Depressed or just down in the dumps?

Written by Anastasia Stephens, personal trainer

If you've got the blues, you're not alone. Depression affects almost two in three adults at some point in their lives. But how can you tell if you're depressed or just feeling a bit sad?

Signs to look out for

You lose a job, a relationship hits the rocks or a close relative falls sick. Each of these could tip anyone into an emotional nosedive.

Meditation could help the symptoms of depression.

But how easily do you bounce back and get on with life's challenges?

'The will to recover or sense you are moving through something is key to knowing whether you're clinically depressed or moving though a hard time in a healthy way,' explains Dr Jane Flemming.

'There's a difference when you feel stuck and hopeless;depression is that feeling. You may wake up in the morning wondering what the point is and feel that you can’t see things getting better.'

Medically, mild to moderate depression is suspected if you've been suffering from low mood, lack of motivation, tearfulness and sadness for two weeks or more and there’s been no clear improvement.

According to Depression Alliance, other signs of depression include: not wanting to get out of bed, listlessness, low self-esteem, sleeping problems, and fatigue.

The severity of depression is judged by the degree to which your feelings interfere with your ability to function in everyday life. Suicidal thoughts are a sign your depression is moderate or severe.

The causes

There's no single cause of chronic low mood. Experts believe it could be the result of several key factors, such as an imbalance of brain chemicals, external circumstances, what you eat and drink, and how you think.

Brain chemistry

'The brain chemicals serotonin and dopamine, which regulate feelings of mood and pleasure, have been the focus of much research,’ explains Dr Flemming.

'Levels of these mood-regulators tend to be abnormal in people with depression and many antidepressants aim to correct the balance.'

Stress

Chronic stress is also linked to depression and women seem particularly vulnerable, especially after childbirth or during the menopause. One survey by the Medical Research Council found that people in high stress jobs are twice as likely to suffer serious depression.

Meanwhile, a link between high levels of the stress hormone cortisol and low levels of mood enhancing brain chemicals has been established.

Junk food

Nutritionists believe the food we eat has an impact on mood. 'Junk food leaves the body and brain depleted of nutrients it needs to function and feel well,' explains Patrick Holford, nutritionist and author of Natural Highs (Piatkus).

'We know that when people improve their diet to eat more oily fish, eggs and whole foods, while cutting out the bad foods, their mood tends to improve.'

Negative thought patterns

'Some people are more prone to depression than others,' says Dr Linda Blair, a clinical psychologist.

'The roots of this may lie in childhood experience. They may suffer from negative thought patterns and low self-esteem that prevents them from seeing life in a more positive way.'

Medical treatments

Mild depression

For mild cases, doctors are likely to prescribe talking treatments, such as counselling, or a brief course of cognitive behavioural therapy (CBT) where you are taught to transform negative thought patterns.

An exercise programme of daily activities plus three 45 to 60 minute sessions of walking, swimming or tennis per week may also be recommended.

Moderate to severe depression

Antidepressants are generally only prescribed for moderate depression where your symptoms mean you really struggle to engage with your social life and work.

In this case your doctor is likely to prescribe a combination of talking therapies and medication, such as Seroxat or Prozac.

However, antidepressants come with a range of side effects and around 25 per cent of patients have problems when coming off them. Talk to your doctor if you're worried about any side effects or you want to change your dose.

Complementary treatments

People are increasingly turning to alternative therapies that are free from side effects and easy to incorporate in everyday life.

St John’s wort

A recent review of 29 studies found the plant extract, St John’s wort, as effective as medication at treating mild to moderately severe depression.

Researchers believe the plant works in a similar way to antidepressants by boosting mood-stabilising brain chemicals.

Talk to your doctor before you start taking any new herbal treatments. You are advised to not take St John's wort at the same time as the contraceptive pill, for example.

Exercise

A study at the UCLA in America found that three bouts of moderate exercise a week boosted levels of serotonin, alleviating symptoms of mild to moderate depression.

Meditation

Research at the University of Exeter's Mood Disorders Centre found a meditation technique called 'Mindfulness Based Cognitive Therapy' to be as effective as antidepressants for mild depression.

The technique involves sitting for at least 15 minutes daily, observing the mind's activity, but detaching from the thoughts themselves. Once you learn the skill it can be used for life.