Depression doesn’t just mean the normal feelings of sadness that everyone experiences when life gets difficult. It can be sadness that doesn’t go away, or a loss of interest or pleasure in the things you used to enjoy, plus a range of other changes in the way you feel, think or act. If any of these feelings or symptoms last for more than 2 weeks, it could be depression.

The symptoms of depression usually develop over days to weeks, although the low mood might start in the months before. It can be triggered by life events, or it may just happen out of the blue.

With effective treatment, about half of people with moderate depression will be much better within 6 to 8 weeks. For people who don’t get treatment, the duration of depression varies widely. Some will get better after several months, some will recover partially, and others will continue to be depressed long term.

If you think you could be depressed, the first step to getting better is talking to someone about it. 

If you feel life is not worth living, get help immediately by calling:

• Lifeline 13 11 14, 
  
• Australian Suicide Prevention Foundation 1800 HOLDON (1800 465 366) or 
  
• Suicide Call Back Service 1300 659 467
  
• the emergency department of any hospital in Australia.

The experience of depression can be quite different from one person to the next. Depression may be triggered by negative events (e.g. a relationship problem, grief or financial problems), but many people with depression feel low whether things are going well or not.

Common symptoms of depression are:

• low mood or a loss of interest or pleasure in things you used to enjoy
• a change in your weight or appetite (an increase or a decrease)
• insomnia, or sleeping more
• feeling restless or slowed down
• fatigue or loss of energy
• feelings of worthlessness, or excessive or inappropriate guilt
• problems concentrating or making decisions
• recurrent thoughts of death, or thinking about or attempting suicide.

For depression to be diagnosed, these symptoms must have been present most days in the past 2 weeks, be a change from your usual state, affect your ability to function normally and not be a symptom of another medical or psychological illness.

Anyone can get depression at any stage of life – this includes children. Most people with major depression first get it in their late 20s.

Some people may be at increased risk of depression because they:

• have a family history of depression
• are experiencing difficult social circumstances, e.g. homelessness, unemployment or chronic illness
• had bad childhood experiences, eg, abuse or neglect
• possess certain personality traits, e.g. disliking yourself, fearing the worst or being easily bothered by things
• do not have a relationship with someone they confide in.

Depression is more common in women than men, and more common in Aboriginal or Torres Strait Islander people than non-indigenous Australians.

References

1. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results, 2007 Canberra: ABS, 2008.
   
2. beyondblue. Understanding anxiety and depression. beyondblue Ltd. Melbourne: beyondblue, (accessed 30 August 2020).
3. Gubhaju L, McNamara BJ, Banks E, et al. The overall health and risk factor profile of Australian Aboriginal and Torres Strait Islander participants from the 45 and up study. BMC Public Health 2013;13:661.

If you think you could be depressed, it's best to go and talk to your doctor about it. If you are not ready to go to a doctor, call one of the support services listed below. Talking to a supportive family member, friend, or another health professional can also help.

Some people don’t seek help because they feel like nothing will help, or that they should be strong enough to solve their own problems. This may be the depression talking — feeling worthless, guilty and pessimistic about the future are symptoms of depression.

If you feel life is not worth living, you need to get help immediately by talking to your doctor, calling a friend or family member, or calling one of the helplines below. 

Did you know that calls to Lifeline from mobile phones are free? 

You can still call from your mobile even if you have a pre-paid account that’s out of credit.

Helplines

There are effective treatments for depression, but there is no single treatment that is right for everybody. It’s important to find a treatment that works for you, and this may take some trial and error.

Treatments for depression can be divided into:

• psychological therapies, such as cognitive behavioural therapy (CBT)
• antidepressant medicines (learn more about antidepressants).

Lifestyle changes and supportive treatments such as exercise can also be helpful, but may not be enough to treat depression on their own.

The decision to take an antidepressant, or undertake psychological therapy, or combine both approaches, is very individual. Talk to your doctor about what you think will work best for you.

An Australian study reported that asking the questions below helped people with depression get more information about how to manage their condition.

1. What are my treatment options?
2. What are their benefits and harms?
3. How likely are these?

References

1. beyondblue. Understanding anxiety and depression. beyondblue Ltd. Melbourne: beyondblue, (accessed 30 August 2020).
2. Morgan, AJ, Reavley, NJ, Jorm, AF, et al. (2019). A guide to what works for depression; 3rd Edition. Beyond Blue: Melbourne (accessed 21 September 2020).
3. Shepherd HL, Barratt A, Trevena LJ, et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: a cross-over trial. Patient Educ Couns 2011;84:379–85.

In addition to formal treatments such as psychological therapy or taking medicines, there are other activities that you can do yourself to help support your recovery. Be realistic when planning these activities and start with something you know you can do. For example, a walk around the block once or twice a week may be enough to get started with an exercise program. 

Exercise

Exercise can help you feel better when you are depressed. If you find a type of exercise you enjoy, you are more likely to stick with it. Exercise can provide an opportunity to get support from others, and help you to reconnect with people, when you are ready. 

Eat well

Getting all the nutrients you need by eating well is another way you can support yourself to stay well.

Read more about healthy eating and depression. 

Avoid alcohol and drugs

Drinking alcohol or using illegal drugs can add to your problems rather than help them, especially if you drink more than the recommended limits. Sometimes people use alcohol or drugs to try and cope with depression. Reducing your reliance on alcohol and other drugs will be an important part of your recovery.

If you are dependent on alcohol or drugs, specific counselling can help. 

Do things you enjoy

Schedule time in your week for activities you enjoy, as this can help you recover from depression. Get together with friends each week or continue with a hobby you used to enjoy.

References

1. beyondblue. beyondblue guide to the management of depression in primary care. Melbourne: beyondblue, 2009 (accessed 22 February 2012).

Some people can have a one-off episode of depression that doesn’t return, while for others, depression is sometimes thought of as a chronic condition — one that can come and go over a longer period of time.

Take the full course of antidepressant to help yourself stay well

If you are taking an antidepressant, taking it for at least 6 months after you are better will make it less likely that your depression will come back. If you have had depression a few times in your life, longer treatment (e.g. 2 years) will increase your chances of staying well. Talk to your doctor about the right length of treatment for you.

CBT keeps depression away longer than antidepressants

Compared with antidepressant treatment, cognitive behavioural therapy (CBT) is better for preventing depression coming back.

Watch out for signs of depression coming back

After completing your treatment for depression, it’s a good idea to keep an eye on yourself, or the person you are caring for, in case the symptoms come back. Talk to your doctor or psychologist about what to look out for so you know the signs, and make a plan for what to do if you think the depression is returning.

There are certain times that are more stressful than others, and these can trigger the return of depression. Think about the things you can do to help yourself, or someone you care for, in these situations, and talk to your doctor about making a plan for these stressful times.

References

1. National Institute for Health and Care Excellence. Depression in adults with a chronic physical health problem: recognition and management. London, UK: NICE, 2009 (accessed 15 September 2020).

Support groups

Getting together with other people who know what it’s like to go through depression, or care for someone with depression, can be very helpful. Support groups provide a place where you can encourage each other, share coping strategies, talk about feelings and make new friends.

You can find a support group through your state mental health association, the The Black Dog Institute or GROW.

Suicide prevention 

• Lifeline
• Suicide Prevention Australia

General information about depression

• beyondblue
• The Black Dog Institute
• The Clinical Research Unit for Anxiety and Depression (CRUfAD)
  
• SANE Australia
• BluePages
• The Royal Australian & New Zealand College of Psychiatrists
  
• E-couch
• head to health

Postnatal and antenatal depression

• Just Speak Up

For men

• MensLine Australia

For kids

• Kids Helpline

For teens

• Youth beyondblue
• ReachOut.com
• HeadSpace

For people from culturally and linguistically diverse (CALD) communities

• Mental health in multicultural Australia