Depression is always at its worst the first time you experience it. It can be really scary and a shock to the system. Major depression or a ‘break down’ usually starts after a period of severe stress. It can be caused by environmental or internal stressors. Recreational drugs are also one of the most common causes of depression, especially cannabis. Depression usually starts in late teens or early adulthood. Intrusive thoughts can occur which are debilitating and can overwhelm sufferers. Intrusive thoughts can occur every few seconds and they tend to be very obsessive by nature. Severe insomnia may occur because sufferers may find that the thoughts keep them awake. When very ill, sufferers may only get one or two hours sleep per night. Having said this some people find that they will sleep too much and can sleep all day long, not getting out of bed.
The standard treatment for depression is antidepressants. They can be very effective and you should start feeling better after a couple of weeks after they have built up in your system. Sometimes psychiatrists will prescribe an antipsychotic alongside an antidepressant if you are severely ill. These days they are likely to prescribe second generation antipsychotics such as Olanzapine and Quetiapine. If the depression is treatment resistant, Clozapine is sometimes prescribed. Psychiatrists need to be careful prescribing antidepressants because they can lead to mania. Antidepressants sometimes ‘unlock’ bipolar disorder for those with a genetic disposition.
A component of depression is anxiety. It sometimes occurs alongside depression and can be debilitating. It is common for those with depression to suffer from panic attacks. Panic attacks include feelings of dread, difficulty breathing, a racing heart beat, trembling and shortness of breath. Also terrible feelings of ‘impending doom’.
Depression may contribute to a lack of confidence, shyness, lack of motivation, distancing from friends or loved ones, confusion, inability to look after oneself, and alcohol misuse. Alcohol consumption in people with depression is relatively high because people try to self-medicate. Alcohol is in the same class of drugs as Valium and works in a similar way. Sufferers find alcohol can mask the symptoms of depression. However a hangover in the morning can cause the depression to worsen.
People should only be transferred to psychiatric hospitals as a last resort. They can sometimes help because psychiatrists and health care workers such as nurses can monitor them close up. However living conditions in hospital are quite basic and there is not very much to do. Sometimes people come out of hospital worse than as they came in.
Alongside depression, thoughts of suicide might occur. Sadly suicide is one of the most common causes of deaths in young adults. If you think someone is suicidal the best thing to do is telephone a doctor or the local mental health team. They can then make an assessment to whether the person should be admitted into hospital or not. They could be encouraged to telephone the Samaritans.
In 2001 I was a student at Lancaster University. I was working on my psychology dissertation in my final year. I left it to the last minute. I handed it in but I was not happy with it. I became terribly stressed and nauseas. I suddenly couldn’t sleep because I had very severe intrusive thoughts. The same obsessive thoughts went round and round my head until I was only getting about one hour’s sleep. The intrusive thoughts were psychotic in nature. I saw a psychiatrist and he prescribed Paroxetine, a very potent antidepressant. I did not improve so he prescribed Chlorpromazine, the oldest antipsychotic medication. I believe it started to work but suddenly I suffered from side effects. My tongue came out of my mouth and I couldn’t control it. My mother had to drive me to the hospital and they prescribed Procyclidine which helps control Parkinson type side effects. I was still suffering from severe insomnia after about two weeks of treatment so I was prescribed Zopiclone, a very effective sleeping aid. I couldn’t believe it, it was great to be able to sleep again.
I improved and the depression dissipated. However, as I am bipolar, the Paroxetine made me manic. I got a diagnosis of bipolar disorder about a year later after having a very turbulent time. Since then I have been in hospital seven times. Life has been tough.