What is depression?

Most people, children as well as adults, feel low or ‘blue’ occasionally. Feeling sad is a normal reaction to experiences that are stressful or upsetting. However, when these feelings go on and on, take over your usual self and interfere with your whole life, it can become an illness. This illness is called 'depression'.

How common is it?

Depression usually starts in the teen years, more commonly as you near adulthood. It is less common in children under 12 years old. It can affect anybody, although it is also more common in girls compared to boys.

Symptoms during a depressive episode

• Feeling very sad
• Decreased energy and activity
• Not being able to enjoy anything
• Decreased appetite
• Disturbed sleep
• Thoughts of suicide or self harm.

On the milder end, one may just feel sad and gloomy all the time. Here too, at the extreme end some people can develop psychotic symptoms.

What effects can it have?

The exaggeration of thoughts, feelings and behaviour affects many areas of the young person's life. For example, it can lead to:

• Problems in relationships with friends and family
• Interference with concentration at school or work
• Behaviour that places the young person's health or life at risk
• A loss of confidence and a loss of the sense of control the person feel over their life.

The longer the condition continues without treatment, the more harmful it is likely to be to the life of the young person and to their family.

How is it treated?

The goal of treatment is to improve the symptoms, prevent the illness from returning and help the young person lead a normal life. Families play an important role in preventing the illness from coming back, and also seeking help early before it comes severe.

Medication

Medication usually plays an important role in the treatment of depressive disorder, especially if episodes are severe. In the initial stages of the illness, medication helps to reduce the symptoms.

Talking treatments (also known as 'psychotherapies')

It is crucial that drug treatments are combined with practical help for the young person and their family.

• Help with understanding the illness (psycho education)
  It is very important that the young person with depressive disorder and their family are helped to understand the condition, how best to cope and what to do to reduce the chances of it recurring.
  The young person and their family may notice particular 'triggers' to their episodes and/or early warning signs that an episode may be starting - being aware of these can help reduce the chance of episodes occurring, and getting help in the earliest stages of an episode can stop it from escalating.
• Family-focused treatment
  Stress at home can worsen the situation and can even trigger an episode of the illness. Talking therapy in which the whole family is helped to find ways of reducing stress, solving problems and communicating more effectively has been shown to help young people with BD get better, and stay well.
• Cognitive-behavioural therapy (CBT)
  This is another type of talking therapy in which the young person, sometimes with their family, learns to understand the links between their feelings and thoughts and how this affects their behaviour.