This information was written with the intention of helping people who are experiencing feelings of depression. It can be used as an aid in itself or to bridge the gap between self-help, the assistance of friends and family and professional services.
It was written because depression is a common experience and not a sign of inadequacy or failure. University life has its stresses as well as having many advantages. It is wrong to assume that exams, pressure of work, financial worries or other practical problems are the only factors in causing stress for students. High personal expectations, social expectations, difficulties in living in a university environment affect all students, although not all will become depressed.
Because it is so hard to admit to feeling depressed, particularly when others around us seem to be enjoying themselves and well able to cope, we can feel unjustified in seeking help. This is unfortunate because feelings of failure or inadequacy can add to the downward spiral of depression and make it more difficult to regain your confidence.
What is depression?
As with all human experience it is not easy to generalize and depression has its degrees of severity from sadness, loss of interest in life to helplessness and despair. However, at the time depression is being felt, most people who experience it say that it is a completely here-and-now experience when all good things are forgotten or can't be felt. Neither does the future hold out hope. Isolation and a sense of being paralysed by a sinking mood can be overwhelming.
People who are depressed characteristically experience many of the following:
- loss of interest and enjoyment in life;
- a sense of worthlessness, loss of self-confidence;
- loss of energy, concentration and motivation;
- feeling useless, inadequate, helpless and bad;
- feelings of emptiness and despair;
- thoughts of suicide.
Some of the physical symptoms of depression can include:
- Sleep disturbance (such as insomnia or wanting to sleep all the time or nightmares)
- Impairment of bodily functions, including:
- a speeding of functions such as palpitations, diarrhoea, agitation (as a result of accompanying anxiety)
- slowed down functions such as constipation
- slow thought processes, slow movements
These feelings and symptoms will go away or be significantly reduced when the depression passes. It is crucial to try to hold on to the fact that depression is temporary and short-lived in its intensity, that it is a natural response and that help is available.
What causes depression?
People who experience depression usually wonder why they are depressed. Friends and relatives also try to look for a reason in order to make sense of what is happening. The search for an explanation or an answer is particularly common. When reasons aren't obvious or seem insufficient to explain the experience of depression some of the feelings associated with depression can seem worse. It is usually more helpful to accept the feelings experienced in depression than to search for the cause. Usually there is more than one reason why any particular person becomes depressed but some of the following can play a part in depression.
Distressing or traumatic events often give rise to a period of depression. Normally these feelings about the event are eventually understood and we come to terms with them after a period of time. Sometimes this does not seem to happen and a deeper and more persistent depression sets in, from which it can feel difficult to emerge.
Life circumstances at times of stress or around distressing events in our lives can affect the way we are able to come out of the depression. For example, if we are lonely, away from friends and family, have lots of pressures and worries, then we may not cope as well, becoming more seriously depressed than we might at other times.
Physical illness can often be accompanied or followed by depression, especially when the illness is serious and painful. It is not uncommon after glandular fever and bouts of 'flu. Depression around the time of childbirth and afterwards can occur in women.
Personality may predispose some people to depression. Anyone can become depressed under certain circumstances but some of us because of our early life experiences or because of our individual vulnerabilities seem more prone to depression.
Gender factors play a part in depression. Statistically women seem to get depressed more than men. There are probably many factors involved in this, including social and economic reasons. Men tend to be less likely than women to admit their feelings, bottling them up or sometimes expressing them through aggression or through drinking heavily. This means that there seem to be gender-related forms of expression of feelings which are both expected and acceptable in our society. This can lead to hesitation in seeking help.
Can I be helped by my friends and family?
It is difficult to generalize about how helpful friends and family can be to someone who is feeling depressed. For some people they can be, perhaps, literally a 'lifesaver', for others there may be a fear of not being understood or burdening people, leading to an overwhelming feeling of isolation. For most people the reality is probably somewhere in between. The support and care of friends and family is very necessary and it is with social support that a depressed person can begin to feel reconnected with others.
Part of what happens when people experience depression is a disconnection with other people and perhaps from their own ability to feel. Getting back in touch with one's feelings can be frightening and confusing but it can also be exciting and life-giving. It may help the depressed person and their friends and family to recognise that there may be mood swings and a shifting around of ways of behaving as someone emerges from depression.
How can I help myself?
You are the most important person in your own life and some of the ways in which you can begin to help yourself are listed below.
It is important to accept that coming out of depression can take time. A healing process is needed. Being free from depression does not mean having trouble-free or achieving total happiness. All people have problems from time to time. It is part of life.
Don't bottle things up. Try to tell people about how you feel or about what has happened if you have experienced a major upset in your life. For most people, in the long run, re-living painful experiences several times with an empathic listener will help. Crying and expressing other painful feelings are all part of the healing process.
Recognise how many obstacles you place in your own way. Don't play what Dorothy Rowe calls the "Yes, but ….."game. This can prevent you from doing things that might help, from trying new things and from looking at things in a different way.
Treat yourself kindly. Depressed people do not have a caring, nurturing approach to themselves. Depression is one of the most punishing experiences a person can undergo. It is very important to remind (and forgive) yourself that you are suffering from depression and take steps to look after yourself. This will have different meanings for individuals but can include:
- resisting the temptation to drown your sorrows (in drink, drugs or food)
- taking rest periods (even if you don't want to sleep), breaks, holidays, a change of scene etc.
- taking up old hobbies or trying out a new experience which has the potential to give you pleasure
- caring for your body through exercise, pampering yourself etc.
- Find ways of discovering a peaceful place for yourself. It is essential for the healing process to allow your natural resources to play their part. Many people find relaxation helps them to get relief and peace away from their tensions. Others use meditation or yoga, aromatherapy or therapeutic massage. Music can help a great deal. It is necessary to stop struggling, take a risk, trust yourself and let go in order to experience the calmness and peacefulness that evades you.
If your depression is such that you cannot even contemplate any of the above and that the only thing you can think of is that you are unable to go on without seeking professional help, this in itself might be the most important decision towards helping yourself that you can take.
Depression is a very common experience and you are not unusual in the suffering you are experiencing. Help is available through a number of sources (see page 8), although relief might not be immediate.
Ask yourself how many times you said "Yes, but ……" to the above.
Dorothy Rowe, in her book 'Depression: The Way Out of your Prison' reminds us that,
"A journey of a thousand miles starts under one's feet."
What organised help is available to me?
People differ in the forms of help they find acceptable or suitable. It is important to find the approach that best suits your needs. Some people want to get through their depression without using medication, others find they need to use this form of help at least for a while. Many people approach their GP when they experience depression but this does not mean that their GP will automatically prescribe anti-depressants. Nowadays, the GP is quite likely to suggest a form of counselling or psychotherapy.
Talking things through with a counsellor or psychotherapist who is trained to listen and understand can bring tremendous relief. It may be that powerful feelings will need to be experienced in a period of counselling with painful experiences being talked about, relationships explored and difficulties confronted. Counsellors and psychotherapists are able to recognise that this can be a very difficult process to go through particularly for someone who is severely depressed.
Anti-depressants may be prescribed by a GP if someone is severely depressed or when the depression goes on for a long time. Anti-depressants don't begin working as soon as you start taking them. It may be necessary to wait two to four weeks. Your doctor will advise you on this and also on the possible consequences of stopping them suddenly. There may be some side-effects with anti-depressants and your GP can tell you what to expect.
Psychiatric help. A few people do not recover from depression without more specialised help and are likely to be referred to a psychiatrist. The psychiatrist may offer or refer you to more specialised treatment which can range from psychotherapy, different medication or (rarely)hospital admission.
Other sources of help
The Counselling Service is very able to help with drug and alcohol related problems. We work in a non-judgemental way to help you achieve the goals you have set yourself. As you will see from our confidentiality statement we do not normally inform anyone of any illegal activity we hear about in counselling. The only exception to this rule is when there is a clear and immediate risk to someone's life.
Other specialist help can be obtained through your own GP, via Student Health or by contacting one of the national support and information services:
Alcoholics Anonymous Information Line
01904 644 026/7/8/9
Alcohol Concern Information Line
0207 928 7377
How can I help someone else?
People are different in the way that they respond to attempts to help and in what they find helpful. These are general approaches that have been found to be helpful but the suggestions are by no means definitive:
- Spend time with them even if the person isn't able to say very much about how they are feeling. Depressed people find it very hard to express feelings and may not know why they are depressed;
- Accept what the person says about themselves even if this is not the full picture as you see it;
- Resist putting pressure on them by giving too much advice or by probing too hard. It is often the case that depressed people have thought a lot about what they could 'do' about their problems but aren't ready or able to do anything about them at that time;
- Avoid trying to cheer up depressed people. This doesn't mean you can't offer to go to places with them, or offer reassurance. It can be very helpful for depressed people to have time away from their depressing situations but this is unlikely to effect a lasting change of mood and it is important not to take this as a personal slight;
- Be consistent. It can be hard to stay close to someone who is depressed but your friendship is likely to be more valuable than you think. Depressed people can feel insecure and unworthy of friendship.
- Caring for yourself
It is important to take care of yourself and not get overwhelmed by someone else's depression. This isn't easy to do and often why people steer clear of people who are depressed. It won't help if you get depressed too.
- Be clear and firm about your own boundaries. Offers to support 'any time - day or night' are unrealistic and not helpful to anyone.
- If you are getting too affected by the situation, limit the help you can offer, eg part of an evening, then some time on another day. Stick to the time you have agreed.
- Talk to someone else about the situation to help you offload and get some support.
- When other help is needed
Know your limits. If what the person tells you (eg about suicidal feelings) is more than you can cope with, take this seriously, tell the person as gently as you can and suggest they seek outside help. Your ongoing support will still be very valuable. You might need to be patient for a while and offer encouragement and support until the person is ready to seek help.
Dragging someone to the GP or the Counselling Service is unlikely to be helpful and is more likely to reflect your exasperation or wish to make things better than the depressed person's motivation to seek help.
There are cases (although rare and difficult to distinguish) when a person is feeling so entirely lacking in hope that they are unable to seek help and could put themselves at serious risk. It might be at this point that someone will need to act on their behalf. It is not possible to be clear about if and when this might be necessary. On the whole, people have a tremendous capacity to survive, particularly when they receive help and understanding.
Unhelpful advice to depressed people
This mainly involves trying to impose your views and values on to the depressed person such as:
“Pull yourself together and get on with it.”
“I always find busying myself with work helpful.”
“Don’t let them get you down. I wouldn’t stand for it ……!”
“I don’t believe in taking anti-depressants.”
“I wouldn’t go to a counsellor. I’d rather solve my problems myself.”
“Everybody gets depressed. Don’t worry about it.”
“There’s always someone else worse off than you.”
This information was written with reference and thanks to:
Dorothy Rowe: Depression:. The Way out of Your Prison
Routledge Kegan Paul. 1983
Depression. Royal College of Psychiatrists. 1992
The Blues. University Counselling Service, The University of Cambridge
Conference proceedings: Depression, its diagnosis, its diversity and treatment. St George's Hospital Mental Health Library. 1994
Professor Pam James, Liverpool John Moores University
Carys Wyn-Jones, formerly Accommodation and Welfare Advisor, The University of Liverpool
Dr Fergus McMillan, formerly of the Student Health Service, The University of Liverpool