Everyone has spells of feeling down, but depression is when you feel persistently sad for a longer period – weeks, months or years.

Some people also think that depression is ‘a weakness’ you should ‘snap out of’ and ‘pull yourself together’, but they are very wrong. Depression is a real illness with real symptoms.

Depression is more common than you might think, affecting 5-10% of the UK population at any one time. In the course of a lifetime, everyone has a 20% chance of going through a spell of depression. Women are more likely to get depression than men.

Among older people depression affects 1 in 5 living in the community and that increases to 2 in 5 for those living in care homes, according to the Mental Health Foundation.

With the right treatment and support, many people can make a full recovery. Dan Parton reports.

This article includes:

  • What causes depression?
  • Symptoms of depression
  • Diagnosing depression
  • Treatment

What causes depression?

Research suggests genetic factors can play a part and depression has been known to run in families for generations. Another common trigger for the condition is a stressful event, such as the death of someone close, losing a job, financial worries or the end of a relationship.

Depression can be caused by the onset of physical illness, such as Parkinson’s disease or Multiple Sclerosis.

It is also common in people with heart disease or who suffer strokes. In such cases, depression can hinder or prolong recovery times. Moreover, depression can lead to physical illness, especially in older people. This makes diagnosing and treating depression quickly a priority.

Symptoms of depression

There are many common symptoms of depression. The most well-known is constant feelings of sadness, hopelessness, irritability or tension. Other signs depending on the severity of the depression include:

  • Loss of energy
  • A change in appetite, including significant weight loss or gain
  • A change in sleeping patterns, such as difficulty sleeping, waking early in the morning, or sleeping too much
  • Restlessness or feeling slowed down
  • Tearfulness
  • Anxiousness
  • Complaining of various aches and pains
  • Inability to cope with normal life
  • Finding it increasingly difficult to make decisions or concentrate
  • Forgetfulness – especially short-term memory – and confusion
  • Feeling useless and inadequate
  • Suicidal thoughts

Depression in older people is often mistaken for the early signs of dementia – and vice versa – because many of the symptoms are similar, such as short-term memory loss and finding it difficult to concentrate.

Diagnosing depression

Many people wait a long time before seeking help, but its’ best not to wait. The quicker you get help, the quicker you’re more likely to find the road to recovery. Start with your GP.

Diagnosing depression can be difficult because there are no formal tests or scans that can reveal it. GPs and psychiatrists can only base a decision on the symptoms they see.

But if someone has a low mood that significantly affects their everyday lives for at least two weeks, and exhibits three or more of the above symptoms, they will generally be diagnosed with depression.


But depression is treatable – mainly with psychotherapy and medication – and many people respond positively to it.

Psychotherapy tends to work best in mild and moderate cases of depression. There are several forms of psychotherapy:

  • Cognitive behavioural therapy: can help identify and change thought and behaviour patterns that contribute to depression
  • Interpersonal therapy: this focuses on how depression can be connected to troubled emotional relationships
  • Psychodynamic therapy: this links depression to traumas and conflicts that happened earlier in life, especially during childhood

Alternatively, there are antidepressant drugs, although these tend to be used in more severe cases. Antidepressants make essentially treat the symptoms, users feel less anxious and agitated.

There are some misconceptions about antidepressants, such as that they change your personality or are addictive, but this is not the case.

Yet many people never seek help for their depression. This can be especially true in older people, who often feel it is not something they can talk about – viewing it as a sign of weakness – or would be taken seriously by their GP.

While 4 out of 5 people do get better without treatment, it can take months; seeking treatment can shorten the depression.

If you do not seek treatment, there are several methods that can help:

  • Talk about your problems with non-judgemental friends and family – it is a form of psychotherapy and can help greatly, rather than ‘bottling up’ your emotions
  • Try to keep active – doing nothing and thinking about your problems only makes matters worse. Exercise not only takes your mind off things but can result in the release of endorphins (feel good hormones)
  • Take your mind off how you feel - reading or watching TV provides entertainment and learning
  • Self-help books – many renowned psychiatrists and psychotherapists have written books which can really help
  • Join a support group or club – sports clubs, the U3A (University of the 3rd Age), the Depression Alliance (http://www.depressionalliance.org/how-we-can-help/self-help-groups.php ) can put you in contact with a group in your area
  • Do not try and ‘drown your sorrows’ with alcohol – it only makes depression worse and harder to treat
  • Eat well – a balanced diet is important because if your body runs short of vitamins, it can make matters worse