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Depression

Depression: hope, advice and wisdom

Hope

First, many people we talked to wanted to make it clear that they had been severely depressed. That is, they know what it was like to be in absolute despair. Secondly, they stressed they were speaking from experience when they said that recovery from episodes of depression was not only possible, but probable. A woman who had a severe debilitating depression that lasted five years (she was on incapacity benefit all that time) felt qualified to talk about how life could be turned around and be enjoyed. It was pointed out that even though everything can look very bleak while depressed, people mostly recovered from depression, and things do tend to get better over time. Several people with severe depression had not realised early on that recovery was possible (see 'Getting better from depression'). They also said that recovery should be thought of as a gradual process.

 

While people may be sceptical, there is life after depression, and life can improve.

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Age at interview: 50
Sex: Female
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[Sigh] I would just like to say there is light at the end of the tunnel and I just know that people watching this who are really ill will just be thinking, "Oh yeah bog off you stupid old woman". But I felt like they may be feeling now, and I would never, ever have believed I could be this well. I am more well now that I have ever been in my life. My quality of life is better in terms of... I've got a bounce in my step. I have fun. I don't kind of live for weekends or live for holidays, I enjoy every day. And I guess there's stuff that sounds patronising like just take the best out of every day, but we only have one shot at life don't we? This isn't the dress rehearsal. This is it. You know, I have got well and I'm taking my tablets and I'm happily going to take them for the rest of my life. I'm not going to muck about with them.

 

Says people with depression should hang on during the worst of depression because things are...

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Age at interview: 68
Sex: Male
Age at diagnosis: 57
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Right well, I suppose the thing I would like to say is hang on in there, hang on in there. Most people, and I stress most people, do recover from depression. Of itself, it doesn't appear to be life threatening. But of course it can lead you to you know self harm if you so get that far along the line. But if you cling on to the thought that most people recover, and that you will get better. But it may take time, and I think I would just stress that you need hope, you need hope that it's not the end of the line for you. 

You very likely will get better but you need time. And you needn't be too hard on yourself and think that you're a failure and you've got it all wrong... you cannot see the end because your circumstances are such that you're locked into this cycle of hopelessness, you can't function, your brain doesn't function, and you can't believe then that you're going to be okay as a human being, in which case you've just got to hang on. 

It's lovely if you've got the support and encouragement of those around you, but you're not necessarily going to get that, and we needn't pretend that you will. But as I say most people do get better with depression.

Help seeking and giving

'Doing nothing' is probably not going to help. People emphasised that people who are very depressed need to get professional help rather than think they can do it on their own. Even if doctors seemed unable to understand, or provided poor help in the past, they are the first port of call. If nothing else a GP can help with medication and referrals to other professionals (see 'Help with depression: General Practice' and 'Help with depression: psychiatrists & other mental health professionals'). It was recommended that people try to find another doctor if the one they have is unhelpful. If you are not wanting medication, you can get other kinds of help, such as a referral for counselling.

 
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Strongly urges people with depression to get help from somewhere because outside help is...

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Age at interview: 39
Sex: Male
Age at diagnosis: 32
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I would strongly urge and recommend that they seek help. Don't suffer in silence. I mean for a long time I kept quiet about it, I did nothing about the depression and, believe me, it festers, it gets worse, it doesn't get any better. My advice to them is to, [pause] talk to somebody that you feel close to, somebody who you can confide in, a family member, a relative, a close friend and also to your GP. And get help, get counselling and try and get as much help and support as you can because there is no stigma to depression anymore, whereas for a long time in the past it was all covered up. It is recognised as a major illness now; it affects so many thousands of people. 

The only way that one can ever combat it and deal with it effectively is to actually get the help that they need and to be open about it. To be open about your feelings, and to be open about the symptoms, and to seek help in doing something about it.

 

Argues that the depressed person is the best person to overcome the depression, but they need to...

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Age at interview: 75
Sex: Male
Age at diagnosis: 35
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You are stuck. They are stuck with the professionals. That... that does not sound very complimentary to the professionals, but initially, they [sufferers] need to get help from wherever it comes. I would like to think that today, people are more compassionate than maybe they were when I was depressed. Perhaps they are I would think there were more skilled people about. And you need to take help from wherever you can get it, but equally it's [pause] Really, the bottom line is the person who's got it is the best person to overcome it. The only person to overcome it.

 
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Dissatisfied with his GP, he wrote to his local Primary Care Trust to get a new GP at a new...

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Age at interview: 30
Sex: Male
Age at diagnosis: 26
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I know that for instance down here with the [name removed] Health Authority ... all I had to do to get a new GP was to write to them saying that "I met this GP, I now wish to change" and they... 'cos I found that going to different GP surgeries, often I'd be turned away and they'd say, "Sorry, we've got too many patients", whereas somehow the Health Authority just force you into the books. So I wrote to them... So when I had my first sort of health check with the new GP I was just amazed, having had the previous experience of just being fobbed off by my GP. 

I went in complaining, for instance, of really, really bad headaches. It was always on one side of the head and I had convinced myself I'd got a tumour. But it was just the way he... He might have been thinking, "Oh, you're a hypochondriac, you're worried about nothing," but he actually went through and he explained everything. He said, "I'm going to do this test, and this test and this is why I am doing this test" and he said, "It's unlikely but...". And then he checked and said, "No, you have no symptoms of it, so it's probably just stress", you know. There was another skin condition I had that he explained what it was. He even gave me a printout of what it was, what causes it, "This is the medication I'm giving you, that's why it works, that's how it works, and that's what's going to happen after the treatment is finished". And he said to me that, "Whenever you feel that, you know, your headaches are coming back or are too persistent, then don't hesitate to come back and see me, and... similarly, if the depression ever relapses, come back here' we can refer you to the on-site counsellor".

 

Says doing nothing about depression does not help - it is better to try to be active in getting...

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Age at interview: 50
Sex: Male
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It's like a hole, it's sort of like slipping into a muddy hole and you're trying not to slide... trying to get up the sides and you keep sliding down again and you need help. I think that's what I would say. The periods of counselling I've had, self-help psychology, rebirthing. Things I've done have all helped, even going for physical therapies, like acupuncture, shiatsu, have helped, because you can talk to somebody sensible and they do give your physical system a boost, you know. I mean depression makes you feel different physically. It upsets your physiology in some way and doing those sort of things, going to the gym, doing exercise and things, getting out, doing something can help reverse that, and doing nothing never helps I've found. I mean I've tried just sort of giving in to it, just laying about and, "Oh, OK, eventually it will go", but you don't get anywhere with it.

It sounds like you been active in dealing with your depression?

I was thinking that before you came, you know, but I have been a positive person. I haven't just sat back and I haven't accepted drug treatment because I don't think they solve the problem. It may be that some people have chemical imbalance or something like that and that's a different matter. If the cause is physiological then maybe you need some drugs. But if the cause is psychological then you need to do something in order to think in a different way.

Some also stressed that in a deep depression you need to see a professional without delay, since you are probably not thinking clearly enough to really help yourself. Some emphasised the need to take action if medication was not working after the allotted time (e.g. ask for different medication, get referred to a psychiatrist who has more experience with medication). Several people pointed out that a wider network of help may be available to people in distress than they might at first believe. The advice to those who know a person who is depressed was to listen and offer practical help, including helping the depressed person in completing tasks, helping them to seek professional help, and advocacy. Interview 28 recommended the use of touch, “because when you're perhaps too ill even to speak, then you can be touched”.

 

Argues that very depressed people need to accept help from doctors, including medication, at...

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Age at interview: 75
Sex: Male
Age at diagnosis: 35
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I mean it obviously needs to be a medical person. And I've met with such a lot of kindness from the medical world that... you've got to trust them. And accept that they are giving you drugs for your benefit. You've.... you've nowhere to go. So your back's to the wall, so the only way to get better is to... let the medical people help. 

I mean I can judge situations in retrospect, but at the time, I was almost immobilised, inert really. Yeah it was.... I would sit in a darkened room with my arms over my head for hours, feeling so wretched I didn't want to eat or drink. So I was totally.... almost totally withdrawn, so you're not really able to make any judgements and that's it....
 
 

Urges very depressed people to get medical help without delay because they are not in a position...

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Age at interview: 31
Sex: Male
Age at diagnosis: 17
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You go and see the doc, you've got to go straight away... you won't do it without some help, it's as simple as that... you feel really alone, you feel weedy, you feel cack, you just think that you're no good. I would say that you're wrong [laughs]. Point one. And just accept you're wrong, say no that's wrong I'm probably.... also accept you're not well, and therefore you not thinking right, so anything you think now is probably not right. 

That's hard to do because we tend to trust what we think, especially if we think it is as powerfully as we do. But if you can just say, "No, actually at the moment, I'm ill and what I think is probably wrong," that's good... the voice that says to you bad things seems incredibly undeniable and it's not. And if you could just try and say, try to act as if it's not, then that's really good. And again you will not believe it, but you get better and not very, not very far away from now, you will feel better.
 
 

Advises those who are not responding to medication to ask for a different medication or for...

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Age at interview: 50
Sex: Female
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It isn't a one size fits all is it? You know, I think I would say to folk if you feel like you're not getting any better, and it's not a quick journey to get well anyway, but if you really feel after say three or four months on the particular medication that you are just not getting any better, go back to your doctor and ask your doctor to change, to consider changing your medication. Ask your doctor to refer you to a psychiatrist if you are not under a psychiatrist. 

And my personal experience is.... is go for a younger doctor who has had more recent training in the more modern anti-depressants. And particularly, I know, you read stuff about people saying Prozac has done this, done that, you know, but any drug, you know has some side effects you know, and don't let that put you off because living with depression is far worse than any side effects. And I... I don't have side effects I don't think. Perhaps I would say I'm not quite as sharp in my mind as I used to be, but maybe that's just because I'm getting older [laugh]. But I am certainly smart enough to be able to function extremely well and do a challenging job that demands my brain to work.
 
 

Argues that people in distress may have more help available to them than they think. (Played by...

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Age at interview: 33
Sex: Female
Age at diagnosis: 24
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There are so many people out there that I know that are in distress right now because they say that one in four people suffer from depression, so how many millions of people is that? There are more people who die through suicide than die in road traffic accidents and I don't hear much about suicide in the media. 

So what I would say to anybody who is reading this, and that is in distress, is that you're going through a process for a reason. And that may be difficult to read. You're having feelings, maybe thoughts and feelings that you think are unusual or that are distressing you, but help is out there. In lots of different ways, and lots of areas. 

I know in my local area there is a 24-hour mental health line now, and there is The Samaritans, there is Depression Alliance. There are people out there who are the same. Although you may not think it, your friends and family would want to know that you are in this distress and would want to help. 

You may think.... It may be difficult for you to reach out, and I understand that because I didn't for a long time. But I would really urge you to reach out if you can muster anything, reach out because there is help out there.

 

He needed a lot of help when very depressed, and says that friends and family can assist the...

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Age at interview: 33
Sex: Male
Age at diagnosis: 24
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I think realistically in the stage that I was, I was not capable of doing anything. It needed somebody around me to do the initiating... Say look, here is somebody who needs help. If someone could actually come and said you know, "Are you depressed?" "Yes." "Are you feeling suicidal?" "Yes." "Do you feel capable of initiating contact with anyone and asking help?" "No." That would have been the total of what I was capable of doing at the time. It really needed somebody else to make that contact for me and ultimately yeah, it was my wife saying, "You must go to the doctor, I will make the, the appointment. I will drive you there. I will take you there. I will sit in the, in the waiting room with you", but, "you need the help". It really had to come from somebody around me because I was incapable of doing it myself. 

And I wanted to finish by saying that the worst thing you can say to a depressed person is, "What have you got to be depressed about?" It is really as useful as saying to someone with hayfever, "What's the point of sneezing at flowers?" Depression is an illness over which a person suffering has no control. 

Instead of searching for a possibly non-existent reason for a person being depressed, if you know someone who is having problems, offer them positive help. Offer to help them open their mail, offer to help them with their daily correspondence, check that they are able to get up in the morning. When I was depressed I was unable to cope with many daily tasks, it was only with the help and support of those around me that I was able to function at all.

Develop a 'recovery attitude'

People recognised that it could be near impossible to think positively while depressed. However, as Interview 24 said, even when depressed, you can still try to cultivate a belief that you will eventually get better. Additionally, as Interview 24 and many others pointed out, the person with depression had to be the person to take responsibility for getting better. Even though others can help, when all is said and done, ultimately it was up to the person to get better.

 

Argues that those with depression ultimately need to take responsibility for recovery, although...

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Age at interview: 59
Sex: Female
Age at diagnosis: 19
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Have belief in yourself that you will get out of this. And what I often say to people constantly on the telephone when they say, people say, "They won't do this" and, "they won't do that." I say, "Well that's right, no-one else can do it for you. The only person that can actually bring you out of this is yourself". That was a very difficult concept for me to grasp... but I now know it, it's true. And so if I am the only one who can get me out of this pit of depression, then it is up to me to get on with it.

It is a case of not allowing yourself to forget that you can do something for yourself. You can get yourself out of it. In fact, the only person who can get yourself out of it is yourself, and no one else. It doesn't mean to say other people can't help you, therapists, medication, whatever, going to classes, there are other people who can help you. But you have actually got to do an incredible amount of work yourself. Developing that self-belief "I deserve the best".

Several people argued that, once they were feeling well enough, people with depression can help themselves by becoming the expert in their illness. Additionally, although it may seem strange at first, one way of developing a recovery attitude is to 'aim low'. One man in his 30s reconciled himself to “the possibility that my life might be absolutely dreadful”. This actually allowed him to be more positive and helped him in his recovery from a lifelong low mood and episodic depression which finally began to improve several years before he talked to us. Others talked about it as taking “little steps”, e.g. Interview 14 said “do a little thing and win, rather than trying to battle against a huge thing. I'm sure that's the way to do it, easy bites”.

 

Setting small tasks or 'mini goals' is a way of feeling you have achieved something, rather than...

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Age at interview: 24
Sex: Female
Age at diagnosis: 14
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Because I think that if I set goals for myself that are, unattainable, because I feel different on a daily basis, then I'll just set goals for myself to be disappointed. And therefore result in me feeling bad, which won't help. So, I set mini goals. I need to get to lunchtime. I need to get to home time. I need to get to here. I need to get to there. And then I come home and I just maybe... sort of think about all the good things I've had, try my best not to dwell on the bad things, try and still argue my chatterbox, still sort of trying to make head or tail of the situation. Still accepting that I might still need help, keeping up to date with my GP. Speaking to my counsellor whenever I need her across the phone.

 

Lowering expectations can be a way of feeling better about yourself.

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Age at interview: 35
Sex: Male
Age at diagnosis: 17
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I've also, because I've got to that low point I think, one thing I sometimes mention to people is that I kind of reconciled myself with the possibility that my life might be absolutely dreadful. I might have a really horrible life, and die having fulfilled none of my ambitions. And you know, you might think that might be gloomy but I think somehow being able to accept that, it was good because then anything positive is a bonus. So anyway, I've gone through that period of, that's probably it.

Another example of a recovery attitude is seeing depression as ultimately happening for a reason, and even as being a 'beneficial' way for the mind to protect itself, and ultimately guide you to finding better ways of living.

 
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As when an over-loaded fuse blows, she feels that depression has come for a reason, making her...

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Age at interview: 33
Sex: Female
Age at diagnosis: 23
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I think it's (depression) definitely made me stronger, definitely, definitely. Because I have been a bit perfectionist in the past but I'm, also I'm very honest, I can't kind of, I can't handle false, so I feel like I've been honest in that I've kind of gone with the flow and tried to... tried to deal with it, you know. I'm not... I definitely learned a lot from it. I think, I think it was almost like, what's, what's the thing when you know, like a fuse going, like a fuse going when, when there's overload or whatever. It's like a fuse going, it's for a reason, it's like you're body is telling you, stop, hang on, maybe you need to go, turn around, go in another direction. So, I think I've learned a lot and it's, it's been very useful, yeah.
 
 

Thinking about depression as a way of changing her life, rather than as the enemy, helped her...

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Age at interview: 58
Sex: Female
Age at diagnosis: 20
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It may be the lesser of the two evils. It may have a protective... Also if somebody is traumatised, I'm thinking of people who in the Second World War for example, who were in prisoner of war camps, they're traumatised, they keep having flashbacks. Maybe a period of depression protects them against unbearable pain. Although the depression itself feels unbearable at times, it may be protecting them from something even worse. That would do more damage. So...

So it can be seen as not the enemy?

As part of the whole story. No, not the enemy, not the enemy. It's not helpful to think of it as an enemy. And it's not helpful for me to think badly of myself because I'm depressed. It seems to me it's ok, in the sense, I am ok, not the whole of me is depressed, a part of me. This depression is a manifestation of a malaise, of a need to become more whole. That's how I look at it. If I am depressed, then I have the opportunity to change. I get to a point, when the depression is not so severe, I get to a point, and only I know when that is, and I know in my bones, when I can choose either to change certain ways I live, attitudes I have, or to go back to the old ways which will probably result in another depression. It's rather like having a dream, which is telling me something. I take no notice so it recurs and recurs until I do.
 

Last reviewed September 2017.

Last updated October 2012.

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