Tony Bates: Signs of depression

If you think you may be suffering from depression, or know someone who may need your help, here’s a list of the most common symptoms of depression from Tony Bates’ bestselling book. Don’t be afraid to seek help!

Who gets depressed?

It is estimated that about 20 per cent of us become clinically depressed at some point in our lives. This figure seems to have stayed the same over the past 50 years. When you consider that people are experiencing depression earlier and earlier in their lives, and that it recurs in over half of those who experience it, then it is clear that there are far more people suffering from depression on any given day, then one might realise.

One remarkably consistent finding in studies across different continents has been that women are about twice as likely to experience depression as men. The highest incidence of depression in women is among those in the 20-40-year age group. However, men and women become depressed in equal numbers where they are in similar roles, such as in student life or in professional careers.

In spite of its frequency, only one in 10 of the people who become depressed seek professional help. Sometimes this is simply because people do not know where to turn up for help, but, for many, their lack of help-seeking is because they feel ashamed, and they fear how others will judge them if it comes out that they had any kind of ‘mental health’ problem. The stigma that has surrounded talking about mental health is lifting as we speak more openly about the way mental suffering touches all our lives and hear from people who have recovered from all kinds of mental health difficulties. We are beginning to see how experiences like depression can deepen our lives and make us more compassionate towards ourselves and others.

Signs of depression

Depression is characterised by a particular set of changes in how person thinks, feels and behaves. As well as being an experience of intense psychological suffering, a person’s sense of physical wellbeing is greatly affected, and sleep, appetite and energy levels are al disturbed. The primary signs or ‘symptoms’ of depression are discussed below. The symptoms are categorised and grouped according to their impact on our thinking and our feeling; and on our behaviours and our physical health.

THOUGHTS:
• Extreme;
• Self-criticism;
• No self-confidence;
• Indecisiveness;
• Inability to concentrate;

PHYSICAL SYMPTOMS:
• No energy;
• No pleasure;
• Reduced appetite;
• Sleep disturbance;
• Weight gain/loss;
• Unexplained physical pains;

FEELINGS:
• Sad;
• Confused;
• Frightened;
• Guilty;
• Ashamed;
• Trapped;
• Inadequate;

BEHAVIOURS:
• Inactivity;
• Procrastination;
• Restlessness;
• Withdrawal from others
• Excessive dependency;
• Irritability;

Checking your mood

What have you learned from the above? Do you recognise something of your own experience of depression? Perhaps you have been afraid to acknowledge that something is wrong. You can name what is happening, no matter how painful that may be. It may be that the place you’re in is extremely difficult, and that you are experiencing depression, that you’ve realised how real your problems actually are, and that you are now in a position to begin to address those problems. It is also possible that you are not depressed, but that you are hurting in your life because of the challenges you are trying to face that are difficult and painful.

Sometimes we need to stop and be honest with ourselves about the reality of our lives, in order to identify the strains that are affecting us, and to start taking some new steps to deal with them. Often, doing something, which may be very small or simple, can make a big difference towards easing the pain of our difficulties.

The list below identifies the 12 most common symptoms of depression. To help you clarify what your experience of depression may or may not be, look at each symptom and tick ‘Yes’ to any of the symptoms that describe how you have been feeling, for most of the time, over the past two weeks (or longer).

Checklist of the most common symptoms of depression

Indicate which of the following, if any, you’ve experienced over the past two weeks by ticking yes or no.

1. Have been feeling down most of the time. YES __ NO __

2. I get no pleasure from the things that normally mean a lot to me. YES __ NO __
3. I feel tired all the time. YES __ NO __
4. I can’t concentrate and remember details. YES __ NO __
5. I have lost weight quite dramatically. YES __ NO __
6. My sleep is disturbed and doesn’t leave me feeling rested. YES __ NO __
7. I am more irritable than usual. YES __ NO __
8. I have lost all confidence in my ability to make decisions. YES __ NO __
9. My thoughts are mostly self-critical and gloomy. YES __ NO __
10. I feel guilty without really knowing why. YES __ NO __
11. I feel sensations in my body that trouble me. YES __ NO __
12. I have thoughts of killing myself. YES __ NO __

If you have ticked ‘Yes’ to either of the first two items and ‘Yes’ to at least four of the remaining items, this suggest that you may be experiencing depression. The higher the number of items you ticked, the more severe your depression.

Pay particular attention to your answer to question 12, the last item on the checklist, which relates to suicidal thoughts. While it is common for people who are depressed to think that everything would be somehow easier if they were dead, it is important to emphasise that if these thoughts are more than just occasional, or if they have progressed to where you are actively thinking about ways to ‘end it all’, then it is imperative that you seek professional help, or contact one of the helplines (www.aware.ie, www.headstrong.ie, www.pieta.ie, www.samaritans.org). Your GP is probably the most appropriate and accessible person for you to consult because he or she can direct you to someone who can help.

’Coming through Depression’ by Tony Bates has been written for all who suffer from depression and for those who are close to the depressed person, be they partner, child or friend. While intended primarily as a guide to recovery for the sufferer, it is also written with the relatives and friends of the sufferer in mind in the hope that it can make sense of what can be a difficult problem to grasp from the ‘outside’. Understanding of the problem by all who are affected can act as a bridge between people who feel isolated by depression and those who care about them.

We have three copies of the book to give away! Simply enter your details here, adding COMING THROUGH DEPRESSION as a subject line!

Tony Bates is Founder Director of Headstrong, the National Centre for Youth Mental Health. Prior to this he worked as Principal Clinical Psychologist at St James’s Hospital in Dublin and has more than 30 years’ experience in the area of mental health.