January 20

The Ultimate Guide to Understanding (and Overcoming) Unipolar Depression

Stress and Anxiety

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You feel exhausted and have no motivation.

You can’t focus and you’re restless, irritable and agitated.

There’s a dense darkness that hangs over your thoughts, saps you of energy, and makes your days challenging to face.

“What is the problem?” you ask, “Why do I feel so distraught?”

If you can relate to any of these feelings, you could have unipolar depression.

It’s a heavy mood of despair that affects millions of people around the world.

When you’re stuck in a depressive haze everything seems pointless and futile. Life seems barely worth living.

You always feel sad and have lost interest in the world. You may struggle to get out of bed in the morning, your weight might have changed, or you may have lost interest in the hobbies and activities that you used to enjoy.

But no matter how desperate you feel, remember that you have options. There are several treatment methods for unipolar depression. And there is a wealth of free information from reputable sources available online.

It’s possible to take steps toward living a happier, more fulfilling life.

Most importantly, don’t despair; help is available if you can find the strength to take it.

So let’s talk about depression.

What is Unipolar Depression?

Unipolar Depression is another name for Depression.

Unipolar means having one pole and is different from Bipolar, which means two poles.

In Bipolar Depression, people swing from depression to mania and back again. These are the two poles (high and low). A person with Unipolar Depression is different. They are always in a low mood and seldom experience highs.

The lows can be agonising. They fill you with intense pain that’s hard to describe. Like you’re “on fire”, “trapped at the bottom of the ocean”, or “stuck in a tunnel” is how some people describe it.

Depression can make you worry you’re going mad. Your brain seems alien to you. Even regular tasks such as going to the local shop become difficult. You long for nothing more than to shut yourself up in your room. It seems safer there and the pain is less intense. You’re lethargic and have no energy.

Yet if you do nothing, your situation could get worse.

Even tiny changes can help. Experiment with some of the natural ways many depression sufferers overcome their illness.

Take care not to remain cocooned away from the world for too long. You don’t want the main challenge of your day to be getting out of bed in the morning or cooking dinner in the evening.

You can’t believe it now, but there is a future where the pain has gone. Where life seems worth living. Where you feel motivated and energised. Where vitality defines you.

Your pain feels unique - and it is to you. But others have suffered depression and found their way through it. You can overcome it too.

There are proven solutions that work.

I’ll get to them in a bit. But first, some background.

How Common Is Unipolar Depression?

Unipolar depression is widespread and increasing.

The World Health Organisation estimates that depression is now the costliest and most debilitating disease in the world.

In modern Western countries, about 20-26% of women and 8-12% of men experience a major depressive episode at least once in their life. Many men and women suffer repeated depressive episodes.

Women are possibly more at risk from depression due to fluctuating hormones and a genetic predisposition. They can be particularly at risk around puberty, childbirth and menopause.

During these times, most women experience mood swings. Happy highs that turn into teary-eyed lows. Cheerful times followed by crabby days.

Yet sometimes the low moods can stick.

A person with depression has persistent sadness and a loss of interest in activities that people usually enjoy. Daily activities become a burden and difficult to endure.

Symptoms of Unipolar Depression: Do You Recognise Any?

The symptoms of unipolar depression aren’t pleasant, and they vary from person to person. The main ones include:

  • Prolonged sadness or depressed mood
  • Lack of energy and motivation
  • Lack of interest in things that were once enjoyable
  • Lack of concentration
  • A tendency to withdraw from family and friends
  • Feelings of helplessness or guilt
  • Disrupted sleep patterns – under or oversleeping
  • Suicidal thoughts and feelings
  • Negative, pessimistic thinking
  • Rapid or significant changes in weight

Everybody exhibits these symptoms from time to time, but you only suffer from unipolar depression if they last for a few weeks or more.

And you only have depression if you the symptoms are present throughout most of the day.

If you’re depressed, it’s common to have several of these symptoms at once. If you notice that you have a few of these symptoms, and they are lasting for several days or more, keep a careful eye on how you feel.

Unipolar Depression: A Definition for Self-Recognition

Formally doctors know unipolar depression as Major Depressive Disorder. To be diagnosed with unipolar depression, you must experience at least five depressive symptoms during a continuous 2-week period. At least one of the symptoms must either be a depressed mood or loss of interest or pleasure.

The symptoms must also cause clinically significant distress (scoring high on a standard stress testing questionnaire, for example) or impairment in social, occupational, or other important areas of functioning. Furthermore, the symptoms must not be a result of substance abuse or another medical condition.

Does this definition of unipolar depression help you?

This is the standard unipolar depression definition that doctors use, but even if you don’t see yourself here, there are some special types of depression it’s worth knowing about.

Additional Types of Unipolar Depression

As well as the more general forms of Unipolar Depression, there are also some specific types.

The distinctions are important because they each have their own causes, symptoms and treatments.

Each type can vary quite considerably from one to the other, both in who they affect and the recommended treatments.

Here are these special types:

Pre and Post-Natal Depression

The risk of depression increases sharply for women who are pregnant, both during and after pregnancy.

Close to ten percent of women experience prenatal depression during their pregnancy. Sixteen percent of women experience post-natal depression within the first three months after birth.

Pre- and postnatal depression may be caused by a combination of factors, including hormonal changes and the stress of adjusting to pregnancy or a new child.

Almost every mother experiences feelings of sadness and is tearful after birth. Often called ‘baby blues,’ these feelings usually pass after two weeks.

Post-natal-depression is more severe than this common phase of motherhood

You might feel sad or low over a long period of time, lose interest in the world around you, lose your appetite, and feel tired all the time.

If you have postnatal depression you could also feel guilt, hopelessness and self-blame. You may feel that you’re unable to look after your baby or struggle to bond with and feel indifferent to your new child. You may also feel agitated and irritable.

Occasionally post-natal depression sufferers have frightening thoughts such as suicide, self-harm or harming their baby. These thoughts are scary but seldom acted upon.

Because of its severity, postnatal depression affects the mother, her baby, and her partner, as well as other family members.

If you feel you have postnatal depression, talk to your local doctor or health care professional. There are a range of options to you including counselling, medication and self-help.

For tips on how to overcome depression naturally, see the next section.

Psychotic Depression

Sometimes people with a major depressive disorder can lose touch with reality. If this happens, doctors refer to this as psychotic depression. During a state of psychotic depression, a person may see and hear things that aren’t there (hallucinations) or have false beliefs that aren’t shared by others (delusions).

They can be paranoid, feeling as if they are being watched or followed, or that they are wrong and evil. Because of this, sufferers of psychotic depression may find it hard to trust others.

The treatment for psychotic depression is similar to other forms of depression – counselling, medication or self-help. Suffers of psychotic depression are extremely vulnerable and benefit from social support to help with education, employment or accommodation. They are often unaware that their thinking is distorted.

A person with psychotic depression may need to stay in a hospital for a short period of time while they receive treatment. Contact your local doctor or health care professional if you have any concerns about yourself or someone else.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder occurs in tune with the seasons.

Depression that starts in winter and ends in spring is most common. SAD is found in countries that have dark, cold winters. For this reason, SAD is thought to relate to the levels of natural light available at different times of the year.

A person with SAD is likely to experience mood changes and to experience a lack of energy, weight gain, and have a tendency to oversleep.

If you have SAD, UV light therapy might be beneficial. The UV light simulates sunlight making up for the lack of natural light outside. Usually 30-min exposure a day is enough although some people need a couple of hours.

There are a variety of lamps now available, many at a reasonable price.

UV light treatment is popular and lots of people with seasonal affective disorder feel better using one.

Melancholia

Melancholia is the name used to describe severe forms of depression in which a person has physical symptoms such as a stooped posture. A person with melancholy moves slower and is unable to experience any pleasure at all. Occasionally a person with melancholic depression may show signs of agitation and increased irregular movement.

Scientists believe it’s an inherited condition. It’s characterised by an extreme lack of interest in the world. A person with Melancholic Depression may also have severe weight loss or loss of appetite, may wake early and have a worse mood in the morning. They may also feel a lot of guilt about events in their past.

Research suggests differences in the brain may be responsible for melancholia. Someone with melancholia may have fewer neurons connecting to their insula (the part of the brain responsible for attention). They may also have an altered hypothalamus, pituitary gland, or adrenal glands. These changes may affect a person’s appetite, stress levels, and more.

In addition to these three special types of depression, it’s also worth knowing about bipolar depression.

Difference Between Bipolar Depression and Unipolar Depression

People with bipolar depression will switch from high to low states. When they are in a depressive state, they have the same symptoms as someone with unipolar depression, but when they are in a high state, their behaviour is entirely different.

The high state is often called mania. When a person with bipolar disorder is in a high or manic state, they seem happy, energetic, confident and productive. However, they may also have these symptoms:

  • Easily irritated.
  • Seem too happy or high
  • Say they don’t need sleep, and don’t feel tired
  • Talk and think at a rapid pace
  • Struggle to concentrate or stick to one task
  • Easily agitated
  • Engage in impulsive behaviour such as going on spending sprees.
  • Seem to have lots of energy
  • Have an increased sexual drive
  • Can be provocative or aggressive.

If you notice any of the symptoms of bipolar depression in yourself or others, it’s vital to get help. Visit a counselling centre or mental health professional to get the right diagnosis and treatment.

Be careful, though. Doctors are not always fully aware of the differences between unipolar and bipolar depression. The low depressive part of bipolar depression is the same as, or similar to, unipolar depression. The similarity means unipolar and bipolar depression are often confused. If you do visit a doctor or a mental health professional, make sure to tell them all your symptoms. Don’t leave anything out.

There are different medicines and therapeutic approaches for bipolar disorder. You don’t want to be misdiagnosed.

Unipolar Depression Treatment

There are several essential methods for treating unipolar depressive disorder. Counselling and psychotherapy are known to have a significant effect in reducing depression. Anti-depressants are also widely available.

Perhaps more importantly, there are also scientifically proven natural steps that you can take. For millions of people these have proven just as effective (sometimes even better) than medication.

That’s because doctors and scientists do not yet know with certainty how antidepressants work, and more and more scientists are beginning to suspect they only work by a placebo effect. A placebo effect is where we feel better because we think something will make us better, not because it does.

A placebo has no real effect on you. You often feel better simply because you believe it will help.

The problem is that in reality nothing about your situation has changed. After a while you may feel much the same as before.

If you find yourself continually increasing your antidepressant doses, then you might want to question if antidepressants are working for you. The same applies if you’re always switching medication because you feel the ones you’re currently on have stopped working.

If you or your loved one find yourself in this situation, consider seriously the non-medication steps (including therapy) that you can take yourself to improve your mood and well-being.

Research backs up that they work.

Here are seven suggestions.

If you want to lift your gloom and start to heal yourself, try these natural activities.

1. Get Your Body Moving

Everyone must get enough exercise, but if you’re depressed, it’s even more critical.

Your body is made to move. Throughout all human evolutionary history, we have been active. It’s only more recently that we have become much more sedentary.

If you’re depressed, it’s imperative to build some form of exercise into your day. It doesn’t need to be much, but you do need to be moving. Jogging, cycling, and swimming are all excellent forms of exercise, as is a brisk walk.

Brainstorm as many possible ways you can increase the amount of exercise you do. Many scientists believe lack of exercise is one of the key reasons more and more people are becoming depressed.

2. Get A Winter Tan

Try to get some sunlight at least once a day, you’ll feel better for it.

Sunlight is especially essential if you have SAD (seasonal affective disorder). In the winter, when the days are short, most people feel a little down. It can be especially tough when it’s dark when you start and finish work.

As I write this it’s December in the UK where I live. The days are short, dark and damp. It’s hard not to feel a little down.

Don’t despair though; there are a number of steps you can take.

Go for a walk at lunch if your employers let you. If it isn’t currently allowed, but your manager is open-minded, explain how vital exercise is to your physical and mental health.

If a walk is not possible, or not sufficient, then try supplementing with UV light. Many people have found it useful in curing their SAD.

And remember, getting enough daylight is not just for winter, it’s an integral part of staying well at any time of the year.

Something all of us need to bear in mind.

3. Go Green

If you can take a walk or a cycle through a local park do so.

Some scientists think depression is in part due to the fact nature no longer surrounds us. Make sure you build or maintain a connection with nature. It’s easier than you might think, even if you live in a city.

Could you get a house plant, join a gardening club or volunteer to do some conservation work, for example?

In his book Lost Connections Johan Harri writes how his understanding of depression changed when he realised how disconnected from nature he was.

His research uncovered the case of Lisa, a severely depressed patient who struggled with depression for a number of years.

One day her doctor tried a new approach. He ordered her to join a city gardening project.

At first, it didn’t go well at all.

Lisa and her group got everything wrong. She felt like a failure. Her depression got worse.

Over time, though, she began to tune in to nature’s rhythm.

“There’s something about nature,” Lisa now says.

“You can’t change how nature is –because the weather will do that. The seasons will do that.”

“You might not feel you have made much impact in one gardening session, but if you do that every week, over some time, you’ll see change. It’s about committing to something that might take a long time and having the patience to do that.”

4. Crawl Out of Your Hole

Don’t follow your instinct and reduce your connections with others.

When you’re depressed, you’ll often experience a natural tendency to withdraw from society. You may not feel like going out with old friends, or you don’t want to take your nephew to watch football games like you used to.

Yet a lack of connection to others may be one of the reasons that more and more people are becoming depressed. Only a couple of decades ago, we used to live in active communities. In these communities we supported our neighbours, and they helped us in return.

Now the number of social activities that we undertake is dwindling, and more and more of us spend our evenings alone.

Fight the tendency to lock yourself away and try to be social if you can. Take small steps. Consider joining a club even if you’re not sure it will interest you. Volunteer and lend your time to help others.

You don’t have to say much or do much. Turn up and share your company. People will be grateful, and you’ll start to feel better.

5. Don’t Carry the World

Stress can cause depression. If you take on too much responsibility, eventually something has to give.

If you’re always helping other people, then stress may be a source of your depression.

Are you known as a reliable person that others trust to always get the job done?

You may feel your family and friends need you to help them out with certain tasks and you find it hard to say no. Over time you feel the weight of the world on your shoulders.

It may sound strange to hear me say so, but you’ve taken on too many obligations. You feel responsible for too many people, and now something has broken. Your mind has shut down.

Start by asking yourself why you have to say “yes” to others demands? What life experiences or personality traits mean you have to help others? For most people with this type of depression, something in their past causes them to feel obligated to take on other people’s responsibilities.

Learn to draw boundaries and protect yourself, and your depression will get better.

Protect your time and space. Make sure you have time for yourself and that your life is in balance.

Learn to minimise the effect others have on you and take life easy for a while.

6. Find a Purpose

Many things can get in the way of living with meaning and purpose.

Your job may be unfulfilling, or you may be distracted by goals that seem rewarding but don’t deliver the sense of satisfaction your soul requires.

Work can be dissatisfying for many reasons. Perhaps you feel you have little control over your work, or that your position at a company is precarious. Or you find it hard to see how your labour contributes to the world in any meaningful way.

Feeling that life is futile and that your efforts go unrecognised can contribute to depression. As can chasing goals such as high status or more money at the expense of other meaningful tasks.

Look for meaning in other parts of your life. You may be able to create more meaning in your work, but you can also find it in health and fitness, relationships and personal growth, and in fun and recreation.

Try to make sure you have balance in all these areas. List out the activities you currently engage in daily and score how meaningful they feel to you. Are there any ways to do less of the low scores and more of the high scores? Are there any ways to turn meaningless activities into more meaningful ones?

The more meaning you have in your life, the less depressed you’re likely to be.

It’s Time to Beat Your Depression

You or a loved one has been feeling low. You think you might be depressed.

Or you have a formal diagnosis, and you’re wondering what to do next.

If you spot any of the signs or symptoms of depression in yourself or others don’t hesitate to get help. Talk to your local doctor or mental health professional about your concerns.

Talk to family and friends too. There is much less stigma about depression today. Most people know it’s a universal illness that is common around the world.

Consider antidepressants if you think they will help and go to a therapist if you can afford it.

But also take steps to try to heal your depression yourself.

It’s not easy, and the journey can be a long one.

But it is possible.

Many people suffer from depression, but many learn to overcome it too.

You can be one of them.

Don’t give up hope.

Change is possible.

Start by selecting some steps to take.

Set small goals and work to achieve them.

You’ll soon kick the dust on your depression.

Related Video: Living Through Depression: Julia's Story (3:45 min)

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