Living with depression
An interview with Clinical Psychologist Dr Dawn Proctor
Q. How do you think we can begin to remove the stigma associated with depression?
Depression is common and 1 in 5 of us will experience it at some point in our lives. We need to recognise that it affects us all in some way and does not discriminate. Reducing stigma requires us to come together as a society in raising awareness, increasing our understanding and being there to support, listen to, and talk with those we care about. Clients often tell me it is this level of understanding and taking the time to step into their shoes that helps them feel supported by family and friends.
Q.We all feel sad and ‘depressed’ from time to time, so how do people recognise when they are truly depressed and require medical help?
It is important for us all to ‘check-in’ regularly on our own mental wellbeing, just as we would our physical health. It is the case that most people will experience low mood at some point in their lives. However, if someone were to notice they were feeling down most of the day nearly every day and/or had lost interest in the things they used to enjoy and this persisted for at least two weeks they should visit their GP. Take note of any physical changes such as loss of appetite, weight loss/gain and increased/decreased sleep. It is also important to look out for more subtle signs when it comes to children and older adults. These might include, but are not limited to, reports of feeling physically unwell, being socially withdrawn and more moody/irritable than usual. Family and friends are often good at picking up when somebody is acting out of sorts, becoming more withdrawn, turning down social invitations and no longer getting enjoyment from things. When you notice these things you can talk about it with the person or get some advice or further information from organisations like Beyond Blue or your local GP.
Q. How does a Psychologist help a depressed person? And when should you see a Psychologist instead of a Psychiatrist to treat depression?
Psychologists work with clients to understand the factors involved in the development and maintenance of the person’s depression. We use the first session to complete an assessment and gather information that will help us to build a formulation. A formulation is our understanding of the person, the ‘jigsaw puzzle’ we put together to understand why somebody is feeling the way they are. This guides our treatment and the strategies that might be discussed in sessions. Psychologists are often trained in several different forms of therapy and can draw on this knowledge to develop a treatment plan suited to the individual. Cognitive Behaviour Therapy is one form of treatment and involves targeting unhelpful patterns of thinking and unhelpful coping behaviors that maintain low mood.
I make a simple distinction to my clients that Psychologists tend to be the experts in talking therapies and human behaviour, whilst Psychiatrists are medically trained experts in mental health and the prescription of medications. This is a rather crude definition and does not do justice to the many Psychiatrists that hold professional qualifications in psychological therapies but helps to explain the key difference between these professions. Treatment guidelines recommend that antidepressant medication and psychological therapy work most effectively in combination for the treatment of moderate to severe depression. A GP is the best person to contact initially and, depending on their assessment, they will decide if a referral is required. It is not unusual to be under the care of both a Psychiatrist and Psychologist, where regular talking therapy occurs and the medication reviews are undertaken less frequently by the Psychiatrist.
Q. Can people living with depression long term make lifestyle or behavioural changes to help reduce symptoms?
Using a diary or notebook to monitor your mood can really help you to spot the things that affect mood positively or negatively. Gradually increasing your level of physical activity can help to boost energy levels and mood. Going for a 10 minute walk each day can make a real difference. It is also important to take a look at things you might be able to change about your sleeping and eating pattern. Talking to people about your concerns and getting that support can also be very helpful to give you a different perspective and reduce isolation. When people have experienced a depressive episode they also have an increased risk of future episodes and can work on relapse prevention by keeping an awareness of early warning signs and getting professional help.