Keeping the Blues Away

The Ten-Step Guide to Reducing the Relapse of Depression

Cate Howell

• Publisher: CRC Press
• Year: 2018
• eBook ISBN:
  9781315342924
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Keeping the Blues Away is a clinically tested programme to help prevent depression from returning: it has also shown efficacy in reducing depression severity. It includes information and exercises to teach coping, cognitive-behavioural and interpersonal skills and strategies to prevent relapses, drawing on a wide array of evidence-based techniques. The ten-step programme aims to support the patient as a whole person, and includes free access to supporting relaxation audio material. The programme is designed for use by GPs or mental health professionals in supporting patients, involving family members or carers where possible, and accommodating medication and the management of co-existing medical problems where necessary. Keeping the Blues Away will be a key relapse prevention tool for primary care healthcare professionals.

STEP 1

__________________________

Getting started – information about depression

Or the ‘who, what, why, how, when and where’ of depression and relapse!

Your GP or MHP may have already talked with you and provided information about depression. Having information for yourself and your family to look at is really important in managing the depression. It can help you have a greater sense of understanding and control, which can be a very positive step towards recovery.

Some information may be repeated here, and other information may be new. Other ways to access more information in the community or via the internet will be outlined later (see Resources in Step 10).

WHO GETS DEPRESSED?

Depression is a common problem and can affect anyone – in fact, it will affect about 1 in 5 individuals at some time in their lives. It is experienced by males and females of all ages, but is more common in women. However, women with depression are more likely than men with depression to seek help from their doctor (Evans, Burrows and Norman, 2000; Hickie, 2002; Kessler, Berglund, Demler, et al., 2003).

WHAT IS DEPRESSION?

Everyone experiences feelings of sadness, loss or ‘depressed’ feelings at some time. These are part of life, and part of coming to terms with difficult events in life. But these common feelings are not the same as ‘depression’.

The term ‘depression’ is used to describe a condition in which mood is persistently and severely depressed. The low mood and other associated symptoms are debilitating, affecting the ability to cope and function (Evans, Burrows and Norman, 2000; Hickie, 2002).

It can be very difficult to go to a GP or MHP and talk about feeling depressed. There are still a lot of myths about mental illness in our community and misconceptions about depression. These lead to stigma (Hickie, 2002). Depression may be wrongly viewed as weakness, and it may be thought that the person should, for example, just ‘get over it’.

Sometimes it is hard to pick that the problem is depression. It may seem that the main problem is tiredness or disturbed sleep. Often individuals go to the doctor with a physical problem, rather than recognising that there is an emotional concern. Another complication is that anxiety often accompanies depression, and may seem to dominate initially.

The diagnosis of depression requires the following symptoms to be present.

For at least a two-week period, either consistently low or depressed mood, and/or loss of enjoyment or interest in most activities. At least four other key depressive symptoms will have been present:

• significant weight or appetite changes
• too little or too much sleep
• agitation or slowing down
• significant decrease in energy levels, or excessive tiredness
• feeling very guilty or worthless
• having trouble making decisions, thinking clearly, or concentrating
• thinking frequently about death or suicide.

(American Psychiatric Association, 2000.)

HOW DO I KNOW THAT I HAVE DEPRESSION?

Depression varies in severity, and symptoms may be mild, moderate or severe. Symptoms vary from person to person. The symptoms of depression affect a person’s thoughts, feelings and everyday functioning. It can be helpful to think of the symptoms as being psychological and physical.

PSYCHOLOGICAL SYMPTOMS	PHYSICAL SYMPTOMS
Low mood, feelings of sadness	Sleep problems – finding it hard to get off
Loss of pleasure, interest	to sleep, sleeping too much or too little
Loss of motivation	Tiredness, low energy
Irritability	Physical aches and pains
Crying easily	Agitation or restlessness
Emotional numbness	Slowing down
Withdrawal from others	Appetite/weight changes
Anxiety	Decreased libido
Concentration/memory problems	Nausea, diarrhoea, constipation
Depressive or negative thinking	Menstrual disturbances
(e.g. worthlessness, self-blame)
Poor self-confidence
Alcohol, drug abuse
Thoughts about death or suicide

(Adapted from Kidman, 2006.)

Thinking changes in depression – your view of yourself and the world may seem very black. The depressed feelings worsen, with some describing depression as a black cloud, or like being in a dark tunnel with no light at the end. As a result, behaviour is affected, and you might, for example, become more withdrawn. Treatment for depression aims to give you tools to deal with negative thinking, feelings and behaviour, an...

Table of contents

• Cover Page
• Half Title
• Title Page
• Copyright Page
• Contents
• Preface
• Acknowledgements
• Introduction to this guide for clinicians
• Introduction
• Step 1 Getting started – information about depression
• Step 2 Assessment and goal setting
• Step 3 Healthy lifestyle issues
• Step 4 Useful coping skills
• Step 5 Helpful thinking or cognitive strategies
• Step 6 Dealing with psychological issues
• Step 7 The benefits of activity
• Step 8 Fostering social support and skills
• Step 9 Developing a plan to manage early relapse symptoms
• Step 10 Reassess and review, plus helpful resources
• Resources: Where to go for help
• References
• Index