Everything you need to know about depression
The word ‘depression’ gets thrown around a lot, but there’s more to this condition than many people realise. Get some information on what symptoms and signs to look out for and tips on what you can do about them.
In this article we cover:
What is depression?
‘Depression’, which is often diagnosed as 'major depressive disorder' or ‘clinical depression’, refers to significant feelings of sadness or a low mood that lasts longer than two weeks and starts to get in the way of your everyday life.
People often use the word ‘depressed’ when they're talking about moments or periods of time when they’re feeling sad or down. It’s normal to feel down when you’re going through a stressful or difficult time or the general ups and downs of life. However, if you feel low on more days than not for a few weeks, or if you really aren’t sure why you feel so bad, there might be something serious going on.
5 facts about depression
If you’re experiencing depression, you’re not alone – around 1 in 7 Australians will experience depression in their lifetime.
Depression can make everyday activities more difficult, but this is a totally different thing from being ‘weak’ or ‘lazy’. In fact, people with depression display an enormous amount of resilience and strength as they deal with the challenges in their lives.
In Australia, depression and anxiety are the most commonly reported mental health challenges in people aged 12-25.
Treatment can help with depression. More than 80 per cent of people who are treated for depression say that the experience helped them.
So, what causes depression?
There is no single cause of depression, and it often develops due to a combination of factors. Some factors can be external, such as trauma, loneliness, unemployment or a break-up. Some factors can also be internal, such as genetic factors, medications or hormones. It’s important to understand that no one chooses to be depressed. If people could ‘choose’ to have depression, it wouldn’t exist.
External causes of depression
External factors leading to depression are things or events that happen in your life. For example:
grief or loss
abuse from family, friends, school staff or employers
a heavy workload at work or school
loneliness or social isolation
life changes such as transitions between school, university and work
unemployment or economic hardship
addiction to drugs, gambling or alcohol
conflict with friends and family
a break-up with a partner.
Internal causes of depression
Internal factors leading to depression are things that occur inside your brain. For example:
Genetic factors: If your family has a history of depression, that may increase your risk of experiencing it in your lifetime.
Medications: Lots of different medications can cause depression as a side-effect. If you’re on any medications that you’re worried may be causing you to feel depressed, talk to your doctor.
Other biological factors: There are other biological factors in our lives that can cause depression, such as problems with our brain chemistry, nutrition, hormones, immune system and gut health.
People affected by depression often experience negative thinking patterns and may stop doing their regular activities, which can make their symptoms worse. In other words, depression becomes a bit of a cycle: your mood is so down, you don’t feel like doing anything, so you stop doing the things you enjoy or that you need to do (such as schoolwork or daily tasks), which makes you feel even worse.
If you feel low almost every day for a few weeks, or if you really aren’t sure why you feel so bad, there might be something serious going on.
Do I have depression or anxiety?
It can be hard to figure out if you have depression or anxiety. These two mental health conditions can share some similar symptoms, and it’s also possible for people to have both depression and anxiety at the same time.
However, this summary may help you to distinguish between the two.
Difference between depression and anxiety
Depression is generally characterised by having a low mood most days, or an inability to enjoy activities or a loss of interest in activities, for two weeks or longer.
Anxiety (which is an umbrella term and includes a variety of conditions) is usually characterised by feelings of being on edge or fearful, or experiencing excessive worry, restlessness or irritability (and having difficulties with controlling these feelings), in a way that interferes with your everyday life.
It’s important to know that only a doctor can accurately diagnose whether you have depression or an anxiety disorder, so if you think you might have either of these conditions it’s best to visit your GP for diagnosis and support. You can learn more about anxiety conditions and how to find support here.
Can anxiety cause depression?
Anxiety and depression are two separate conditions, but often they are linked.
When someone has anxiety, their nervousness and constant worrying can make it hard for them to connect to others and reach their goals. This can lead to depression.
Nearly half of those who experience depression also encounter anxiety on a regular basis.
Do I have burnout or depression?
Feeling tired is a common experience for people who have busy lives at work or school. But if you’re feeling constantly worn out, exhausted and cynical due to stress and pressure from your career or studies, you might be experiencing burnout.
Burnout is a state where you feel mentally, physically and emotionally drained over a period of weeks, months or years. Depression and burnout present themselves quite similarly, but the difference is that burnout is a state of exhaustion, whereas people with depression regularly experience negative thoughts towards themselves. While it’s possible to experience burnout but not depression, if burnout is left unchecked, it can easily lead to depression.
Click here to learn more about burnout and how it can affect your mental health.
What are some signs and symptoms of depression?
Everyone who experiences depression will have a different array of signs and symptoms, but there are some common ones, which can range from mild to severe. Many people don’t realise that depression doesn’t just affect someone’s mood – it also affects their body. When someone is experiencing depression, some of the signs and symptoms are apparent to other people. Other signs, however, aren’t so visible. Signs and symptoms include:
feeling sad, disappointed, miserable for no apparent reason
feeling frustrated and having angry outbursts
withdrawing from friends and family
loss of interest in attending social events
struggling to cope with everyday situations
loss of interest in hobbies/favourite activities
inability to concentrate, struggling to keep up at school or work
memory issues, sudden loss of memory or being unable to recall recent events
negative self-talk or loss of self-confidence
feelings of worthlessness or excessive guilt
reluctance to attend to personal hygiene or a sudden lack of interest in their appearance
turning to, bingeing on or increased intake of alcohol or other drugs
reckless behaviour, putting oneself in danger without thinking things through or caring about consequences
suicidal thoughts or planning
intimacy issues, loss of interest in sex or sudden increase in promiscuity
feeling tired or fatigued all the time
moving more slowly than usual
being restless and unable to sit still
having problems sleeping (unable to sleep, sleeping too much, struggling to wake up)
muscle pain or other continuing pains throughout the body
feeling sick or run down all the time
digestive issues – stomach pain, constipation, constant ‘churning gut’ feeling
loss of or change in appetite
sudden weight loss or weight gain
Most people experience some of these feelings and behaviours occasionally. The difference with depression is that the symptoms are more severe, happen more often and don't go away over time.
Different types of depression
There is a vast array of types of depression. There are different ‘types’ of major depression, as well as other specific conditions under the umbrella term of ‘depression’ that have their own particular set of symptoms.
Major depressive disorder
Melancholic: a severe form of depression where the majority of the physical symptoms are experienced and there is an absolute (or close to absolute) loss of enjoyment in everything.
Psychotic: this form of depression specifically involves symptoms of psychosis such as delusions, hallucinations and/or paranoia. Learn more about psychosis and psychotic disorders here.
Perinatal depression: this form of depression is experienced during pregnancy or in the 12-month period after giving birth. Nearly 10 per cent of people will experience depression during pregnancy, and doctors recommend seeking support as early as possible to ensure the health and wellbeing of both mother and child.
Persistent depressive disorder
The symptoms of persistent depressive disorder are very similar to major depression, but they are less severe and last much longer.
To be diagnosed with persistent depressive disorder, symptoms have to be present for more than two years.
Bipolar disorder is characterised by experiencing periods of ‘mania’ in addition to periods of depression. (There can also be periods of ‘average’ moods in between.)
Mania is at the opposite end of the spectrum from depression: it’s usually described as having an abundance of energy and feeling extremely happy, active and ‘switched on’.
It can also present as feeling irritable. Some other common experiences of mania include barely sleeping, speaking very quickly and having constant racing thoughts, feeling frustrated and quick-tempered, and struggling to focus on and complete everyday tasks.
Sometimes periods of severe mania can also include symptoms of psychosis, hallucinations and delusions.
Cyclothymic disorder can often be confused with bipolar disorder. The difference is that the symptoms of cyclothymic disorder are less severe, and the periods of mania and depression are shorter and less regular.
Someone with this disorder will experience symptoms of both hypomania (mania that is mild to moderate) and depression, between which they will have short periods (up to two months) of ‘average’ moods.
This fluctuation of moods has to be experienced for at least two years, or for one year in children or adolescents, to be considered cyclothymic disorder.
Premenstrual dysphoric disorder
Premenstrual dysphoric disorder is a health condition similar to premenstrual syndrome (PMS) but more severe.
People with premenstrual dysphoric disorder experience sadness, mood swings, irritability and anxiety about a week or two before their period. It can sometimes last for a few days after their period starts.
What to do if you’re experiencing depression
If you think you’re experiencing symptoms of depression, visit your GP or a mental health professional. The good news is, if you’re diagnosed with depression, there are treatments available. Your doctors can work with you to create a treatment plan that suits your personal circumstances and experience. This could include things like:
psychological treatments, such as cognitive behavioural therapy
medication (usually antidepressants)
lifestyle changes, such as regular exercise, eating well and implementing sleeping routines.
How do mental health professionals treat depression?
Psychological treatments are provided by an expert such as a psychologist, psychiatrist or other mental health professional. They involve shifting patterns of thoughts and feelings, changing behaviours, or working to improve relationships.
It can be helpful to know about these different treatments because it shows that there are many different expert approaches to healing and recovery. If one method doesn’t work or hasn’t worked, another type of treatment or a different professional might be just what you’re looking for.
Types of psychological treatment that might be used include:
Cognitive behavioural therapy (CBT): This type of therapy usually involves a psychologist working with you to change negative thought patterns and behaviours that contribute to low mood.
Interpersonal therapy: This is a program for improving relationships, which is important because the presence of healthy, supportive relationships has been proven to help in reducing depression symptoms and in preventing relapse, while relationship difficulties or a lack of social support can worsen symptoms.
Acceptance and commitment therapy (ACT): This therapy is based on the idea that difficult thoughts and feelings are normal and are connected to the things that are important to us. ACT encourages you to think about what is and isn’t within your control, to acknowledge how you feel, and to be aware and mindful in your day-to-day activities. The focus is on helping people to behave in ways that are consistent with their values, instead of seeking to reduce uncomfortable thoughts or feelings.
‘If one method doesn’t work or hasn’t worked, another type of treatment from a different professional might be just what you’re looking for.’
What medications are used to treat depression?
Antidepressant medication is most effective when taken in addition to psychological therapy and lifestyle changes. Medications usually take a few weeks or months before any improvement is seen. There are several different types of antidepressant medications prescribed by GPs or psychiatrists. The most common of these are:
selective serotonin reuptake inhibitors (SSRIs)
selective norepinephrine reuptake inhibitors (SNRIs).
SSRIs and SNRIs work by targeting chemicals in the brain. Like most medications, there can be side-effects, and some medications are better suited to adults than young people.
It’s important to ask about what options you have, how the medication will likely affect you and how to take it safely. You should never change the amount of medication you take without speaking to your GP or psychiatrist first.
Lifestyle changes and personal experimentation
If you’ve expressed feelings about your condition to family or friends, they might have recommended a number of common lifestyle tips to help with depression.
It’s important to know that because depression has so many different causes and manifestations, there are lots of different methods you can use to feel better. While scientific evidence has proven that some of these methods help some people with depression, they might work differently for different people.
Some proven lifestyle tips to help with depression include:
The best way to treat depression is through a trial-and-error approach. Many people who have recovered from depression say that they had to try several different mental health professionals, treatment methods, medications and lifestyle changes before they eventually found the plan that worked for them.
How to get help with depression in Australia
If there’s one thing to take away from reading this article, it’s that if you’re feeling depressed, the best thing you can do is talk to your GP about a treatment plan. There are a few reasons for this:
GPs have lots of experience of working with mental health, especially depression.
Your GP is someone you can talk to privately and confidentially about how you’re feeling and any important factors that might be involved.
They can help you to make a plan tailored to what’s going on for you at the moment.
In addition to some of the treatments we’ve talked about already, your GP might use blood tests and other diagnostic tools to learn more about what you’re going through.
If you talk to your GP, one thing they might recommend for you is a mental health-care plan.
If there’s one thing to take away from reading this article, it’s that if you’re feeling depressed, the best thing you can do is talk to your GP about a treatment plan.
What is a mental health-care plan in Australia?
In Australia, a mental health care plan is a document written up by your doctor that will help you access the Medicare rebate on up to 10 sessions per year with a mental health professional. What this means is that for those 10 sessions, the fee will be partly covered by the government, or sometimes the sessions will be free, depending on the amount that the mental health professional charges.
Here’s how you can do this:
Make an appointment with your GP. These appointments sometimes take a bit longer than regular checkups, so when you book, let them know you’re looking to get a mental health-care plan.
Have a look online at different mental health professionals in your area. This step is optional, because your GP can always recommend someone for you. If you’re in a regional or rural area, you could also look for professionals that offer help via telehealth.
During your appointment, your GP will ask you some questions about how you’re feeling and what’s going on for you at the moment.
After your appointment is done, your GP will give you a referral for the mental health professional that you both picked.
Make an appointment with the mental health professional to begin your treatment.
Read our full article about getting and using a mental health care plan here.
What if I can’t afford treatment for depression?
If you’re under financial stress and you need treatment for depression, here are a few tips:
See a GP who does bulk billing. Bulk-billed appointments are free because they’re covered under Medicare.
Look online to find a mental health professional near you who does bulk-billed appointments. Just be aware that these practitioners often have long wait times.
There is also mental health support available near you through Public Health Networks. They often offer free or discounted access to a mental health professional. Have a look at what services are around you here.
If you’ve looked online and found a mental health professional who you think could help you but doesn’t advertise bulk billing, you could get in contact with them, tell them about your financial condition and ask if they would be able to make an exception for you or give you a discount.
For more tips on getting professional help with your mental health when your finances are strained, check out our guide here.
Personal stories about depression
Sometimes when you’re struggling, it can help to hear that other people have faced the same battles. Some of these stories from young people living with different types of depression might help with learning about depression and how we can learn to manage it in all different sorts of life situations.
Major depression (melancholia)
Tara started experiencing deep feelings of sadness, and of feeling ‘removed and distant’, when she was in Year 11. She says that it became worse over time, and eventually became so bad it affected her relationships with her family and friends.
Major depression (psychosis)
A young person shares her experiences with bulimia, psychotic depression and a desire to end her life. She says finding something she was passionate about helped her cope with mental illness and the psychosis she experienced.
Zoe tells us about living with bipolar disorder and ‘the whirlwind of extreme emotions that goes with it’. She shares her advice on coping with situations that are out of our control.
Ashlea didn't know that she had postnatal depression and anxiety until her baby was four months old. She says that once she received her diagnosis and understood what was happening to her, it became far easier to manage.
Seasonal affective disorder
A ReachOut Online Community user shares their experience of realising they have seasonal affective disorder. Their symptoms appeared at the same time each year, but they say they had ‘chalked it up to uni stress worsening’ until they realised they needed to speak to a mental health professional about it.
How to help someone with depression?
Sometimes it can be hard to know how to help someone with depression or even know what to say. A great way to start is by learning and understanding what depression is. You can also listen non-judgmentally and offer to help find support with them. Learn more in our guide on how to help a friend experiencing depression or anxiety.