saw it as a double edged sword' she was concerned that her medical records now said, 'Psychiatrist all over it,' but she was also grateful she was finally being taken seriously. One young woman did not want a diagnosis of depression because her father had depression and she saw it as stigmatising and spent her childhood 'trying to be completely different to him'. Sometimes, the experience of depression was considered so horrible that people preferred to deny they were depressed. One man explained he did not want to know that he had descended into depression, and so denied the possibility to his doctor when he initially went to see him about sexual problems.

It was striking how some people managed to struggle on with depression even with severe symptoms. Sometimes only a crisis (e.g. suicide attempt, inability to work) made them take notice. For instance, a number of people were alarmed enough about their attempts at suicide that they finally saw a doctor.

Last reviewed April 2015.

Last updated October 2012.

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