The hardest thing for me is I can never forget I am a carer.

Even if I get some ‘me

time’,
first I have to organise alternative care and if I can’t get it, I have to cancel
what I wanted
to do.”
When you're feeling really low and hopeless, you might find yourself thinking about
suicide. Whether you're only thinking about the idea, or actually considering a
plan to
end your life, these thoughts can feel difficult to control and very frightening.
If you're worried about acting on thoughts of suicide, you can call an ambulance,
go
straight to A&E or call the Samaritans for free on 116 123 to talk.
See our pages on how to cope with suicidal feelings for more information.
The risk of isolation
It can sometimes be hard to explain your thoughts and feelings to others. You might
find it
difficult to talk about your depression and instead you might cut yourself off from
other
people. The more overwhelming your symptoms, the more isolated and lonely you might
become.
Without treatment and support, depression can have an impact on your relationships,
work, finances and overall health, so it's important to get help as early as
possible. See
our pages on treatment and support for more information.
Anxiety
It's very common to experience depression and anxiety together. Some symptoms of
depression can also be symptoms of anxiety, for example:
 feeling restless
 being agitated
 struggling to sleep and eat.
See our pages on anxiety for more information.“I flit between states of anxiety and
depression. At times, each seems to fuel the other.”
Can depression be a symptom of other mental health
problems?
Depression can be a part of several mental health problems, such as:
 bipolar disorder
 borderline personality disorder (BPD) and other personality disorders
 schizoaffective disorder.
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6
If feelings of low mood or suicidal thoughts are the reason you first speak to your
doctor
about your mental health, your GP might offer you treatment for depression without
realising that you are also experiencing other symptoms.
If you think you're experiencing other symptoms, you can talk to your doctor about
this to
make sure you're getting the right treatment to help you. See our pages on seeking
help
for a mental health problem for information on how to make sure your voice is
heard, and
what you can do if you're not happy with your doctor.
What causes depression?
There are several ideas about what causes depression. It can vary a lot between
different people, and for some people a combination of different factors may cause
their
depression. Some find that they become depressed without any obvious reason.
In this section you can find information on the following possible causes of
depression:
 childhood experiences
 life events
 other mental health problems
 physical health problems
 genetic inheritance
 medication, recreational drugs and alcohol
 sleep, diet and exercise.
Is depression caused by a chemical imbalance?
The human brain is extremely complicated. Because antidepressants work by changing
brain chemistry, some people have assumed that depression is caused by changes in
brain chemistry which are then ‘corrected’ by the drugs. Some doctors may tell you
that
you have a ‘chemical imbalance’ and need medication to correct it.
But the evidence for this is very weak, and if changes to brain chemistry occur, we
don’t
know whether these are the result of the depression or its cause.
Childhood experiences
There is good evidence to show that going through difficult experiences in your
childhood
can make you vulnerable to experiencing depression later in life. This could be:
 physical, sexual or emotional abuse
 neglect
 the loss of someone close to you
 traumatic events
 an unstable family situation.
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Research shows that going through lots of smaller challenging experiences can have
a
bigger impact on your vulnerability to depression than experiencing one major
traumatic
event.
Difficult experiences during your childhood can have a big impact on your self-
esteem
and how you learned to cope with difficult emotions and situations. This can make
you
feel less able to cope with life's ups and downs, and lead to depression later in
life.
NAPAC support anyone who experienced abuse in childhood – including sexual,
physical
and emotional abuse, and neglect.“I first experienced depression at 15, after
psychological abuse and domestic violence
(both myself and my mother) at the hands of my father, for many years.”
Life events
In many cases, you might find your depression has been triggered by an unwelcome,
stressful or traumatic event. This could be:
 losing your job or unemployment
 the end of a relationship
 bereavement
 major life changes, like changing job, moving house or getting married
 being physically or sexually assaulted
 being bullied or abused.“I started to feel that depression really took a hold
after a torrid time in my job, where I
was bullied – I just crumbled.”
It’s not just negative experiences that cause depression, but how we deal with
them. If
you don't have much support to help you cope with the difficult emotions that come
with
these events, or if you're already dealing with other difficult situations, you
might find that
a low mood develops into depression.“My depression seems to flare up during times
when I am stressed and isolated from
other people.”
When does grief become depression?
Grief, and the low mood that comes with it, is a natural response to losing someone
or
something we love. How long your grief, or bereavement, lasts will be individual to
you.
This period of feeling low is referred to as bereavement.
But if you feel that what you're experiencing might be something more than just
grief,
you can talk to your doctor about it.
You might want to try bereavement counselling first, as this may be more helpful
for you
than general treatment for depression. Cruse Bereavement Care offers support and
counselling for anyone affected by bereavement.
© Mind 2019
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“For me, it started when my mother died. After struggling and burying things
deeper, I
finally cracked.”
Other mental health problems
If you experience another mental health problem, it's common to also experience
depression. This might be because coping with the symptoms of your mental health
problem can trigger depression. You may find you experience depression if you also
experience:
 anxiety
 eating problems
 PTSD.
Physical health problems
Poor health can contribute to your risk of developing depression. Many health
problems
can be quite difficult to manage, and can have a big impact on your mood. These
could
be:
 chronic (long-term) physical health problems
 life-threatening physical illnesses
 physical health problems that significantly change your lifestyle.
You might be offered support for your mental health at the same time as you are
treated
for a physical health problem, as part of your overall treatment.
There are some physical health problems that can cause depression:
 conditions affecting the brain and nervous system
 hormonal problems, especially thyroid and parathyroid problems
 symptoms relating to the menstrual cycle or the menopause
 low blood sugar
 sleep problems.
If you think any of the above conditions apply to you, make sure your doctor knows
about
them. Some can be diagnosed by simple blood tests – your doctor may suggest these
are
done to help make the right diagnosis, or you can ask for blood tests if you think
they
may be relevant.
Genetic inheritance
Although no specific genes for depression have been identified, research has shown
that
if you have a close family member with depression, you are more likely to
experience
depression yourself.
While this might be caused by our biology, this link could also be because we
usually
learn behaviour and ways of coping from the people around us as we grow up.
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Medication, recreational drugs and alcohol
Depression can be a side effect of a lot of different medicines. If you are feeling
depressed after starting any kind of medication, check the patient information
leaflet to
see whether depression is a side effect, or ask your doctor. If you think a drug is
causing
your depression, you can talk to your doctor about taking an alternative,
especially if you
are expecting your treatment to last some time.
Alcohol and recreational drugs can both cause depression. Although you might
initially use
them to make yourself feel better, or to distract yourself, they can make you feel
worse
overall. See our pages on the mental health effects of recreational drugs and
alcohol for
more information.
Sleep, diet and exercise
A poor diet and lack of sleep and exercise can affect your mood, and make it harder
for
you to cope with difficult things going on in your life.
Although a poor diet, or not getting enough sleep or exercise, cannot directly
cause
depression, they can make you more vulnerable to developing it.
See our pages on food and mood, sleep problems and physical activity for more
information.
What can I do to help myself for
depression?
Experiencing depression can be very difficult, but there are steps you can take
that might
help. This section has some suggestions for you to consider:
 talk to someone you trust
 try peer support
 try mindfulness
 look after your physical health
 try to keep active
 keep a mood diary
 spend time in nature
 practise self-care.
Some people find these ideas useful, but remember that different things work for
different
people at different times. Only try what you feel comfortable with, and try not to
put too
much pressure on yourself. If something isn't working for you (or doesn't feel
possible just
now), you can try something else, or come back to it another time.
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Talk to someone you trust
It might feel hard to start talking about how you are feeling, but many people find
that just
sharing their experiences can help them feel better. It may be that just having
someone
listen to you and show they care can help in itself.
If you aren't able to open up to someone close to you, the Samaritans run a 24-hour
helpline that you can call to talk to someone confidentially.
Read Jess' blog about how talking about her depression made her feel less
alone.“[What helps is] surrounding myself with friends and family who understand
without
pointing it out, who treat me normally but recognise that everyday life can be a
struggle
sometimes.”
Try peer support
Peer support brings together people who’ve had similar experiences to support each
other. Many people find it helps them to share ideas about how to stay well,
connect with
others and feel less alone. You could:
 Contact a specialist organisation. For example, you can find details of support
groups, forums and helplines on the SANE and CALM websites.
 Join Elefriends, Mind's supportive online community.
 Contact Mind's Infoline and ask about support groups near you. Alternatively, you
could use our interactive map to find your local Mind, and contact them directly.
See our pages on peer support for more information about what peer support
involves,
and how to find peer support that suits you. If you're new to online peer support,
you
might find it helpful to read our information on online mental health.
Read Sue's blog about finding a place to fit in at her local peer support group.“[I
find reading other people's experiences makes me feel less like I'm alone in this.
It's
actually made me feel more comfortable.”
Try mindfulness
Mindfulness is a way of giving your full attention to the present moment. Some
studies
show that practising mindfulness can help to manage depression.
Some structured mindfulness-based therapies have also been developed to treat these
problems more formally. For example, the National Institute of Health and Care
Excellence (NICE) recommends mindfulness-based cognitive therapy for the management
of depression.
See our pages on mindfulness for more information about what it involves and how to
get
started.
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“Mindfulness does help me with my mental health issues. It's not the cure and it
won't
work every single time, but it has helped me to alleviate anxiety and depression by
centring my thoughts.”
Look after your physical health
Experiencing depression can make it hard to find the energy to look after yourself.
But
taking steps to look after your physical health can make a difference to how you
feel:
 Try to get good sleep. For lots of people who experience depression, sleeping too
little or too much can be a daily problem. Getting good sleep can help to improve
your mood and increase your energy levels. See our pages on coping with sleep
problems for tips to help.
 Think about your diet. Eating regularly and keeping your blood sugar stable can
make a difference to your mood and energy levels. See our pages on food and
mood for more tips.
 Try to do some physical activity. Many people find exercise a challenge but
activities like yoga, swimming or walking can be a big boost to your mood. If you
don't feel confident doing exercise, you could start off with smaller activities -
such
as gentle chair-based exercises in your own home - and build from there. See our
pages on physical activity and your mental health for more information.
 Try to look after your hygiene. When you're experiencing depression, it's easy
for
hygiene to not feel like a priority. But small things, like taking a shower and
getting
fully dressed whether or not you're going out of the house, can make a big
difference to how you feel.
 Try to avoid recreational drugs and alcohol. While you might want to use
recreational drugs or alcohol to cope with difficult feelings about yourself, in
the
long run they can make you feel worse and can prevent you from dealing with
underlying problems. We have more information about how recreational drugs and
alcohol can affect your mental health.
Read Karl's blog about how exercise helped him manage his depression.“I try to keep
active, even if that's just getting out of bed, washed and ready before 10am,
so that the days don't become an endless blur of nothingness.”
Try to keep active
 Try joining a group. This could be anything from a community project or a sports
team to a hobby group. The important thing is to find an activity you enjoy, or
perhaps something you've always wanted to try, to help you feel motivated.
 Try new things. Trying something new, like starting a new hobby, learning
something new or even trying new food, can help boost your mood and break
unhelpful patterns of thinking and behaviour.
 Try volunteering. Volunteering, or just offering to help someone out, can make
you
feel better about yourself and less alone. Your local Volunteer Centre and the
charity Do-It can help match you with a volunteering opportunity in your area.
 Set realistic goals. Try to set yourself achievable goals, like getting dressed
every
day or cooking yourself a meal. Achieving these things can help you feel good and
boost your self-confidence, and help you move on to bigger goals.