Diagnosing Depression

Your Guide to Depression & Mental Health in the UK

Mental health problems are one of the world’s most common conditions, with behavioural patterns such as depression and anxiety affecting millions of people every year. Startlingly, 1 in 6 people experience a common mental health problem every week.

What is depression?

Many people use the words depressed and depression in everyday life, without understanding the full extent of what it really means to have a mental disorder, such as anxiety or depression. A lot of people will have ups and downs in their everyday mood, but depression strikes for weeks and even months on end. It’s a health condition that can’t be cured by ‘snapping out of it’. However, with the right diagnosis and treatment, most people with depression can make a full recovery.

Mental health problems in the UK

Anxiety and depression are the most common mental disorders in Britain

7.8% of people meet the criteria for a diagnosis

4-10% of people in the UK will experience depression in their lifetime

One fifth of days lost at work can be attributed to mixed anxiety and depression

One in six adults have a common mental disorder

Mental health gender divide

Women are more likely than men to have a common mental health problem
Women are twice as likely to be diagnosed with an anxiety disorder
10% of mothers and 6% of fathers have a mental health problem
About 5% of men and 10% of women will experience Major Depressive Disorder at some point in their life

Spotting mental health problems in men

Feeling sad or "empty"
Feeling hopeless, irritable, anxious, or angry
Loss of interest in work, family, or once-pleasurable activities, including sex
Feeling very tired
Not being able to concentrate or remember details
Not being able to sleep, or sleeping too much
Overeating, or not wanting to eat at all
Thoughts of suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems
Inability to meet the responsibilities of work, caring for family, or other important activities

Spotting mental health problems in women

Persistently sad, anxious, or having an "empty" mood
Loss of interest or pleasure in activities, including sex
Restlessness, irritability, or excessive crying
Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
Sleeping too much or too little, or early-morning awakening
Appetite and/or weight loss or overeating and weight gain
Decreased energy, fatigue, feeling "slowed down"
Thoughts of death or suicide, or suicide attempts
Difficulty concentrating, remembering, or making decisions
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Depression triggers in the UK

1. Overwhelming stress at work, school, or home

2. Marital or relationship problems

3. Not reaching important goals

4. Losing or changing a job; embarking on military service

5. Constant money problems

6. Family history of mood disorders

7. History of mood disorders in early reproductive years

8. Loss of a parent before the age of 10

9. Loss of social support system or the threat of such a loss

10. Ongoing psychological and social stress

Mental health in over 65s

22% of men and 28% of women aged over 65 are affected by depression. However, it is believed 85% of these don’t receive help from the NHS.

Is it Depression or Dementia?

Symptoms of Depression	Symptoms of Dementa
Mental decline is relatively rapid	Mental decline happens slowly
Knows the correct time, date, and where he or she is	Confused and disorientated; becomes lost in familiar locations
Difficulty concentrating	Difficulty with short-term memory
Language and motor skills are slow, but normal	Writing, speaking, and motor skills are impaired
Notices or worries about memory problems	Doesn’t notice memory problems or seem to care

There are 850,000 people in the UK with dementia. This will reach 1 million by 2025 and 2 million by 2051
225,000 people will develop dementia this year
1 in 6 people over 80 years-old have dementia
The total cost of dementia in the UK is £26.3 billion a year

Mental health in the younger generation

20% of adolescents may experience a mental health problem
50% of mental health disorders are established by age 14
10% of children have a clinically diagnosable mental health problem

Young Minds is a charity specifically dedicated to helping younger people overcome depression and other mental health conditions.

Mental health and suicide

There are over 6,000 suicides in the UK every year. On average, around 78% are male and 22% female

18,220 people with mental health problems took their life between 2003 and 2013

Suicide is the most common cause of death for men under 45

1 in 15 people have made an attempt to end their life

What to do if you have suicidal thoughts

Suicidal feelings can be different from person to person, whether it’s a thought of ending your own life, thinking of life-ending methods, or believing people would be better off without you. What’s important to remember though, is that you are not alone – there is always help and support available.

One of the most important things you can do to alleviate suicidal thoughts, is to speak to someone. This could be a friend, family member, or medical expert – such as a therapist, psychiatrist or GP. Although you may not want to confide, the earlier you do this, the more other people can support and help you recover.

Emergency help

If you don't feel you can keep yourself safe right now, seek immediate help.

Go to any hospital A&E department (sometimes known as the emergency department)
Call 999 and ask for an ambulance if you can't get to A&E
Ask someone else to contact 999 for you or take you to A&E immediately

You can also:

Contact the Samaritans on 116 123. They're open 24 hours and are there to listen
Contact your GP for an emergency appointment, or the out of hours team
Call NHS 111 (England) or NHS Direct 0845 46 47 (Wales)
Contact your local crisis team

What are the different types of depression?

Depression isn’t a one size fits all condition. There are different types that will affect people in different ways – including Major Depressive Disorder, Dysthymic Disorder, and Seasonal Affective Disorder.

Major Depressive Disorder

Major Depressive Disorder (MDD) is often diagnosed in people with an intense and persistent low mood, or lack of pleasure in activities they’d usually enjoy. This would be every day for at least two weeks. To be diagnosed with MDD, patients would also need to exhibit at least five of the symptoms below:

Gaining or losing a significant amount of weight
Sleeping much more or less than normal
Noticeable extreme restlessness or lack of movement
Feeling very tired or having a lack of energy
Feeling worthless or inappropriately guilty
Difficulty in concentrating or making decisions
Having thoughts of death or suicide
Feeling hopeless

Dysthymic Disorder

Dysthymic Disorder is similar to MDD, but it’s described as less severe and could be with you for years before a diagnosis. There are often mood problems, but the patient can usually get through daily functioning.

Symptoms include:

Depressed mood most of the day, for at least one or two years
Many of the symptoms outlined under MDD

Seasonal Affective Disorder

This depression type will only be present at certain times of the year. Typically, patients struggle during the darker seasons of autumn and winter, when there are fewer sunlight hours.

Symptoms for SAD include:

The same as MDD, but only during certain times of the year – without symptoms in spring or summer
Reoccurring problems for more than one year in a row

Am I Depressed?

Many people go through highs and lows in their daily life, but aren’t diagnosed with depression. Try the following survey and seek medical advice if the results reveal you have the symptoms for a diagnosis. Help and treatment can then be provided.

This article and PHQ-9 Questionnaire is information only – it is not intended for diagnosis or treatment of medical conditions. Please seek medical advice from a qualified professional for advice on diagnosis and treatment of any medical condition.

Patient Health Questionairre (PHQ-9). Over the last 2 weeks, how often have you been bothered by any of the following problems?

Patient Health Questionairre (PHQ-9). Over the last 2 weeks, how often have you been bothered by any of the following problems?
Little interest or pleasure in doing things? Not at all Several days More than half the days Nearly every day
Feeling down, depressed, or hopeless? Not at all Several days More than half the days Nearly every day
Trouble falling or staying asleep, or sleeping too much? Not at all Several days More than half the days Nearly every day
Feeling tired or having little energy? Not at all Several days More than half the days Nearly every day
Poor appetite or overeating? Not at all Several days More than half the days Nearly every day
Feeling bad about yourself - or that you are a failure or have let yourself or your family down? Not at all Several days More than half the days Nearly every day
Trouble concentrating on things, such as reading the newspaper or watching television? Not at all Several days More than half the days Nearly every day
Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual? Not at all Several days More than half the days Nearly every day
Thoughts that you would be better off dead, or of hurting yourself in some way? Not at all Several days More than half the days Nearly every day

Total score:

Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

Source: http://patient.info/doctor/patient-health-questionnaire-phq-9

How to help someone with depression

If someone you know has a mental disorder such as depression or anxiety, it’s best to recommend they visit their GP and seek professional help. With the right diagnosis and treatment, a full recovery is possible.

You can also help their situation by:

Being compassionate and listening to their problems
Offering your assistance to help them in day-to-day life
Taking walks or carrying out physical activities together
Taking good care of yourself, to ensure remaining positive and upbeat
Encouraging a healthy diet

Do say:

You’re not alone. I’m here for you
I may not be able to understand, but I am here to help
Tell me how I can help you
You are important to me

Don’t say:

It’s all in your head
We all go through times like this
Look on the bright side

Treatment of depression

For those who are suffering with depression, it can often feel as if you’re living under a dark cloud. However, there are treatment options available, including medication, lifestyle changes, and even therapy.

Treatment will depend on your personal condition and how severe the depression is.

Mild depression

Watchful waiting: After diagnosis, your condition may improve by itself. You’ll probably see your GP again in a couple of weeks, who will be able to monitor your progress.
Exercise: Mild depression can often be eased with exercise, and this is prescribed as a leading treatment. You may be referred to a fitness trainer to help you find the right activities.
Visit self-help groups: Talking to others about your feelings can be really helpful. Visiting a local self-help group or chatting to your friends and family could be a great way to get things off your chest. Your GP may also recommend books or online cognitive behavioural therapy.

Mild to moderate depression

Attend talking therapy: If your symptoms don’t improve, or you’re diagnosed with moderate depression, therapy will often be arranged. Talking treatment is a form of psychotherapy - ranging from cognitive behavioural therapy to counselling.

Moderate to severe depression

Antidepressants: These tablets will help to alieve your symptoms. There are nearly 30 types available and these will often be prescribed by a doctor.
Combination therapy: As well as taking antidepressants, you may also be referred to talking therapy to help with treatment. The combination of both usually shows better results in recovery.
A mental health team: These teams are made up of psychologists, psychiatrists, specialist nurses and occupational therapists. They’ll be able to provide targeted help and treatment, whist offering prescribed medication too.

Tips for treating your depression:

Learn more about your depression: It’s important to find out if your condition is due to an underlying medical condition. If so, this will need to be treated first. The severity of your depression will need to be taken into account too.
Trial and error: It can take time to find the right cure for your depression, as everyone’s condition differs slightly. Some people may find therapy works wonders, whilst others may be more comfortable using prescribed medication. Lifestyle changes, such as healthy eating and exercise can also be considered.
Don’t focus on medication: Medication will help relieve the symptoms of depression, but may not always be suitable for long-term use. There are side effects to beware of as well.
Consider social support: Seeking the help and support of your friends and family is a great way to protect yourself from depression. It’s not a weakness and you won’t be considered a burden.
Give your treatment time: Don’t go into treatment thinking you’ll be instantly cured. It can often take some time until you start to feel the full effects, whilst recovery will have its ups and downs.

Diagnosing Depression - Your Guide to Depression & Mental Health in the UK