What is depression? By Dr Sue Bagshaw and Michael Hempseed

  • 11 September 2018

In the last few weeks, there has been a great deal of talk about “what is depression”. Many people think that depression is just an emotion, that is equal to anger, or opposite to happy. We don't call anger a mental illness, so why do we call feeling sad and down an illness?

Depression is a very real and, in some cases, a very serious illness; not an emotion, evil spirit or a sign of weakness. Researchers have found that a part of the brain called the hippocampus, which is responsible for memory and emotion, seems to be most affected by depression. The hippocampus can shrink and change by 17%. Just imagine if an All Black woke up with one leg much shorter than the other, we wouldn’t say it’s just imaginary.

Depression often starts in people under 25 years old but it can affect all ages, genders, and ethnicities. It is the most common mental illness in the world according to the World Health Organisation.

People with depression can lose all enjoyment in life and might give up many of the things they enjoy like playing sport, enjoying art or meeting up with friends. Depression can also affect a person's ability to concentrate, making small choices, like choosing which breakfast cereal to buy, overwhelming.

For many people with depression everything becomes negative, and in spite of many assurances they may feel worthless, a burden to others, and find it hard to think of anything positive. Depression affects the whole body, not just how someone feels. Sleep and appetite are affected which often results in a sense of exhaustion, making it hard to do things such as walking upstairs or having the energy to get out of bed. People’s energy and urge to take care of themselves such as washing or dressing well may also be affected.

All this happens because of an illness that changes a part of the brain that we cannot see. Does that mean that there are no signs?

There can be clear and visible signs that someone has depression. Some people do hide their depression really well and no one will notice. But for others there can be visible signs, like looking sad or being angry all the time. Often the most important thing to look for in a person is a change. They may slowly withdraw from activities they used to love, or start to be late, or look dishevelled.  They may not know they have depression, and it could be a friend, a family member, a teacher or employer who simply says, “I’ve noticed you don’t seem to be yourself, have you noticed this too? Would you like to talk?” This support, rather than telling them to “pull your socks up and cheer up” is important.

You can also support them by encouraging them and helping them to access professional help. There are many different talking therapies. Sometimes lifestyle changes like diet, a proper sleep routine and exercise are helpful but when the person is ill they don’t have the energy to do those things and medication may be needed.

Treatment works, and we need to help people with depression to understand and believe that. If we spend more time with each other and listen to understand we could help catch illness early.

The most important thing that anyone needs to know about depression is that there is hope and there is a way through this.

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