In any one year, around one million Australian adults experience depression. On average, one in eight men and one in five women will experience depression in their lifetime (Australian Bureau of Statistics, 2008).
According to Beyond Blue, depression can make the person experiencing it feel overwhelmed, guilty, frustrated, lacking in confidence miserable and sad, amongst many others emotions.
It’s important though, to understand that depression is more than feeling sad, moody or low from time to time. Some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason (Beyond Blue, 2021).
Dr Grant Blashki is a practicing GP and Lead Clinical Advisor at Beyond Blue. He says that clinical depression can present as a diminished interest in day-to-day activities, significant weight loss when you’re not dieting, or significant weight gain, loss of energy, feeling worthless, poor concentration, and recurrent thoughts of death or even suicidal thoughts.
‘There are a couple of caveats,’ he tells Wellbeing by Teacher. ‘These symptoms can’t be attributable to a medical condition or substance abuse, and it needs to be enough that it’s affecting your functioning significantly – like in your family, or your work roles, or your relationships.’
In his experience as a GP, Blashki says that he often sees people come in with a mix of depressive symptoms, as well as other issues, and often people have a lot of big things going on in their lives.
‘It’s often mixed in with anxiety symptoms – even though in the textbook they’re beautifully separated – most people with depression have a bit of anxiety and most people with anxiety have a bit of depression. There’s quite an overlap,’ he says.
In a 2020 survey by the Royal Australian College of General Practitioners called General Practice: The Health of a Nation, GPs indicated that psychological issues, including depression, anxiety and sleep disturbance, remain the most commonly seen presentations in general practice, with 64 per cent of GPs reporting it in their three most common reasons for patient presentations.
‘I think the message is its really common, and we see it in the community,’ Blashki says. ‘A couple of things we know is that men are less likely to seek help for depression and we know that many people just don’t seek any help and try and manage it themselves, often counterproductively.’
Signs of depression in others
Blashki says for people who’ve experienced depression, they know it’s much more than a bit of sadness. ‘It’s not something that they can just snap out of and they often describe feeling like they’re really stuck in a hole that they just can’t get themselves out of.
‘The sorts of things I check are: How does this affect your day-to-day life? Can you go to work? Is this affecting your relationships? And a really helpful question for me is: Is there anything in your life that you’re still enjoying?’
Blashki says that people experiencing depression often have trouble sleeping, or find themselves constantly oversleeping, or they may withdraw from their usual activities. ‘They might not be seeing friends, not answering their phone, and they’ve really gone off the air and they just can’t deal with anyone. So I think these are some red flags for me as a GP.’
For an observer or close friend, Blashki says signs of depression in others could include uncharacteristic moodiness, anger, loss of sense of humour, poor performance at work, or in some cases, talking about suicide.
‘Obviously if someone was talking more specifically about suicide or death, that’s something that we need to act on and encourage them to get in contact with Lifeline on 13 11 14. We take comments about suicide pretty seriously and make sure that we get them with either Beyond Blue or Lifeline or maybe offer to go with them to the GP so that they’re hooked into some mental health support,’ he says.
Starting a conversation
If you’re concerned about someone you care about, Blashki has some tips on striking up a conversation with them.
‘Use your common sense, you don’t want to be too intrusive,’ he begins. ‘Pick the right place, generally when they’re on their own. A lot of people, particularly men, will prefer doing something else while you’re asking them. So you might say, “let’s go for a walk” or “let’s go for a drive” so you’re not face-to-face, you’re next to them.
‘And then you can start with saying things like, “I’ve noticed that you don’t seem to be yourself at the moment” or “I’ve noticed that you’ve missed a lot of days of work” – so you can just comment on what you’ve noticed.
‘Keep in mind, you don’t need to solve their depression, but you might just open the door. And even if they say, “look everything is fine, I’m okay” – at least they know that you’re there and they might come back to you for help later on. It is worth touching base with somebody if you’re concerned about them.’
In general terms, there are several ways you can manage depression in your daily life. One way is through your lifestyle. Blashki says routine is really helpful for people experiencing depression. Exercise and healthy eating can also positively impact the way you feel. Blashki also recommends sleep and limiting phone and social media use.
For a lot of people, seeing a psychologist can also prove really helpful. Blashki says an approach called Cognitive Behavioural Therapy can help you to identify negative thinking patterns that you may have gotten into. The best place to start is with a visit to your GP. ‘We’re very lucky in Australia to get a GP mental health plan and that enables you to draw on Medicare to see a psychologist for up to 10 and in some instances 20 sessions to really learn some proper psychology skills,’ he says.
In some instances, people experiencing depression require medication. ‘Generally, it’s for people at the more severe end and there’s no evidence that antidepressants help people with mild depression. You don’t need it for mild depression. But severe depression, they definitely have a role and you can talk with your doctor about the risks and side effects of anti-depressants,’ he says.
In 2019, Beyond Blue published an evidence-based review called A guide to what works for depression. Blashki says over two years, researchers reviewed all the lifestyle, psychology, medication and complementary treatments for depression. It’s an evidence-based tool Blashki highly recommends reading if you’re interested in learning more about depression.
Australian Bureau of Statistics (2008) 2007 National Survey of Mental Health and Wellbeing: Summary of Results (4326.0). Canberra: ABS.
Beyond Blue. (2021). The facts: Depression. https://www.beyondblue.org.au/...
Morgan, A.J., Reavley, N.J., Jorm, A.F., Bassilios, B., Hopwood, M., Allen, N., Purcell, R. (2019). A guide to what works for depression; 3rd Edition. Beyond Blue. https://resources.beyondblue.org.au/prism/file?token=BL/0556 (PDF, 6.7MB)
The Royal Australian College of General Practitioners. (2020). General Practice: Health of the Nation. https://www.racgp.org.au/getmedia/c2c12dae-21ed-445f-8e50-530305b0520a/Health-of-the-Nation-2020-WEB.pdf.aspx (PDF, 7.5MB)
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