Depression comes in many guises. So
why do we treat them all the same way?
The black dog. The blues. A bit down. There
are almost as many descriptions for depression as there different experiences.
And right now, it’s the most common mental health problem in the world, with
10% of us here in the UK suffering with it at any one time.
But, unlike other illnesses, there isn’t a
one-experience fits all when it comes to symptoms. From stress through to
all-encompassing grief, and taking in post natal illness and Seasonal Affective
Disorder depression comes in many guises. Go to your doctor, though, and the
diagnosis is likely to be startlingly simple you’re depressed. But The Lancet,
the world’s leading general medical journal, recently voiced concern that all
these conditions are being lumped together and ‘medicalised’ to such an extent
that treatment is becoming uniform, and this ‘simplistic and flawed’ approach
is resulting in people receiving the wrong treatment.
‘Most GPs don’t get sufficient
training in all the emotional illnesses’
‘GPs have a tendency to oversimplify
depression’, agrees Dr Jonty Heaversedge, GP and presenter of BBC’s Street
Doctor. ‘Different forms of emotional illness may share symptoms like loss of
libido, poor sleep or lack of appetite, but the root causes and the way we
experience it are never the same, so the treatment needs to be individual, too’.
‘Most
GPs don’t get sufficient training in all the emotional illnesses’
Ask around and it doesn’t take long to
discover stories of same symptoms, same advice yet very different conditions.
When Sarah Robson, 34, lost her mum, for instance, her GP diagnosed her as
depressed when she admitted she was struggling to cope. ‘I went to my GP when,
after three or four months, I still couldn’t sleep, lacked appetite and almost
constantly felt on the brink of tears. He immediately prescribed
antidepressants’, she says. Anita McLagan, 28, received very similar advice for
a very different problem. ‘I went to my doctor last year’, she says. ‘Looking
back, I was going through a really stressful period with mass redundancies at
work but, at the time, I didn’t recognize that as the cause for how I was
feeling. I was struggling with tearfulness, insomnia and frequent headaches. My
doctor asked a few questions, then suggested I think about counseling or try a
course of antidepressants. I felt uncomfortable with taking medication, so I
joined the waiting list to see a counselor. In the meantime, I signed up for a
one-day mindfulness workshop my friend recommended. That helped me realize it
was work that was stressing me out, and I learned a few techniques on how to
cope in a high-stress situation. In the end, I didn’t need either the
counseling or antidepressants. In fact, I’m a bit shocked the drugs were even
suggested’.
‘It is possible to generalise a little with
some types of depression – for example, grief is reactive, so you should be
offered psychotherapy’, says Dr Heaversedge. ‘Whereas depression with no
apparent trigger is more likely to have come from a chemical imbalance in the
brain and may need a more medical approach, potentially including
antidepressants’.
‘Feeling down is the third most
common reason for GP appointments’
But there’s a difference between
‘generalising’ and providing blanket treatments for a range of experience that
couldn’t be more unique. So why do patients so often experience a carbon copy
response? ‘Unfortunately, many GPs don’t get sufficient training for all the
different emotional illnesses’, says Dr Heaversedge. ‘Most would refer patients
to a general counselor without thinking about the different types of therapy
available, and what’s most likely to help that particular patient’.
‘Feeling
down is the third most common reason for GP appointments’
When you consider that feeling depressed is
the third most common reason for people to see their GP, it’s not so surprising
that doctors offer the same tried and tested services. But you don’t have to
accept their first treatment suggestion; you can insist on discussing all the
options available. After all, you know better than anyone else how you’re
feeling and what you’re comfortable with.
Professor Cary Copper, president of the
British Association of Counselling and Psychotherapy (bacp.co.uk) agrees that
matching a patient’s emotional problem to a specific therapy is crucial. ‘For
example, we know the main driver of grief is loss, so bereavement counselling,
with specific techniques for loss, is the only answer’, he says. Even then,
it’s important to find a counselor who specialises in your type of grief. ‘A
couple who’ve lost a young child will have a different experience from someone
who’s lost a parent’, he says. In short, the way to beat your strain of the
blues is to find the cause and treat that, not just the symptoms.
The good news is that there are just as
many treatments available out there as are shades of blue. Here’s how to work
out which will suit you best and how to get it, whether with suit you best and
how to get it, whether with your GP’s help or going it alone.
Stress
‘The human body has a biological physical
stress response, which kicks in when you perceive a threat, for example, your
boss demanding a document you know you won’t have ready in time’, says Gladeana
McMahon, co-director for The Centre of Stress Management (managingstress.com).
‘Once the threat has been dealt with, your body starts its recovery process.
But if the stress continues over longer periods say your boss repeatedly sets
demands you can’t meet you’re likely to suffer emotionally and physically’.
Treat it:
treatment depends on how severe your stress is and what’s causing it:
‘The
human body has a biological physical stress response, which kicks in when you
perceive a threat, for example, your boss demanding a document you know you
won’t have ready in time’
Stage 1 mild
Symptoms are normally physical feeling
tired and achy, the odd tummy problem or allergy flare-up.
Try looking at your schedule and building
in more relaxation time. Increase your exercise, too, even if it’s something
low impact like walking or, better still, yoga.
Stage 2 moderate
You’re more forgetful than usual, losing
keys and belongings more easily. You may be more tearful, irritable and
accident prone, too.
Try writing a list of all the demands on
your time, then consider how you can enlist help at work, at home or both. Ask
yourself if you’re trying to do too much and, if so, work out what’s essential
and what’s not.
Stage 3 severe
You’re on edge all the time and feel
anxious and upset. You may have panic attacks and your appetite and sleep may
be affected.
Try a stress management class. Speak to
your GP as lots of doctors’ surgeries and community centres run groups that
help you identify the cause of your stress and teach you coping techniques.
Another option is solution-focused brief
therapy (brief.org.uk), which you would have to pay for. These targeted,
one-on-one sessions will teach you practical solutions and coping strategies.
Many people learn enough in just three sessions to change the way they handle
stress for good.
