Does stigma around depression stop sufferers seeking treatment?

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From the darkness

A third of us suffer from depression, but does stigma stop many seeking help?

 

When Prince Harry confessed, with searing honesty, to the depression he developed in the years following the death of his mother, Princess Diana, people sat up and took notice. It opened up a new conversation about depression and mental health, but it also left many wondering why the stigma around the condition continues to exist. Sufferers still feel unable to share the truth about how they are feeling, with family, friends and employers, perhaps because of a lack of understanding around how serious clinical depression can be.

According to the mental health charity Mind, approximately 1 in 4 people in the UK will experience a mental health problem each year. Of these, 3.3 in 100 people are suffering from depression. Although depression is more common in women than men, rates of suicide among young men are rising, while rates of depression and anxiety among young people have increased by 70% over the past 25 years. The World Health Organisation says that, “if we don’t act urgently, by 2030 depression will be the leading illness globally”.

 

Cause and effect

Depression isn’t always caused by any single factor, but several triggers:

• Social – loneliness and isolation, losing your job, divorce, bereavement

• Psychological – a traumatic experience from childhood, family issues

• Physical – illnesses such as glandular fever, side effects of some medications

• Genetics – certain people may be genetically predisposed to depression.

 

Treatments for depression

 

Antidepressants

These medicines treat the symptoms of depression by acting on chemicals in the brain that lift mood. They include:

• Selective serotonin reuptake inhibitors (SSRIs) – the most widely prescribed, these include Fluoxetine (brand name Prozac), citalopram (Cipramil), paroxetine (Seroxat) and sertraline (Lustral).

• Serotonin-noradrenaline reuptake inhibitors (SNRIs) – similar to SSRIs, these include duloxetine (Cymbalta and Yentreve) and venlafaxine (Efexor).

• Noradrenaline and specific serotonergic antidepressants (NASSAs) – the most prescribed of these in the UK is mirtazapine (Zispin).

• Tricyclic antidepressants (TCAs) – older types of antidepressant, they may be prescribed to people who have failed to respond to other medications, or those with OCD or bipolar disorder. They include amitriptyline (Tryptizol), clomipramine (Anafranil) and imipramine (Tofranil).

 

Talking therapies

Used alone or in combination with antidepressants, talking therapies aim to help patients to recognise factors that might be causing their depression, and find ways to cope. They include counselling and cognitive behavioural therapy, and referrals are normally made by the patient’s GP, but waiting lists are long. Patients can also consult charities such as Sane for information on free or low–cost counselling, or pay for private therapists or counsellors. Go to sane.org.uk

 

Self–care

Joining self–help groups, where patients meet others in similar situations, can help people cope with their depression. Good self–care, including eating healthily, exercising and asking family and friends for support can aid recovery. 

Help is out there

No one should suffer in silence from depression, and there are many organisations which provide support, advice or empathy, without judgement or discrimination. 

Go to mind.org.uk; sane.org.uk; samaritans.org; justonelook.org; depressionuk.org; supportline.org.uk.

There are also a number of platforms which allow peer-to-peer interaction. Go to depressionalliance.org; turn2me.org; friendsinneed.co.uk; headstogether.org.uk.


Case study:

Georgina Lloyd

I have always been a high-achiever and put myself under continuous pressure to succeed. I have a fear of failure, due to the demands which I place on myself. I strive for perfection.

Academically, I did well at university before going on to become a lecturer. After a successful two years I gave up this career and applied to become a police officer. While waiting for intake, I spent time gaining further experience as a pharmaceutical representative.

Early in 2015, I went though IVF treatment and, unfortunately, things did not work out. Instead of my partner and I dealing with it, talking things through and grieving, we both ploughed ourselves into work. I became obsessive about exercise and began taking part in cycling events and triathlons as I knew I could do well and get a sense of achievement and self-worth. They were a distraction from the hurt and pain I was going through.

I didn’t want to drop the professional image. Yes, there were external pressures, but it was the internal pressure I put on myself which became my downfall. I did not want to show any sign of weakness, so I just hid how I was really feeling.

My relationship ended a week before Christmas 2015. I did not want to see or speak to anyone and spent Christmas on my own, as I didn’t want to face the world. It was a work colleague I had confided in that saved my life on Christmas Eve, as I had serious thoughts of ending it all.

In work, I still presented myself as ‘happy smiley George’. I did not want people to know how broken I was, but at the end of March 2016 I sought help from my doctor. Everything came out and I sobbed for 30 minutes. I remember arguing with the GP who told me not to go to work the following day. I wanted to as I didn’t want to be seen as a failure or weak. It was midday when I finally said to my line manager that I had to leave. That was 15 months ago.

I have had fantastic support from my GP and workplace. I completed a 10-week mindfulness programme organised through work and some local courses on managing depression and stress through the NHS. Taking part in the BBC 1 documentary Mind over Marathon encouraged me to talk and forced me to be open with family and friends.

My puppy, Olly, has also been a saviour. He has been brilliant for me; I now have responsibilities and he keeps me grounded.

There is still a massive disparity with physical health. Thankfully, with all of the positive work being done to support mental health and with all of the well–known faces speaking out about their battles, the shift is happening, but there is still a long way to go.    

Follow Georgie’s story at depresseddetective.com and on Twitter @georgie_lloyd.

 

Case study:

Lisa Browning

My depression began in September 2009 when my daughter (22 months old at the time) was diagnosed with cerebral palsy just two days before I was due to have my son by C-section.

When my son was born I felt he was just in the way of me trying to learn about my daughter’s condition and how I could help her. I had no feelings for my son and just went through the motions. It was a terrible time.

I also blamed myself for my daughter’s disability, becoming very tearful, angry and panicky when I left the house. My husband urged me to see the doctor, but I was brought up thinking that antidepressants were addictive and that depression was not a ‘thing’.

In November 2009 I woke at 2am and went to buy a frozen turkey for Christmas and presents for the children. I had decided I should get in my car and drive off somewhere, but first needed to be sure the children would have a nice Christmas. I felt I was bad for them and they would be better off if I were not around. In the car park I sat there sobbing, then decided I needed help, so went home and woke my husband.

The next day I saw the doctor, who prescribed antidepressants. I felt better after a few months of these, combined with getting help for my daughter, and took them for the following two and a half years.

We emigrated to Australia, however, and I started slipping back into the dark hole and was unable to scramble out. We returned to the UK six months later and I fell pregnant with my third child. I could not take medication due to the pregnancy, but my depression seemed to level out. My GP advised walking and this really helped – I was worried about postnatal depression and was monitored, but everything seemed okay.

Six months later my stepfather was diagnosed with a terminal brain tumour and both my husband and I were made redundant. I was falling back into that hole and immediately sought help. I was put back onto the same medication I took in 2010 and have been taking this ever since. I still walk often and this lifts my mood.

I always advise anyone who has depression to seek medical advice from a GP and talk, talk, talk as much as possible to someone they trust.   

 

Case study:

Charlie Reid

I was diagnosed with depression towards the end of 2014.

It’s something that, deep down, myself and my family had known I’d been suffering with a lot longer, but I kept pushing it aside, telling everyone ‘I’m fine – there’s nothing wrong – I don’t need help’ until it eventually became too much for me to cope with and I struggled to deal with everyday life.

The decision to brave that first trip to the doctor was one of the scariest things I’ve ever had to do. I finally had to admit I wasn’t coping with my feelings and emotions and ask for help. I had to open myself up to a complete stranger and tell him things that I hadn’t told anyone before. I cried my heart out and I told him I didn’t know why I felt so upset or angry all the time and why I couldn’t bring myself to even get out of bed in the mornings.

I had nothing to worry about. My doctor was really easy to talk to and didn’t make me feel silly or attention seeking. He understood.

After talking for a while, we discussed different options of what we could do together to help improve my feelings/emotions and how to start dealing with the depression. This included finding the source of why I felt how I did (still a work in progress), counselling and medication.

I was first put on a daily medication to trial and was scheduled to return in a few weeks. The thought of taking medication worried me and I told him I didn’t want to become addicted or rely on it. He provided me with a non-addictive medication which I started taking the next day. He also told me that I could start counselling sessions and provided me with a number to call when I was ready to go ahead.

I’ve found ways to calm myself and help deal with my emotions – exercise is amazing – I can feel so low and then stick on a workout DVD and I feel so much better. I’ve also taken to adult colouring books and art therapy. Sitting quietly outside drawing and colouring is so therapeutic and really helps when I feel an attack coming on.

Having a doctor to talk to really did help, but I hope in future there are more professionals are available to discuss mental health with outside of a doctor’s surgery and provide a more varied range of ways to help deal with it, apart from just medication. Things are looking up and with the help of family and friends I’m learning to cope with my depression.

Case study:

Gemma Wood

I started suffering with depression from the age of 17, however through treatment, it may have suggested that my depression had become masked through other coping techniques since the age of 12.

The combination of school life and the secrets I carried at home was where my depression began. There were many family secrets that I had withheld from sharing, in fear of further consequences. This impacted my school experience, where I was badly bullied due to suffering with serve dyslexia. I was finally assessed for this aged eight (in the 80s it was not recognised as a learning disability). I was known as the ‘thick’ girl. My older sister was incredibly challenging in our household, and was in and out of psychiatric assessments. I had spent my youth trying to be everything BUT her, and opening up to my depression seemed impossible.

My parents put me into hospital at the age of 18, after they had begun to notice my complete withdrawal from life and massive weight loss. I was diagnosed with depression and an eating disorder.

Once I came to terms with the idea that I may have episodes of depression throughout my life, and that very stressful experiences can trigger this, I have found certain structures that help minimise the impacted my depression can have on my everyday life. I cannot and will not carry secrets again. I regularly engage in therapy to help keep a healthier and balanced lifestyle, I take antidepressants if and when needed. I keep being honest with the people who I need in my life.

You don’t have to suffer alone. Sharing this with a close friend, GP, or other professional doesn’t mean that it defines you. You are you, and something at this time is preventing you from being able to be all of that. Asking for help is a strength – even if it feels a weakness. There are people out there that can truly help you, so reach out.

(Pictured: Left – Georgina Lloyd, Right – Lisa Browning and family)