DEPRESSION

What is depression?
Most of us have had some periods of time in our lives when we have felt at least mild depression. Sometimes the feelings are linked to disappointments or losses, sometimes they are more like black moods descending upon us, not obviously linked to any event, and then dissipating after a while. Depression becomes a mental health problem when the feelings are so intense that normal life is disrupted and when the feelings last for a very long time.

Getting help for depression
Sometimes the hardest thing is to recognize when one is depressed. Depression can creep upon a person in such a slow way that it is hard to notice, and it may be endured for a very long time before the realization dawns that this is not normal and not how life used to be. Often people feel shame about being depressed, as if it represents a weak character. The combination of shame and the difficulty in getting motivated for action may prevent useful attempts to deal with the problem. . Family and friends can help the person to come to an understanding that they are not as they used to be and that there is no shame attached to being depressed.

Because medication can be very effective for depression, the best starting point is your GP. Sometimes the GP will prescribe medication or may refer the person to the Acute Community Mental Health Service for a more specialist opinion. Individuals may refer themselves if preferred.

The doctor in the Service will assess the problem and, if indicated, prescribe an anti-depressant. The tablets take several days to work fully, so progress will be monitored over the first few weeks and adjustments made to the dosage as necessary. Once improvement occurs, it is usual to continue the medication for some months.

Sometimes another member of the Community Team will also be involved to support the person to deal with the depressed feelings. Psychological therapy may be recommended and this can work on changing negative thoughts and actions as well as exploring the deeper underlying issues that may be involved in the cause of the depression. The aim of this would be to give the person more power over the experience of depression and to be more skilled in preventing depression occurring again.

Suicide risk
People who are depressed can feel so hopeless that life literally does feel worth living. If someone expresses ideas about wanting to kill themselves, then these thoughts should be taken very seriously. As well as supporting the person by listening and being available, you should encourage the individual to seek help and to be assessed by a doctor.

If you are worried that someone is suicidal, call the Acute Community Mental Health Service (Mon – Fri, 8.00 – 5.00) on 239 2261, or, after-hours and at weekends, call the Helpline on 236 3770. Someone will be able to advise and respond quickly to the situation.

Dr. Maggie Cormack completed her postgraduate training in Britain and has been with Bermuda Hospitals Board for 3 years. She is employed as a clinical psychologist working with adults in the Acute Mental Health Programme at St. Brendan´s Hospital.

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