Treatments for Depression This leaflet contains information about depression and how it can be treated Children and Families Community Services Mental Health Secure Services Specialist Services Adult Mental Health Page 1
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What is depression? Depression is a very common problem, which many adults will at some time experience. In its mildest forms depression does not stop you from leading a normal life, but the most severe depression can be life threatening, with thoughts of suicide. What are the symptoms of depression? Common symptoms of depression include: Feeling sad, guilty, upset, numb or despairing Losing interest and enjoyment in things Crying a lot or feeling unable to cry Feeling alone even if you are in company Losing confidence in yourself Expecting the worst and having negative thoughts Feeling hopeless Thoughts of suicide Negative self-image Poor memory or concentration Tiredness Restlessness Sleep problems, especially waking early or interrupted sleep Feeling worse at particular times of the day (usually morning) Changes in appetite, eating and weight Not everyone who is depressed experiences all of these symptoms and even if you are not seriously depressed it is usual to experience some of these things from time to time. If these feelings are very strong or continue for some time it is likely that you have depression. Page 3
What causes depression? Many things may cause depression. Causes of depression differ from person to person. You may become depressed after distressing events such as the death of someone close to you, or because of circumstances such as being alone or living on a low income. You may become depressed for no apparent reason. Who gets depressed? Some people are more likely than others to develop depression. This may be because of body make up, early life experiences or family influences. How can I help myself? Physical activity: Walking, running or swimming can be helpful. Building some time into your day to do this can make you feel less tired. Talk to others: Talk about how you are feeling to your friends and family. You may be surprised to find that they too have felt depressed at some time and understand how you feel. Look after yourself: Resist the temptation to cope with your depression by drinking alcohol, misusing medication or turning to illegal drugs. Eat well and treat yourself to things you normally enjoy. What other help is available? Your GP is usually able to help you himself. He can also ask for help from other professionals such as counsellors, and specialist mental health workers. Page 4
What choices of treatment are available? Because depression has a number of different causes and can be of varying severity, your treatment should suit your own personal situation. You may have your own thoughts about which treatment you would like. Your GP can offer a range of treatments. These may include exercise programmes, talking therapy or antidepressants. Most depressed people can be successfully treated by their GP. If the treatment is not successful or if you are suffering with a more severe form of depression your GP can refer you to a mental health worker if you wish. Like many other illnesses, milder forms of depression will usually get better by themselves and no treatment is needed. Sometimes simple advice about sleep and coping with problems helps. What are Talking Therapies? There are a range of talking therapies or treatments which can help. They include counselling, problem solving and cognitive behavioural therapy (CBT). The availability of these therapies is variable. Talking treatments work best for depression of milder severity. They usually take about 15 hourly sessions given weekly or fortnightly. When are Antidepressant Medications used? If you have a more severe form of depression or your depression has lasted a long time, then antidepressant medication is likely to be a better choice of treatment. Antidepressants can be given instead of or as well as talking treatment. They are also helpful when talking treatments are not readily available, if you prefer them to talking treatments or if they have helped you before. These drugs can be prescribed by your GP or psychiatrist Page 5
How do Antidepressants work? Antidepressants work by altering the way in which certain chemicals work in your brain. These chemicals are called neuro-transmitters and they transmit signals between the cells in your brain. When you are depressed some of the neurotransmitter systems don't work properly, as the levels of neurotransmitters are low. It is thought that antidepressants work by increasing the amount of these neurotransmitters in your brain. When you begin a course of antidepressants you will be told that they do not work immediately. It can take 2-4 weeks before they take effect. It is best for most people to continue taking antidepressants for six months after they start to feel better. Try to persevere - stopping too early is the commonest reason for people not getting better and for the depression returning. If you have had two or more episodes of depression then treatment should be continued for at least two years. What are the benefits of antidepressants? Some studies have found that after three months of antidepressant treatment, between 50% and 65% of the people who take them find their symptoms are much improved. All antidepressants work slowly. Most people find that they feel somewhat better after about two to three weeks. It takes up to six weeks for the full benefits to be noticed. It is very important that you continue to take the medication so that the full benefits can be felt. Which antidepressant will I get? These days doctors usually recommend one of a group of newer antidepressants called Selective Serotonin Re-uptake Inhibitors (SSRIs). Antidepressants in this category include Fluoxetine, Citalopram, Paroxetine, Escitalopram, Sertraline and Fluvoxamine*. SSRI drugs are as effective as other antidepressants but usually cause fewer side-effects. Page 6
If you prefer a particular antidepressant or have previously responded to one, this will be taken into account by your doctor. What are the risks of antidepressants? Antidepressants will lead to improvement in most depressed people. Usually they do not cause severe side-effects and most people can take them with no difficulty. When you start antidepressants your doctor will suggest that you meet in a week or two so that if you do develop any problems with your medication they can be sorted out quickly. Antidepressants are different from anxiolytic (anti-anxiety) such as Lorazepam, Diazepam and sleeping tablets which all can lead to addiction. Antidepressants are not addictive but should not be stopped suddenly in order to avoid withdrawal effects. You should talk to your doctor about when and how to stop your antidepressant. Is any other information available? Depression Alliance 9 Woburn Walk, London WC1H 0JE. Tel: 0845 123 23 20 Email: info@depressionalliance.org Mind Infoline: 0300 123 3393 The Wellbeing and Mental Health Helpline provides an information and listening service for people in Lancashire. It is available between 7.00 pm and 11.00 pm Mondays to Fridays and from 12.00 noon until 12.00 midnight on Saturdays and Sundays Tel: Freephone 0300 222 5931. Page 7
Other sources of information: This information is intended as a guide only. If you are concerned about the mental The Wellbeing and Mental Health Helpline health of yourself or another This provides an information and listening service for person, you may wish to people in Lancashire. It is available between 7:00pm consult your GP for further and 11:00pm Mondays to Fridays and from 12:00 advice. noon until 12:00 midnight on Saturdays and Sundays. Other sources of information: Freephone 0800 915 4640. The Mental Health Helpline provides an information and listening service for people in Lancashire. It is available Customer between Care7.00pm and 11.00pm Mondays to Fridays and If from you 12.00 wish to noon pay until a compliment 12.00 about the Trust s midnight on Saturdays and Sundays. Freephone services, make 0500 a comment, 639000. raise a concern or complaint, The Patient Advice and Liaison Service please provides contact advice the Customer and Care Department on information. Please contact East Lancashire 01772 PALS 695315, on: freephone 0808 144 1010 or 01282 474178 or 07507 857345 email customer.care@lancashirecare.nhs.uk If you have problems reading the print we can provide this leaflet in large print, audio If you have problems reading the print we can provide this leaflet in large print, audio book or Braille. W przypadku jakichkolwiek problemow z odczytaniem tekstu z przyjamnoscia dstarczymy Panstwu ulotke z duzym drukiem, book or Braille. tasme do odluchu lub tekst w jezyku Braille. Leaflet number: XXX XXX/XXXX Data Protection Name of Leaflet: Seeing a Clinical Psychologist The Trust will endeavour to ensure that your in Lancashire Blackburn Care with NHS Darwen Foundation Trust. Copies of this information leaflet remains are available secure and from: confidential at all All rights reserved. Not to be reproduced times. The Data Protection Act 1998 explains how in Date whole produced: or in part without February the 2009 permission personal information should be processed and this of Review the copyright date: owner. February 2011 Lancashire applies Care to NHS all information Foundation whether Trust, held on paper or electronically on computer systems. We must Data Protection Sceptre Point, ensure that Sceptre all personal Way, information is processed Lancashire Care NHS Foundation Trust fairly, lawfully and as transparently as possible so adheres Lancashire to The Data Care Protection NHS Foundation Act 1998. Trust Walton Summit, you: Preston PR5 6AW The 2009-02-18. Trust will endeavour All rights to ensure reserved. that Not to be Understand reasons for us processing your your reproduced information in remains whole secure or in part and without the personal information confidential at all times. For further permission of the copyright owner. Tel: 01772 695300 Give your consent for the disclosure and use of information regarding data protection information where necessary please visit the Trust s website or ask a member of staff for a copy of our leaflet Gain Trust in the way we handle your entitled information Copies Sharing of this Information leaflet are With available Us. from:- Website: www.lancashirecare.nhs.uk Understand your rights regarding the right to Lancashire Care NHS Foundation Trust, Date Produced: Review Date: Leaflet Code: request access about Name the of Leaflet: information we hold April Sceptre 2015 Point, April 2017 029/2015 about you. Treatments for Depression Sceptre Way, The Caldicott Guardian, who is a senior health Walton Summit, Page 8clinician, has the role to ensure we meet the highest standards for handling personal Email: communications@lancashirecare.nhs.uk