Most of us know what it feels like to have a low day. Life can bring difficult experiences, losses and changes that leave us feeling sad, tired or overwhelmed for a while.
Depression can feel different.
Things that once mattered may seem distant. Getting out of bed, answering a message, making something to eat or having a shower can take far more effort than they normally would. You might feel sad, but you might also feel numb, irritable, exhausted, hopeless or simply disconnected from the person you remember being.
Depression can affect how you feel, how you think, how your body feels and how you experience yourself and the world around you. When it continues for some time, it can begin to affect relationships, work, sleep, eating, concentration and the ordinary things that make up everyday life.
Although depression is common, your experience of it is still individual to you.
What Causes Depression?
There isn’t always a simple answer.
For some people there may be an obvious event or period in their life that seems connected to becoming depressed. For others, depression can develop gradually and it may be difficult to identify exactly why.
Bereavement, relationship difficulties, financial worries, illness, changes at work, pregnancy and becoming a parent, loneliness, prolonged stress and difficult or traumatic experiences can all affect our emotional wellbeing.
Our physical health can matter too. Hormonal changes, some health conditions and some medications can contribute to changes in mood, which is one reason it can be helpful to talk with your GP if you are experiencing persistent symptoms of depression.
Alcohol and other drugs can also affect mood. Sometimes people use them to try to cope with difficult feelings, only to find that they feel worse afterwards.
Usually, people’s lives are more complicated than a single cause. Our relationships, experiences, physical health, circumstances and individual ways of coping can all interact.
You don’t necessarily have to know why you feel the way you do before asking for help.
What Can Depression Feel Like?
Depression doesn’t look or feel exactly the same for everybody.
You might recognise some of these experiences:
- feeling tired or having very little energy
- sleeping much more or much less than usual
- changes in appetite or eating
- finding it difficult to concentrate, remember things or make decisions
- feeling sad, empty, irritable, angry, hopeless or helpless
- feeling guilty or as though you are a burden
- losing confidence in yourself
- feeling restless or agitated, or finding that everything seems to take much more effort
- losing interest or pleasure in things that you would usually enjoy
- withdrawing from friends, family or activities
- experiencing unexplained aches and pains
- changes in your interest in sex
- struggling to manage ordinary everyday tasks
- thoughts about hurting yourself, not wanting to be here or suicide.
You don’t need to experience everything on this list for depression to be affecting you.
Sometimes depression isn’t immediately obvious either. Someone may continue working, caring for other people and appearing to manage their life while struggling considerably inside.
When Might It Help to Seek Support?
If you’ve been feeling low, numb, hopeless or unlike yourself for a while, or you’re finding that how you feel is beginning to affect your everyday life, it may be worth talking to someone.
That could be your GP, a counsellor or another professional you trust.
You don’t have to wait until things become unbearable, and you don’t need to be able to explain everything perfectly.
Sometimes the starting point can simply be:
“I haven’t felt like myself lately.”
Your GP or another healthcare professional may ask you to complete a questionnaire such as the PHQ-9, which asks about experiences associated with depression over the previous two weeks.
Questionnaires like this can be useful for opening a conversation and monitoring how someone is feeling, but a score cannot tell the whole story of what is happening in someone’s life and does not, by itself, provide a diagnosis.
The Black Dog
Sometimes words aren’t enough to describe what depression feels like.
The World Health Organization’s “I Had a Black Dog, His Name Was Depression” video uses the image of a black dog to show how depression can gradually begin to affect someone’s relationships, energy, confidence and everyday life.
I like this way of describing depression because it captures something that can otherwise be difficult to put into words: depression can become part of almost everything you do without being who you are.
Why Can the Smallest Things Feel So Difficult?
One of the particularly difficult things about depression is that it can affect the very things you might normally rely upon to help yourself.
When your energy is low, concentration is difficult and making decisions feels exhausting, even something apparently simple can feel enormous.
Taking a shower isn’t necessarily just taking a shower.
It can mean getting out of bed, finding clean clothes, getting undressed, washing, drying yourself, getting dressed again and somehow finding the energy for every little step in between.
From the outside, somebody might wonder why that’s difficult.
From inside depression, it can feel like climbing a mountain.
This isn’t laziness, and it isn’t simply a matter of trying harder. Depression can make everyday things genuinely difficult.
And beating yourself up because you’re struggling usually just gives you another difficult thing to carry.
What Might Help?
There isn’t one set of things that everybody with depression needs to do.
You may hear advice about exercising, eating well, sleeping properly, seeing friends, getting outside, practising mindfulness and establishing a routine. Some of these things can be helpful — but when you’re depressed, being given a long list of things you should be doing can sometimes feel overwhelming.
Perhaps a gentler place to begin is:
What feels possible today?
Not what should you be able to do. Not what could you manage last year or what somebody else thinks you ought to be doing.
What feels possible now?
If getting out of bed feels possible, perhaps that’s the starting point.
If you’re already getting up but getting dressed feels difficult, perhaps putting on a clean top is enough.
If making a meal feels impossible, perhaps eating something simple is enough for now.
On another day, you might have more capacity. You might take a shower, go for a short walk, make some food, answer a message or spend time with somebody you trust.
The starting point can change from day to day.
Looking After Yourself
When you have some capacity, you might gently consider some of the things that support you.
Your body. Food, water, sleep, washing, comfortable clothes, fresh air or movement can all matter. They don’t have to be done perfectly.
Connection. Depression can make withdrawing from other people feel tempting or necessary. Sometimes being with somebody who doesn’t expect you to be cheerful, entertaining or “better” can help you feel a little less alone.
Things that matter to you. You may not get the same enjoyment from familiar activities when you’re depressed. That’s okay. Perhaps there are small things that still offer some comfort, interest or connection — music, a familiar programme, an animal, being outside, making something, reading or simply sitting somewhere you like.
Structure. Some people find a little routine helpful when days begin to merge into one another. That doesn’t have to mean planning every hour. It might simply mean having one or two things that gently give shape to your day.
Writing things down. If your thoughts feel tangled or difficult to hold onto, writing can sometimes help you notice what you are experiencing without needing to solve it.
None of these things is a test of how well you’re recovering.
If you can’t do something today, that doesn’t mean you have failed.
You Don’t Have to Do This Alone
Depression can make the world feel very small. It can also make it difficult to imagine that things could ever feel different.
You don’t need to have reached a particular level of difficulty before you are allowed to ask for support.
Counselling can offer somewhere to begin making sense of what has been happening, without expecting you to arrive knowing exactly why you feel the way you do or what needs to change.
Sometimes the first step isn’t about making a big change at all.
It might simply be having somewhere you can say how things really are.
If Things Are Feeling Particularly Difficult
Depression can sometimes bring thoughts about hurting yourself, not wanting to be here or suicide. If this is happening, you don’t have to carry those thoughts on your own.
If you can, tell someone you trust what is happening. You can also speak with your GP or another healthcare professional.
If you need urgent help with your mental health, you can use NHS urgent mental health support or call 111 and select the mental health option.
If you feel that you or someone else is in immediate danger, call 999 or go to A&E.
If you need someone to talk to, Samaritans are available free, day or night, on 116 123.
Asking for help doesn’t require you to know exactly what you need or how to explain everything.
Sometimes “I’m struggling” or “I’m not feeling safe” is enough of a place to begin.
Cover image courtesy of Pixabay.