Introduction

This book is for people who are depressed. It is written from the depressed person’s point of view but provides insights and information for carers, friends and relatives of the depressed.

Depression has surged to epidemic proportions in just two decades, from rarely mentioned misery at the margins of society to a newsworthy phenomenon. It starts, innocently enough, as sadness but, without effective coping skills—which are the very heart of this book—can rapidly deteriorate into clinical depression.

The World Health Organisation (WHO) estimates that more than 300 million people globally have depression at any one time. Let’s assume you are depressed and in need of help. I have been where you are now. What you need is release: release from your all-consuming feelings of misery, hopelessness and isolation. You have just picked up or downloaded the book that is going to make this happen for you. Life is going to get better and you are going to have peace of mind.

Chapter One invites you to take the first step towards recognising, identifying and gaining release from your condition. One tick in the appropriate box is all I ask of you to get started. No matter how depressed you are right now, you can do it. This book will have proved its worth when you are recovered and enjoying life to the full. —David M Hinds Plymouth, 2nd February 2019

PART ONE Depressed

You are not alone. I have been where you are now. I will write for you and you will read for me.

Today is the day we get started. Depression, like the common cold, is an illness that can affect anyone, including the rich and famous. One in five of us will be affected by the condition at some stage in our lives. Like most other illnesses, when correctly diagnosed, it can be treated successfully.

Depression, although frightening, is never permanent. It does not reduce our value as human beings. Are you depressed? If so, how depressed?

Let’s begin to find out. In order to ascertain the best and safest way forward, you must decide how depressed you are on a scale of 0-5. Your choice should reflect how you have been feeling generally over the last two or three weeks.

Don’t worry if your selection is not quite right. Give yourself permission to adopt a trial and error approach. We can always put things right later when we understand more about your prevailing mood, your circumstances, your feelings, your psychological make-up and the overall structure of your thinking patterns. Please go ahead now and tick the box below that seems most applicable to you

4 David M Hinds

 q 0) NOT DEPRESSED q 1) MILDLY DEPRESSED q 2) MODERATELY DEPRESSED q 3) SEVERELY DEPRESSED q 4) EXTREMES OF HIGHS AND LOWS q 5) SUICIDAL It may be that you will revise your choice later but this is a valuable starting point.

If you have ticked (0) above, perhaps you are a loved one, family member, caring friend or professional acquaintance of someone whom you believe may be suffering from depression. If this is the case, it is probable you will read this book in a different way from a depressed person. You will be in a position to heighten your awareness and gain valuable insights into this much-misunderstood condition.

If you have ticked (1) to (5) let me begin by reassuring you. Due to a new generation of therapies and the widespread availability of non-addictive and highly effective drugs, the chances of recovering from depression quickly and safely have greatly increased. Your degree of depression will be dealt with in succeeding chapters.

Depression is best understood by observing its effects. The most obvious sign of depression is a persistent downturn in mood. Depression has a way of creeping up on you and dulling your feelings. You begin to lose interest in what is going on around you. You may feel sad, alone and isolated and cry for no apparent reason. You may assume a vacant, emotionless facial expression and you may feel guilty about things which happened in the past. Sometimes, with a different form of depression, feelings of sadness can alternate with sensations of elation or excitement but this may be a mask for unhappiness.

In everyday language, we have a tendency to speak of feeling depressed when our transitory downturn in mood simply relates to a routine or minor setback—perhaps the prospect of returning to work on Monday morning after a particularly enjoyable weekend. On the other hand, depression as an illness implies a severe emotional disturbance, the source of which may or may not be traceable to external causes.

We all feel down from time to time. Sadness is a normal part of life. Happiness would hold little meaning for us if we were untouched by sadness. But when sadness takes an almost permanent hold of us and seldom returns to joy, the likely cause is clinical depression, also known as major depression.

No one is immune from depression. It strikes people from all social groups, all countries and all cultural backgrounds. A staggering 300 million people are affected in the world today! The death toll from depression is formidable: more people commit suicide every year than die in road accidents around the world.

Statistically, at least 10 per cent of the clinically depressed (whether diagnosed as such or not) will take their own lives. The impact of that one, irreversible action on their families, friends and loved ones will be enormous. Let’s make further progress by examining where you are right now.

It will be illuminating and helpful if you tick the boxes alongside any of the following statements that you believe are applicable to you. Once again, don’t be afraid of making mistakes and bear in mind that your choice should once again reflect how you have been feeling over the last two or three weeks. It is a general picture of your state of mind that we are forming here, not a medical diagnosis. Most of the time, do you* q feel sad? q feel helpless? q feel tired? q feel guilty about things? q feel life is pointless? q feel as if you are moving in slow motion? q feel anxious or cry a lot? q feel pessimistic or worthless? q have difficulty concentrating? q have difficulty making decisions?

Lately, have you* q isolated yourself from others? Or wanted to? q lost interest in things that used to give you pleasure? q experienced problems at work, in school, at university or away from home? q experienced problems at home? q experienced actual personal or professional abuse? q experienced abuse on your social networks? q lost your sex drive? q lost your appetite? Or gained weight? q felt restless and irritable? q experienced persistent headaches, stomach or back aches, muscle or joint pains? q had difficulty falling asleep, staying asleep, or getting up in the morning? q consumed more alcohol than usual? q taken more mood-altering substances than usual? q engaged in risky behaviour? q engaged in self-harm?

Lately, have you been thinking about* q death? q your funeral? q committing suicide? The exercise you have just completed can have the effect of helping to distinguish between depression and normal feelings of being ‘under the weather’. If you have ticked four or more boxes in total, the indications are that you may well be depressed.

Have you been to the doctor? To avoid unnecessary suffering and disruption to your life, I believe you should consult your doctor for a professional diagnosis and opinion. Without a shadow of doubt, if you ticked any of the final six boxes, you should make an urgent appointment, seek help (not on the Internet) and keep on reading.

You know from your participation in the self-screening test what is likely to be the matter with you. Ten minutes with your GP will confirm or disprove this. Knowing precisely what is wrong is a prerequisite to overcoming any of life’s dilemmas, certainly this one. In Chapter Two, let’s find out what is happening to you. Adapted from materials created by The National Institute of Mental Health, Rockville, MD, USA, and The National Depression Campaign, Westminster Bridge Road, London SE1 7JB, UK .