variousfastsolution: 2015

Overcoming depression - a guide for students
This webpage aims to help you understand more about depression. It describes some approaches that can help, whether you are suffering from depression yourself or wanting to support someone else.

What is depression?
Everyone gets down sometimes, especially when things aren't going well. It is a normal response to difficult or upsetting experiences. Usually these feelings last for a few days. If you are depressed, however, these feelings may last longer and make it harder to cope with everyday life.

Depression is very common – 1 in 6 of us can expect to experience depression at some time in their life. There are different degrees of depression, ranging in intensity from mild to severe.

If you are suffering from mild depression you may feel low, sad or fed up for a while. Everything seems harder work and less rewarding. You may feel you're not enjoying life. Gradually, however, these feelings will lift.

If you are suffering from severe depression you are likely to feel very down and unable to cope with normal activities like going to lectures or seeing friends. Severe depression is longer lasting. Sometimes you may feel so hopeless that you think of suicide. If you are severely depressed it's important to seek professional help.

Last semester I began to feel really down. I felt tired all the time although I slept for hours. I didn't enjoy anything, so I stopped going out and gradually withdrew from my friends. I couldn't concentrate on my work, and that made me feel worse because I was afraid I would fail my course. I felt completely useless: some days it hardly seemed worth getting out of bed. I was on edge all the time and the smallest thing would make me cry.

Eventually a friend persuaded me to go to the doctor, and it was such a relief when he said 'I think you're depressed'.

How do I know if I'm depressed?
Depression affects your mood, your thoughts and your physical feelings. You may experience some of the following symptoms:

Mood
feeling low and fed up or numb and empty most of the time
lacking confidence and feeling anxious
being irritable, over-sensitive and tearful
feeling worthless
finding it hard to enjoy anything – nothing seems fun
withdrawing from friends and feeling you can't face going out
Thinking
finding it hard to concentrate, to remember things and to make decisions
feeling guilty and thinking you are to blame for things that go wrong
seeing everything negatively and expecting the worst
finding it hard to be motivated and thinking 'there's no point in doing things'
thinking you would be better off dead, making suicide plans
Physical
either being very restless or unusually slowed-down
feeling tired all the time and lacking energy
changes in sleeping: difficulty in getting to sleep; waking up early; sleeping much more than usual
changes in eating: loss of appetite or eating more than usual ('comfort eating')
weight gain or weight loss
loss of interest in sex
What causes depression?
There is no single cause of depression. It can be triggered by distressing life events such as a relationship breakdown, bereavement or trauma. It can result from prolonged episodes of stress, or physical illnesses such as glandular fever. Statistically, women are more likely to become depressed than men. Early life experiences, genetic tendencies and a family history of depression are also thought to make someone vulnerable to developing depression.

Isn't it just a 'chemical imbalance'?
Medical research has shown that chemical changes take place in the brain when someone is depressed. But it's not clear whether these changes are a response to depression, or a cause. Taking action to overcome depression seems to correct the balance of chemicals in the brain.

How can I overcome depression?
There is no 'magic cure' for depression, but most people do recover and enjoy life again. It helps to have support from other people, and to be patient about taking small steps and building on them.

1: Start by accepting that you are depressed and it's not your fault. Being angry or critical with yourself will only make things worse. Telling yourself to 'Pull yourself together' or 'Snap out of it' won't help. The key to overcoming depression is to break the 'negative cycle' of thinking where you become depressed or anxious about being depressed. If you find this happening, try to stop the negative thoughts. Some people shout 'Stop!' in their heads, or imagine traffic lights on red. Try to give yourself more encouraging messages: 'It's not my fault I feel like this. I will get better – it takes time.'
2: Challenge your negative expectations. Depression makes you interpret events in the worst possible light: 'My housemate didn't speak to me when he came home – he's annoyed with me'. Try to think of alternative explanations: 'Perhaps he's had a bad day... after all, he was quite friendly this morning.' 'Maybe he's still hungover from last night.' Then think which of the explanations is most likely.
3: Set yourself small and realistic challenges. Deciding you are going to write an essay in a day isn't realistic if you haven't been able to concentrate for weeks. Aim to work for a small amount of time (say, half an hour). Reward yourself for your effort. If you don't feel you've achieved much, remember that you are one stage further on than when you started. When you feel ready, work for a little longer each day.
4: Try to establish a routine for meals, bedtime etc and stick to it, even if you don't feel hungry or sleepy. It's important to eat healthily so that your body can fight infections and doesn't become run down. Include something you like doing as part of your routine, even if you don't have much enthusiasm at first.
5: Exercise, including gentle walking, can help to lift your mood. Again, set realistic goals: walking to university may feel more manageable than going to the gym.
6: Learn and practise relaxation techniques which can help reduce tension.
7: Talk to people. Some of your friends may be worried about you and want to help. If going out feels too difficult, try to arrange to meet for a coffee or talk to someone on the phone. Some people find it helpful to talk to other people who have experienced depression, eg on an internet chatline.
8: Avoid alcohol and recreational drugs such as cannabis – they are likely to make you feel worse. Alcohol lowers your mood and recreational drugs will intensify your depression. Some people find herbal remedies helpful, but they can have side-effects. Seek advice before you take any non-prescribed medication.
9: If your studies are affected make sure the University is aware that you are having difficulties. Tell your personal tutor or ask your doctor or counsellor to write a 'medical certificate' on your behalf.
Do I need professional help?
It is important not to ignore the symptoms of depression. If you have experienced five or more of the symptoms described above, for most of the day and for more than two weeks, seek help. Getting professional support can be an important part of helping yourself. It can enable you to recover more quickly and avoid becoming depressed again.

The main treatments for depression are anti-depressant drugs and 'talking treatments' such as counselling, cognitive-behavioural therapy (CBT) or problem-solving. Many people find that a combination of medication and talking is most effective. Different approaches suit different people, so it is important to find the one that suits you best. You can find out more by talking to a doctor or counsellor.

Should I take anti-depressants?
I worried that it was weak to rely on anti-depressants, but I thought anything was worth a try. They helped me feel a bit more motivated and on top of things – and that meant I started to do more and feel more confident. Things just improved from there. Now I wish I'd gone to the doctor earlier.

If you have been feeling depressed for some time and it is affecting your day-to-day functioning, your doctor may suggest a course of anti-depressants. Anti-depressants don't work miracles. They can't take away the causes of your depression, but they can help you cope better and feel that things aren't so hopeless. Most anti-depressants take 2 – 3 weeks to become effective. Your doctor may recommend that you continue to take them for several months, even when you begin to feel better. Modern anti-depressants are not addictive, but some people do experience side-effects. If you have any concerns about taking anti-depressants, discuss them with your doctor.

How can talking treatments help?
I couldn't see how just talking to someone would make a difference. But my counsellor seemed to understand what it's like to be depressed. She helped me make sense of why I was feeling so low, and put things into perspective.

Many people turn to family or friends if they are feeling down. But you may worry that you will burden other people, or upset them. It can be helpful to talk to a professional who can be objective about your situation and won't judge or tell you what to do.

Counselling can help you understand the roots of your depression and make sense of how you are feeling. Your counsellor will help you identify what you would like to change, and support you in taking steps to help yourself feel better.

A problem-solving approach recognises that your depression may be related to problems in your life. Problem-solving helps you tackle those problems in a planned and structured way.

Cognitive-behavioural therapy focuses on helping you to recognise and challenge your negative thoughts and set manageable goals to help you overcome depression.

What if I feel suicidal?
When I was really low, everything felt hopeless. Life just didn't seem worth living. I felt so bad about myself that I thought people would be better off without me. One night I just couldn't stop thinking about suicide and I felt really scared. Out of desperation I called the Samaritans, and that really helped – the man on the phone seemed to understand exactly how I felt.

If you find that you are thinking about death a lot, feeling that life isn't worth living or actually planning suicide, it is important to tell someone. It's a myth that 'People who talk about suicide don't do it'. Feeling suicidal is a sign of how bad you feel and should always be taken seriously. Details of how to contact a doctor, the Brookes Counselling Service and the Samaritans are given below.

How can I help a friend who is depressed?
Someone who is depressed cannot help how they are feeling, and needs understanding and support. It's important to let your friend know that you care and want to help. Encourage them to seek professional help from their doctor or a counsellor, while making it clear that you will continue to support them.

Try to stay in regular contact, even if you can't spend a lot of time with your friend. A quick email, text message or phone call every day is a reminder that you are thinking about them. When your friend is ready to try some of the self-help approaches described above, you can help by encouraging them, praising their efforts, and perhaps joining in.

It's not always easy to support someone who is depressed, especially if they are feeling very stuck. Take care of yourself. Make sure that you go on seeing other people and having fun. Looking after yourself gives you the energy to help your friend. If their difficulties begin to affect you, it's important to seek support for yourself too.

Health alert!
If you search for 'depression' on the internet you will find thousands of sites. Some of them are helpful – others are not and may be harmful if you are feeling vulnerable. Beware of sites which promise a 'miracle cure' if you buy their products.

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