Know the signs: How to deal with depression

While feeling a bit down in the dumps or emotional is a perfectly normal way to react to bad news, grief or stressful situations, experiencing these feelings for long periods of time could be a sign of depression. Between 10 and 15 per cent of older people experience depression, but this figure could actually be a lot higher because stigma prevents many from speaking to a health professional about their mental health and taking it seriously.

“There certainly has been, in the older generations, reluctance to acknowledge mental health problems, to see those kinds of loneliness and daily struggles as being mental health problems,” Rachel Bowes, Executive Director Operations of Crisis Support and Practice at Lifeline, previously told Starts at 60. “It’s certainly becoming less and less as mental health problems are becoming more openly spoken about and people are encouraged to seek help and recognise when they might not be feeling well.”

What causes depression and what are the signs?

There’s no one single cause of depression and people can experience it as a result of changes to brain function, in response to a serious health issue, due to feeling lonely or isolated, problems with their relationships or changes to how people feel about themselves. People can also experience a range of symptoms that impact their feelings, behaviour, physical health and thoughts, so it’s important to know that feeling sad isn’t the only sign of depression.

According to Beyond Blue, people with depression may feel sick and run down, experience headaches and muscle pain, lose or gain weight and feel tired. They may also experience other emotions such as irritability, guilt, disappointment, a lack of confidence, as well as losing interest in things they love, having difficulty concentrating, withdrawing from social activities and becoming dependent on alcohol and drugs.

“A short but prolonged period of experiencing symptoms like feeling a bit sad, feeling tearful, feeling empty, having a reluctance to leave the house or talk to people, staying in bed for longer, but sleeping more and significantly sleeping less can both be signs of depression and other mental health problems,” Bowes said.

“Most doctors would say you need to have symptoms consistently for a couple of weeks.”

Can exercise reduce depression?

While exercise and physical activity can have a positive impact on our physical wellbeing, research shows that it may also play a role when it comes to reducing depression and keeping symptoms at bay. For example, research from the University of Adelaide in 2018 found that stopping exercise can increase depressive symptoms.

Current guidelines recommend being active for most days of the week and completing 150 minutes of moderate intensity exercise such as water aerobics, brisk walking or dancing a week to prevent depression or 75 minutes of vigorous intensity exercise such as cycling, swimming, running or tennis.

Meanwhile, a landmark study led by the Black Dog Institute found that even small amounts of exercise can protect against depression and mental health benefits are seen regardless of age or gender. Researchers found just an hour a week was enough to reduce symptoms and 12 percent of cases of depression in the study could have been prevented if participants undertook just 60 minutes of physical activity each week.

How do psychological treatments work?

Also known as talking treatments, psychological treatments can help people change the way they think and cope with stressful or upsetting situations. According to Better Health, the main types of treatment in Australia are cognitive behaviour therapy (CBT), interpersonal therapy (IPT), behaviour therapy and mindfulness-based cognitive therapy (MBCT).

CBT helps people understand their behaviour and thoughts and how they affect them, while IPT focuses on relationships and problems in them that could be causing them. Behavioural therapy is similar to CBT but encourages rewarding activities, while MBCT uses techniques such as mindfulness and meditation to overcome negative emotions and feelings.

“There’s a huge amount of help and support available and don’t be worried or embarrassed about reaching out for help,” Bowes explained. “A GP is a really good place to start because they will know what to look out for and certain things will ring alarm bells for them or be indicative that something else needs to happen.”

Is medication always needed to treat depression?

Not everyone who experiences depression will require medication but for people who are diagnosed with moderate or severe cases, a health professional may prescribe antidepressant medication when other treatments fail. There are a variety of medications on the market and a health professional will assess each individual scenario and which medication is likely to be most effective.

Doctors may trial a variety of different medications to find one that is best suited and one with the least amount of side effects – which can range from weight gain, dry mouth and headaches to anxiety, dizziness and sexual dysfunction. Selective serotonin reuptake inhibitors (SSRs) are the most commonly prescribed antidepressants in Australia, but others that may be prescribed include serotonin and noradrenalin reuptake inhibitors (SNRIs), reversible inhibitors of monoamine oxidase (RIMAs), tricyclic antidepressants (TCAS), noradrenaline-serotonin specific antidepressants (NaSSAs), noradrenalin reuptake inhibitors (NARIs) and monoamine oxidase inhibitors (MAOIs).

What other help is available?

There are many different mental health organisations in Australia that offer online and telephone support and resources for people in need.

If you need someone to talk to, there are many 24/7 support lines available, including Lifeline on 13 11 14, the Suicide Call Back Service on 1300 659 467, MensLineAustralia on 1300 789 978 and Beyond Blue on 1300 224 636.

“Websites like The Department of Health has a great one called Head to Health that has a great amount of resources, particularly around mental health. Sane and Beyond Blue – all those organisations really do offer some great online resources and telephony ones,” Bowes said. “Things like Lifeline. We have online web chat, as well as the phone calls. We can provide support and advice through those channels and just a listening ear if people need them.”

In many cases, these organisations and resources will encourage people to still speak with a GP or health professional, but may also recommend people talk to their family members and loved ones as well.