Am I Depressed?

Depression is a serious illness and very different from the normal feelings of sadness that we all experience sometimes. It’s not always easy to know if you have a depressive illness or if your symptoms could be caused by something else, which is why an assessment with a Psychiatrist is often the best first step. We can help.

What is depression?

Depression is a mood disorder, characterised by persistent feelings of sadness and lack of interest in activities that you once used to enjoy. Depression is an illness – it can become worse if left untreated and may develop alongside or with other conditions such as anxiety, ADHD or autism.

Sadness and depression are different

People with depression often suffer with a lot of stigma about their illness – although 1 in 5 of us will have depression at some stage there is still a great deal of stigma surrounding depression and many people mistakenly believe depression is something you can simply ‘snap out’ of.

Whilst we all feel sad at times, depression is a clinical illness that can become severe if left untreated and often relapses or becomes a chronic condition.

Causes of depression

Depression can be caused by both environmental and biological factors.

1. Brain chemicals
   Neurotransmitters are thought to have an important role to play in the development of depression. Neurotransmitters like serotonin are chemicals that relay messages from one neuron to another.
   In depressed people, these neurotransmitters are often found in lower levels, meaning the messages (which can control moods) are distorted.
   
   
2. Brain structure
   There are several key areas of the brain that are involved in mood regulation and research has shown that in depressed people, these areas function differently or are even a different size.
   For instance, the hippocampus is an area of the brain involved in forming memories and therefore, managing emotions. In people with depression, this part of the brain is around 13% smaller than in people who haven’t had depression¹.
   
   
3. Genetics
   Our genes are responsible for making proteins which are used in all of our biological process. When the production of genes goes awry, the wrong proteins can be produced which is thought to affect our mood.
   This means that people may have a genetic vulnerability to developing a mental health illness, like depression, and explains in part, why some people have stronger reactions to events than others.
   We know that certain mental health conditions, like Bipolar Disorder, have a strong hereditary link and research has shown that if you have a family member who has had major depression, your risks of developing depression increase as well².
   
   
4. Early experiences
   The psychotherapist, Bowlby, studied infant monkeys and found that when they were removed from their mothers at an early stage, they went through a cycle of emotions from rage, to despair and finally to detachment and apathy.
   If, as a child, you experienced trauma, neglect, abuse or a bereavement you are more likely to develop a mental health condition, like depression, later on in life.

¹ Schmaal, L. (2016)
² Harvard Medical School

Who does depression affect?

Depression affects all ages, races and both men and women. Depression does not discriminate.

We are not 100% sure why more women than men are diagnosed with depression (even though tragically men are more likely to commit suicide) but the following are often suggested:

1. Women seek help more readily and perhaps feel less shame in doing so; they are more likely to get a diagnosis.
2. Hormonal fluctuations and the pressures women can find themselves under, caused by balancing work, family life and relationships could make women more likely to suffer with depression.
3. Differing sensitivities to brain chemicals. A study in 2007 found that women are more sensitive to levels of serotonin in their brain than men.
4. Serotonin is the ‘happy’ chemical, produced by the brain, that is often found in low levels in depressed people. Research found that decreased serotonin levels in women resulted in low moods and more cautious behaviour whereas in men it resulted in increased impulsiveness³.

 ³ Walderhaug, E. et al (2007)

A lot of the time people consider someone who has depression as being weak, overly negative or perhaps even making excuses as to why they can’t go to work or school. Nothing could be further from the truth. Depression symptoms often leave people with huge despair and frustration. The signs of depression can be extremely debilitating to them and their families. They want to seek help but may be unable to do so due to lack of motivation and low energy levels. They may have to rely on family members or their carers to help them seek support. Treatment for depression is available and is most effective if sought early.

Dr Olukemi Akanle

MBBS, MRCPsych

Consultant Psychiatrist

London

Dr Olukemi Akanle is a knowledgeable Consultant Psychiatrist currently working for Central and North West London NHS Foundation Trust. She has a Medical Degree and is a Member of the Royal College of Psychiatrists.