When sadness turns to depression. How to manage and recognise mental health dips

Sadness vs depression

In recent years, depression and poor mental health have become an essential pop culture topic. Depression is still a relatively new concept in the modern age, and many of us still need to learn more about it. Most people in their lives will experience times of sadness, and sadness is a crucial element of depression. However, sadness and depression are two different things and are not the same. We must all be aware of the signs and symptoms of depression and be able to know when sadness turns into depression. If we are aware of the differences between a low sad patch of life and depression, it means we will be able to reach out for medical and psychological help when we need it.

Sadness is a natural way of life, and the ups and downs we all face are out of our control. Sadness is often triggered by events such as the loss of a loved one, failing an exam, not getting a job, or financial stressors. Usually, when you are feeling sadness, a good cry, a gym workout, or time spent with loved ones venting can make you feel better.

Sadness may turn into depression, where it is constant for more than two weeks, and things that usually make you feel better aren't helping further if your sadness prevents you from living as you usually would. For example, if you are feeling so sad you consistently cancel plans with friends and are unable to get to work because of it, this may be a sign your sadness is turning into depression.

Depression is a clinical mental disorder, and the DSM-5 (diagnostic manual) defines the criteria of being clinically depressed as feelings of sadness, low mood, and loss of interest in their usual activities that must mark a change from a person's previous level of functioning and have persisted for at least two weeks. This feeling must also be accompanied by five or more of the following symptoms;

• Change in appetite, losing or gaining weight

• Sleeping too much or not sleeping well (insomnia)

• Fatigue and low energy most days

• Feeling worthless, guilty, and hopeless

• An inability to focus and concentrate that may interfere with daily tasks at home, work, or school

• Movements that are unusually slow or agitated (a change which is often noticeable to others)

• Thinking about death and dying, suicidal ideation, or suicide attempts

If an individual has the above symptoms and they are causing significant distress and interruption to their usual way of life, then they may be diagnosed with severe clinical depression. Disruption of normal life function would negatively impact your social or work life and other essential functioning areas.

Please note that if the individual is experiencing these symptoms due to the use of drugs and alcohol, then they can not be diagnosed with severe depression. Drs diagnosing must also rule out the possibility of other clinical mental disorders such as bipolar disorder and schizophrenia.

How to spot depression in a loved one

If you are concerned about a loved one but have never experienced depression yourself, it can be challenging to spot the signs or to know if they are depressed or just sad. Signs within your children can be challenging to pick up on as they are not always as emotionally aware as adults and may find it harder to express their feelings.

When a child becomes depressed, they are likely to experience emotional changes. You may find they are quicker to become angry or sad and have outbursts of heavy emotional reactions that are out of character. They may start to lose interest in hobbies and activities they were once interested in; for example, they may stop wanting to go to their football club or meet their friends for social events.

You must also look out for behavioural changes. These could be changes in the amount they sleep or eat. They may be spending more time in bed and socially isolating themselves. They could be less interested in looking after their personal hygiene or the way in which they dress.

Cognitive fatigue comes hand in hand with depression, so children can often be misdiagnosed with disorders such as ADHD, as the symptoms could be parallel if they are forgetting things or finding it hard to study or stay focused.

Men and women can both show varying signs of depression. Women are more likely to be affected by depression in their adult life due to the hormone changes they face, particularly in pregnancy or through menopause. Women can show their depression through expressions of hopelessness, sadness, and changes in their behaviour, such as a decreased libido, sleeping more or less and gaining or losing a significant amount of weight.

Men are more likely to become more inward with their feelings; they are less likely than women to understand or express their feelings of sadness or depression. The signs and symptoms can align with women and children, as well as behaviour changes in sleeping, eating, and stopping social activities. They may also become less active on social media and start talking about death.

All these symptoms in adults and children should become a concern if they last longer than two weeks.

Where to find help

There are lots of options if you need support with depression, but if you need immediate support and are contemplating suicide, please call one of these support lines now;

• Samaritans. Samaritans are contactable 24 hours a day, 365 days a year. Call them on 116 123 (free from any phone) or visit some branches in person. You can talk to the Samaritans about anything you are going through.

• Shout is a texting service. To access it, text SHOUT to 85258. Shout is 24/7 and offers a confidential service to those experiencing a mental health crisis.

• Papyrus HOPELINEUK. If you are under 35 or concerned about a young person experiencing a mental health crisis and worried about suicide, you can call  Papyrus HOPELINEUK on 0800 068 4141 (24 hours, seven days a week), email pat@papyrus-uk.org or text 07786 209 697.

• National Suicide Prevention Helpline UK. If you are struggling with feelings of suicide, you can call the National Suicide Prevention Helpline UK on 0800 689 5652 (6 pm to midnight every day).

• Campaign Against Living Miserably (CALM). You can call CALM on 0800 58 58 58 (5 pm–midnight every day). If you don't feel comfortable talking on the phone, you can also use CALM webchat.

• Switchboard. If you are part of the LGBT+ community or identify as this, you can call Switchboard on 0300 330 0630 (10 am–10 pm every day), use their webchat service, and all their operators identify as LGBT+.

• SANEline. If you or someone you are supporting is experiencing poor mental health, you can call SANEline on 0300 304 7000 (4.30 pm–10 pm every day)

• NHS crisis team helpline – Please follow the link on this website to find your local NHS crisis team number https://www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline

There are two options for therapy for depression: you could go the private route and pay for a counsellor or therapist. Please ensure the therapist or counsellor is part of the British Association for Counselling and Psychotherapy (BCAP). The pros of going private are that you won't have to deal with waitlists, you can choose your counsellor or therapist to suit your needs, and you can control when and where you see them. However, the average cost of a therapist or counsellor is typically £40- £50 per session. This can be expensive for most but look and see if there are any lifestyle changes you can make to make this realistic, e.g. cut down on the costs of unhealthy habits such as smoking, drinking and takeaways.

You could also go through the NHS for free counselling through the IAPT service. IAPT NHS Talking Therapies for anxiety and depression. You can ask your GP to refer you to this service or self-refer via the website. IAPT offers a range of talking therapies and will put you on the most suitable course or therapist. The benefit of IAPT is that it is a cost-free service; however, there is a current wait time of 6- 18 weeks.

Finally, ensure that you not only reach out for professional help but also to your loved ones and those who care for you. Asking for help comes in all different shapes and sizes; for example, you could say to a family member, I am struggling with my mental health now; would you mind if we went for a walk together? Or asking work for some time off for rest and to work on your mental health. The more we talk about our mental health and depression struggles, the more we help to eradicate any misconceptions around the subject.  

The most important thing to remember if you are suffering through a period of depression or sadness is that you are not alone. There is help available as listed above and from those who care about you. Also always remember to reach out to your GP service and ask to be contacted by a member of the wellbeing team.

Written by Josie Hopkins Social Prescriber and Burbage and Great Bedwyn Surgeries