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Depression isn’t a weakness and you can’t simply “snap out” of it.

Glenn Nolan Supervisory Pharmacist Grants Pharmacy, The Duffry, Enniscorthy.

This article explores a few aspects of depression in a question and answer style. Lots of people experience depression on some level during their lives, but for some it is all encompassing and can affect their normal daily functioning. Like all mental health conditions, it is somewhat invisible and it is up to all of us to be aware of friends or colleagues who are showing signs of challenging mental health and to extend a supportive hand to them. Equally, in 2017, it is important for us to feel safe to share our own feelings of depression and not to hide behind an age-old taboo that can only lead to pain and suffering.

What is mental health?

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Over the course of your life, if you experience mental health problems, your thinking, mood, and behaviour could be affected. It is estimated that one in four of us will experience some mental health problems in our lifetime, from a low period, to more serious depression.

And what is depression?

Depression is a mental health disorder. In this article, I discuss some aspects of depression, but bare in mind that depression is only one aspect of reduced mental health which can manifest in many different forms.

So who can suffer from depression?

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women are diagnosed with depression than men, but this may be due in part because women are more likely to seek treatment.

Fact: Most people with mental health problems can get better and many recover completely.

So why do some of us get depression and others do not?

Surprisingly, it’s not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences. People with depression appear to have physical changes in their brains.
Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression.

Fact: Altering the quantities of these neurotransmitters is how many anti-depressant medications work.

Changes in the body’s balance of hormones, e.g. during and after pregnancy. Hormonal changes due to thyroid problems, menopause or a number of other conditions.
Inherited traits. Depression is more common in people whose blood relatives also have this condition.

Am I depressed or just having a bad day?

Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviours on a regular basis can be an early warning sign of a problem:

Eating or sleeping too much or too little
Pulling away from people and usual activities
Having low or no energy
Feeling numb or like nothing matters
Feelings of sadness, tearfulness, emptiness or hopelessness
Having unexplained aches and pains
Smoking, drinking, or using drugs more than usual
Experiencing severe mood swings that cause problems in relationships
Having persistent thoughts and memories you can’t get out of your head
Thinking of harming yourself or others
Inability to perform daily tasks like taking care of your kids or getting to work
Loss of interest in most or all normal activities, such as sex, hobbies or sports
Anxiety, agitation or restlessness
Slowed thinking, speaking or body movements
Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility

Oh, I think I have some of those symptoms, what should I do?

Most people will see their GP but many other services are available in the South East.

Before your appointment, make a list of:

Any symptoms you’ve had, including any that may seem unrelated to the reason for your appointment
Key personal information, including any major stresses or recent life changes
All medications, vitamins or other supplements that you’re taking.

Will I have to go on medication; I don’t like the sound of that?

Depression generally isn’t a disorder that you can treat on your own. Different types of psychotherapy can be effective for depression, such as cognitive behavioural therapy or interpersonal therapy. Psychotherapy is a fancy term for treating depression by talking about your condition with a mental health provider. Exercise is also used. Often the best treatment is a combination of all of these.

Tell me more about the meds?

Well many types of antidepressant medications are available, the most common we see are (Warning: here comes the science bit and the big words).

Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer side effects than other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Seroxat) , sertraline (Lustral), citalopram (Cipramil) and escitalopram (Lexapro).
Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Efexor).
Atypical antidepressants. Trazodone (Molipaxin) and mirtazapine (Mirap) are sedating and usually taken in the evening to help sleep.
Tricyclic antidepressants. These antidepressants — Amitriptyline, trimipramine (Surmontil), can be very effective, but tend to cause more-severe side effects than newer antidepressants so generally aren’t prescribed unless you’ve tried an SSRI first without improvement.
Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

So what if I just try them for a few days and see what happens?

Wrong! You may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Are antidepressants addictive, I don’t want to get hooked?

Don’t stop taking an antidepressant without talking to your doctor first. Antidepressants aren’t considered addictive, but stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms.

In addition to professional treatment, these self-care steps can help:

Stick to your treatment plan.
Learn about depression. Education about your condition can empower.
Pay attention to warning signs. Make a plan so that you know what to do if your symptoms get worse. Ask relatives or friends to help watch for warning signs.
Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms.
Take care of yourself. Eat healthily, be physically active and get plenty of sleep.

Simplify your life. Cut back on obligations where possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.

Write in a journal. This may improve mood by allowing you to express pain, anger, fear or other emotions.

Exercise – depressed or not, everyone feels better after getting their body moving and increasing heart rate. In the UK, doctors now use exercise as a first-line treatment for depression, but it is vastly underutilised elsewhere. Aerobic exercise has a positive impact on the entire range of depressive symptoms, regardless of whether they come individually, in the form of a mild episode or combine to form a depressive disorder.

One of the hurdles to conquering depression is that the disorder encompasses such a broad array of symptoms, most of which all of us experience at some point. Who doesn’t feel grouchy, irritable, pessimistic, lethargic, apathetic, self-critical, or melancholy on occasion? Sadness, for instance, is a normal aspect of the human condition – a response to a loss. But being sad isn’t the same as being depressed, unless the feeling never goes away or comes along with a certain number of the other symptoms – including anxiety. Exercise is not an instant cure, but you need to get your brain working again and if you move your body, your brain won’t have any choice. At it’s core, depression is defined by an absence of moving toward anything, and exercise is the way to hijack those negative signals and trick the brain into coming out of hibernation. For mild depressive symptoms, it may be all that is needed to lift mood.

I don’t want to see my GP can I just get something in your pharmacy to try first?

Something as simple as a supplement may benefit general mental health although you shouldn’t replace conventional medical treatment or psychotherapy with over the counter treatments. At Grant’s Pharmacy, we have a special interest in all things mental health so why not ask about the benefits of:

Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression.
A natural ingredient called Valerian has been proven for years to help combat stress.
Kalms night. Does the same as above but also aids restful sleep.
Vitamin D. The ‘sunshine vitamin’ is sourced directly from our contact with natural sunlight. Vit D has a direct role in our mood, but in countries like Ireland people are commonly found to be deficient. Luckily for us it is also available in a very affordable supplement.

Many services are available in your area and the road to recovery is just a phone call away.

New Ross – Maryville house- 051 425648

Enniscorthy – CARN house 053 9233252

Wexford – Ard Aoibhinn- 0539147868, Summerhill House 0539123899

Arklow– Arklow support group- 040224856

Gorey – Tara House- 053 94 88900

Urgently require help, contact these helplines:

The Samaritans
Text: 087 260 9090

www.aware.ie

Pieta House (Suicide & Self-harm)
Tel: 01 623 5606

Aware (Depression, Bi-Polar Disorder & Anxiety)

www.aware.ie
Tel: 1800 80 48 48

National Suicide Helpline (Pieta House)
Tel: 1800 247 247

Teenline Ireland Helpline – Listen when no one else will

www.teenireland.ie
Tel: 1800 833 634 (7pm-10pm)

Grant’s Pharmacy offer free and friendly advice on depression and any other worry you may have about yourself or your family. So visit Grant’s Pharmacy as your first step to recovery.

Grant’s Pharmacy is located beside Pettitts Supervalu, Wexford, Enniscorthy and Arklow and opposite the GPO in Gorey. Free parking. New click and collect service now available on all prescriptions. No waiting times. Ask instore for details.

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