We all now know that depression is ‘real’ - but what about anxiety? Video / NZ Herald
The days – and our moods – might be getting gloomier, but for the many Kiwis who suffer it, depression is much worse than just a case of the winter blues. Experts tell science reporter Jamie Morton three surprising facts.
Depression rates are rising - and fast
You’re drained, you’velost your appetite and can’t get a sound night’s sleep.
Your concentration has ebbed to the point you can’t even get through a chapter of book and you no longer see the point in hobbies you used to love.
You feel worthless, guilty, irritable. Or you simply don’t feel anything at all.
If this sounds familiar and you haven’t sought help, you could be part of a hidden chunk of the population silently enduring depression.
It’s estimated as many as one in six Kiwis will experience a major depressive disorder at some point in life – but researchers say we don’t have a complete picture because the last national prevalence study was two decades ago.
Data does tell us, however, that rates are rising.
“Rates of diagnosed depression have gone up from about 15 per cent of the adult male population to about 25 per cent since 2012, and from 10 to 12 per cent among women,” Mental Health Foundation chief executive Shaun Robinson said.
“We also know that the number of young people mentally distressed is approaching 25 per cent. That’s nearly doubled in a decade so we definitely have some very concerning trends.”
Reported rates of depression have been rising in New Zealand - but it's not clear why.
Just what was driving the increase isn’t easy to untangle.
Clinical psychologist Dr Jacqui Maguire suggested Covid-19, Cyclone Gabrielle and tough economic times, social media and greater awareness about mental health.
It’s not just about brain chemistry
We’ve long heard depression is the result of a simple chemical imbalance.
But depression researchers are at pains to point out that it’s much more complex than having too much – or too little – of something like seratonin in our brains.
“There isn’t very much evidence at all for that theory,” said clinical psychologist Dr Dougal Sutherland.
“It’s a real combination of nature and nurture: or what you’re born with and your genetic predisposition, and your brain structure and what you get exposed to in life.”
Clinical depression wasn’t just a case of “feeling a bit down” during a rough patch in life, nor was it the same as anxiety, which is a separate disorder.
And although society had gradually moved past the old “harden up” ethos toward mental health, Sutherland said some stigma endured.
“One prevalent misconception is that depression is merely a ‘phase’ or a sign of personal weakness, when in reality, it’s a complex mental health disorder influenced by various factors beyond an individual’s control,” Maguire added.
Just taking anti-depressants isn’t the best solution
Having received a depression diagnosis, the natural next step might be to ask your GP for anti-depressants.
It might come as a surprise that, while medication could help, it wasn’t the best measure.
“Biological interventions can tackle how you feel, but they don’t necessarily tackle how you think,” said Dr Paul Skirrow, the NZ College of Clinical Psychologists’ strategic adviser.
“Psychological therapy is the most consistently useful thing you can do if you have depression – far more useful than medication.”
The next most effective step was exercise, which had been shown to be “hugely beneficial” - as were other steps like improving diet, cutting back on drugs and alcohol, and self-care measures.
Exercise has been shown to be among the most effective ways to combat depression. Photo / Kendrick Brinson, The New York Times
Maguire said evidence supported taking a combined treatment approach, which included therapy, medication, lifestyle changes and social support networks.
In teens, the American Psychological Association recommended the initial use of cognitive-behavioural therapy (CBT) – which aims to change unhealthy ways of thinking, feeling and behaving - or interpersonal psychotherapy.
“There’s another approach called behavioural activation therapy that gives people who are severely depressed a behaviour schedule, so you can make sure you get out of bed and do something every day,” Dr Paul Skirrow said.
“That’s actually really hard for some people to do, but if people do it, then it does make a big difference.”
Skirrow stressed that different approaches worked for different people: including tailored types of therapy.
“And it’s the job of a clinical psychologist to figure what’s going to work best for this person.”
Where to get help: If you suspect you may be depressed, see your doctor. If it is an emergency and you or someone else is at risk, call 111.
Jamie Morton is a specialist in science and environmental reporting. He joined the Herald in 2011 and writes about everything from conservation and climate change to natural hazards and new technology.
