One million Australian adults suffer from depression. The condition costs our economy $3.3 billion in lost productivity each year and is a factor in early death by suicide, injury and cardiovascular disease. So how can you tell if you’re depressed or just feeling blue? And what can you do about it? Nicole Senior investigages.
What is depression?
Everybody feels down in the dumps now and then. Termed ‘normal depression’, this usually resolves in a day or two. ‘Clinical depression’ is defined as a disabling and pervasive sadness that persists for most of the day, most of the week, for over two weeks. There may be reduced energy and tiredness, loss of interest in normal activities, low self-esteem, and sleep and appetite changes. Depressed people are often physically unwell, as the immune system, hormones, heart and gut can be affected.
Who gets depressed?
Depression is one of the most common mental health problems with one in five people experiencing depression at some time in their lives. Around 6% of people will experience a severe case of the condition.
Depression is most common between the ages of 18 and 44 years, and women are diagnosed more frequently than men. National research by SANE Australia, published in the Pfizer Health Report, found that people with chronic illness are twice as likely to develop depression.
Children and teens are not immune - about 20% of young people will experience one or more episodes of major depression by adulthood.
What causes depression?
While depression is an illness associated with an imbalance of chemical messengers (neurotransmitters) in the brain, other factors also play a role.
Negative life experiences, stress, use of drugs and alcohol, personality traits, and relationship pressures all play a part.
The death of a loved one or being the victim of prolonged abuse can be a trigger, and personality traits such as perfectionism can make people more vulnerable.
Depression can run in families, but in some cases it occurs seemingly at random.
Depression can be treated
Less than half of people with depression seek professional help. But, like asthma or allergies, depression needs to be seen as just another health problem that can be treated.
The first port of call is a visit to your GP to assess the condition and recommend appropriate treatment. For mild depression, professional counselling and lifestyle measures may be enough. For moderate or severe depression, the combined approach of psychological therapy, such as CBT (cognitive behavioural therapy) and/or medication may be helpful.
Antidepressants that influence serotonin or noradrenalin levels are usually the first-line treatment. Reading a good self-help book based on CBT can also be effective in treating mild depression, says UK research.
Medicare now offers easier access to treatment, such as visits to a psychologist – so talk to your doctor. Luckily, many people with clinical depression will recover fully and, with effective treatment, recover faster.
Depression and exercise
Exercise is an effective treatment for depression, and may prevent relapses. While being physically active reduces the risk of depression occurring, around half of adult Australians are not active enough to obtain health benefits.
You need to do at least 30 minutes of moderate-intensity physical activity on most, if not all, days. Moderate intensity activities include walking, cycling, housework and gardening – any activity that moderately increases your breathing and heart rate.
You don’t have to do the 30 minutes all at once. You can accumulate several bouts of 10 or 15 minutes throughout the day. Doing more than this – or including some vigorous activity such as jogging or aerobics – will provide even more benefits.
When it comes to physical activity, a little is good, but more is definitely better.
Depression and weight
Depression can make people more inclined to overeat for comfort, and less inclined to exercise – leading to weight gain. Being overweight can lead to loss of self-esteem and create poor mood in itself – all of which creates a vicious cycle. To break the cycle, schedule healthy routines of shopping, cooking and exercise. Ask family and friends to help ensure it happens. Having shortcuts on hand, like healthy frozen dinners, can be a big help.
Eat better, feel better
Certain nutrients may help prevent and treat depression by influencing the chemical balance of neurotransmitters in the brain.
Consume carbohydrates for a better mood
The contentedness you feel after a carbohydrate-rich meal, such as pasta, is due to the boost in serotonin levels. Keep up your serotonin supply by eating regular meals of carbohydrates like bread, cereal, rice, pasta, legumes, fruit and dairy foods.
Keep up your tryptophan
An amino acid that also boosts serotonin, tryptophan is found in turkey, chicken, beef, brown rice, nuts, milk, cheese and eggs. To ensure a ready supply, include protein-rich food at every meal. For example, milk or yoghurt at breakfast, a turkey sandwich at lunch, and lean meat, brown rice and vegetables at dinner.
Boost your B-vitamins
Folate, vitamin B6 and vitamin B12 help maintain production of neurotransmitters and low levels may contribute to depression. Find folate in green leafy vegetables, oranges, wholegrains, chickpeas, yeast extract and nuts. Rich sources of B12 are found in animal foods such as meat and fish, eggs and dairy foods. It may also be added to vegetarian meat substitutes and some soy milks. Keep up B6 levels by eating potatoes, salmon, chicken, spinach, bananas and certain breakfast cereals.
The good oils – omega-3 fatty acids
A study published in the Australian and New Zealand Journal of Psychiatry showed supplementing with fish oil (EPA) was as effective as an SSRI drug (fluoxetine) for major depression, with best results from a mix of both. Aim for the increased Suggested Dietary Target of long-chain omega-3 fats recommended by the National Health and Medical Research Council: 610mg for men, 430mg for women, or two to three serves of oily fish a week.
Commonly asked questions
Do antidepressants cause weight gain?
Weight gain is not an expected side effect in the most commonly used serotonin or noradrenalin-type antidepressant medications (SSRIs and SNRIs), however there are other types used for severe depression that typically cause moderate weight gain (for example, Mirtazapine). Antipsychotics and mood stabilisers used to treat other mental illnesses are more likely to cause significant weight gain.
Do herbal medicines work?
St Johns Wort (hypericum perforatum) is an effective herbal antidepressant. However, it is vital to discuss this with your doctor as it can interfere with other medications.
Does alcohol affect antidepressants?
Many people drink more alcohol when they are depressed in an attempt to feel better, however this carries a risk of harm. Alcohol can also interfere with antidepressant medication and cause unwanted weight gain, not to mention the negative effects of a hangover on mood.
A sad fact: Depression is now accepted as a risk factor for coronary heart disease, similar to the risk posed by smoking or high cholesterol.