|At some point in their life,
everyone experiences some sort of unhappiness, often triggered
by a traumatic event such as the break-up of a relationship or
a bereavement. Most people also feel 'down' from time to time.
However this unhappiness can develop into a bout of depression,
a real illness that often goes unrecognised, partly because sufferers
are reluctant to seek help. This fact sheet explains the symptoms
and possible causes of depression. A separate fact sheet Treatments
for depression outlines the options for dealing with the condition.
|Who is affected
|Depression affects up to
40% of people at some point in their lives. It often appears first
during a person's teens or twenties. Some people then experience
recurrent episodes throughout their lives. It is twice as common
in women than men.
|The most common symptom
of depression is low mood. In addition to feeling sad, some people
are irritable and tend to lose their temper more easily than usual.
Often, people notice that they feel worse either first thing in
the morning or last thing at night.
Depressed people find that they can't get pleasure from events
or activities that they normally would. They tend to feel different
and separate from the rest of the world. Lack of energy, tiredness
and poor concentration are also common symptoms. Additionally,
sufferers find they don't sleep well, either waking up unrefreshed
from a long sleep, or waking up very early in the morning. Loss
of sex-drive (libido) and disturbed eating patterns - either loss
of appetite or eating too much - are also common.
Symptoms of anxiety routinely occur with depression. People may
experience fearfulness, palpitations and even panic attacks. Very
often these feelings subside when the depression is treated.
Among the most serious aspects of depression are the thoughts
people have about themselves and their lives. Sufferers start
to judge themselves excessively harshly or critically. They may
think of harming themselves or feel that life is not worth living.
People who are depressed are more likely to attempt suicide.
Many people with depression turn to alcohol or illegal drugs to
try and blot out their difficult feelings. Unfortunately, this
tends to make things worse because alcohol lowers the mood further
and, in excess, is harmful to physical health.
|What causes depression?
|Usually a bout of depression
is set off by a stressful event, often involving some form of
loss. This may be when somebody dies, or after a relationship
breaks up. Financial worries, a stressful job, redundancy or fear
of unemployment, even moving house can trigger depression in vulnerable
people. New mothers are susceptible to postnatal depression. And
long-term or serious illnesses such as diabetes or cancer can
also trigger depression.
Relationship problems are common in depressed people. These may
be part of the cause of a person's depression or a consequence.
Some forms of the illness seem to run in families but researchers
have yet to find a simple genetic explanation. Unhappy childhood
experiences have been shown to be important in the development
of depression in adult life. For example, a child who loses his
or her mother before the age of 14 and lacks adequate care from
another person is more likely to have depression. Other difficult
childhood events such as sexual abuse are linked to depression
in adult life.
Finally, some people tend to always look on the darker side of
things - it's part of their personality. These people are more
likely to develop full-blown depression at some point in their
|The value of treatment
|Depression interferes with
the way people want to live their everyday lives. They may feel
unable to go to work or do any of the things they used to enjoy:
it is truly a miserable condition. Despite this, many people do
not seek help for their problems. This may be because they feel
embarrassed about their feelings - considering them a sign of
weakness - or they blame themselves for their misfortune.
Fortunately, a number of treatments are available for depression
and talking to a qualified professional about one's feelings is
the first step.
|The two main approaches
to treating depression are psychological therapies, such as counselling,
and medical treatment with antidepressants. These are described
in greater detail in a separate fact sheet - Treatments for depression.
For mild forms of depression, psychological treatments are often
sufficient. For more severe depression, a combination of psychological
treatment and antidepressant drugs, or antidepressants alone is
|A wide range of antidepressant
medication is now available. It is important to recognise that
these are different from tranquillisers or anti-psychotic medicines.
However, like all medicines, they can have some side-effects,
but they are not addictive and do not change a person's personality.
The two main groups of antidepressants are known as SSRIs (which
stands for selective selective serotonin re-uptake inhibitors)
and tricyclics (the name refers to the molecular structure of
the drug). They are both known to be effective in treating depression
but SSRIs, a group of drugs which includes fluoxetine (Prozac),
are now being more widely used because their side-effects tend
to be less troublesome.
Most antidepressants take two weeks or so to start gradually working.
They are then usually required for around six months to treat
a single episode of depression, even if the symptoms clear up
sooner. This is because it's been shown that a longer course makes
a relapse of depression less likely.
St John's Wort is now a popular complementary medicine for depression
that can be bought in health food stores and pharmacies. Some
research studies have shown some promising results. If you take
St John's Wort, it's important that you tell your doctor and pharmacist,
as it does not mix well with some prescription medicines.
|GPs can often arrange for
sufferers to have counselling as part of their treatment. Counselling
usually takes the form of a one-to-one session where you have
an opportunity to express your feelings and problems, with the
counsellor listening and asking questions. Generally in counselling,
you won't be told what to do about these feelings. A typical course
of counselling is around 6 sessions. More structured types of
psychological treatment also exist. These include cognitive behavioural
therapy and are described in greater detail in a separate fact
sheet - 'Depression Treatments'.
|For the majority of people,
depression responds to antidepressants and simple counselling.
If depression is severe, or intense thoughts of suicide are experienced,
GPs often refer sufferers to a psychiatrist. Psychiatrists are
qualified doctors who have specialist training in treating mental
health and can suggest a wider range of therapy, medical and psychological.
Sometimes, people need to be admitted to hospital for severe depression.
They (or their family) may feel they are unsafe to be looked after
at home, due to suicidal thoughts. Depressed people are not typically
a danger to others.
|An important factor in the
prevention of depression is learning to manage stress. Stress
is a highly individual experience; we all have different things
in our lives that cause frustration or unhappiness. We all need
to be aware of how we are feeling and of how to develop positive
ways of coping. This may simply mean making more time to relax,
exercise, or learning to talk more openly with people you are
|Hong Kong Mood Disorders
Center (The Chinese University of HK)
Hotline : (852) 2833 0838 - 8
Mental Health Association of Hong Kong
Hong Kong Christian Service (Counselling Service)
Address: 5/F, 33 Granville Road, Tsim Sha Tsui, HK
Tel. : (852) 2731 6251
Fax : (852) 2724 3655
Caritas Family Service
Tel: (852) 2843 4670
St. John's Counselling Service
Address: 7D, On Hing Building., 1-9, On Hing Terrace, Central,
Tel: (852) 2525 7207/8
Fax: (852) 2524 2777
National Foundation for Depressive Illness
Dr. Ivan's Depression Central
The Depression Alliance
Internet Mental Health
The Royal College of Psychiatrists
American Psychological Association
|Healthwise (Health Information Resource
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : firstname.lastname@example.org
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own