What is Unipolar Disorder?

Depression is a serious illness. Health professionals use the words depression, depressive illness or clinical depression to refer to it. It is very different from the common experience of feeling unhappy, miserable or fed up for a short period of time.

When you are depressed, you may have feelings of extreme sadness that can last for a long time. These feelings are severe enough to interfere with your daily life, and can last for weeks or months, rather than days.

Depression is quite common and about one in ten people will experience depression at some point. However, the exact number of people with depression is hard to estimate because many people do not get help or are not formally diagnosed with the condition.

Women are more likely to have depression than men, and 1 in 4 women will require treatment for depression at some point, compared to 1 in 10 men. Men are far more likely than women to commit suicide, which may be because men are less likely to seek help for depression. Alternatively, it may be due to other factors including substance misuse, unemployment and social isolation.

Depression can affect people of any age, including children. Studies have shown that about 4% of children aged 5-16 in the UK are affected by depression.

People with a family history of depression are more likely to experience depression themselves. Depression affects people in many ways and can cause a wide variety of physical, psychological and social symptoms.

A few people still think that depression is not a real illness and that it is a form of weakness or admission of failure. This is simply not true. Depression is a real illness with real effects, and it is certainly not a sign of failure.

With the right treatment and support, most people can make a full recovery from depression. It is important to seek help from your GP if you think you may be depressed.

Symptoms of Unipolar Disorder

The symptoms of depression are complex. If you are depressed, you often lose interest in things you used to enjoy. Depression commonly interferes with your work, social life and family life. There are many other symptoms, which can be psychological, physical and social.

Psychological

• Continuous low mood or sadness
• Feelings of hopelessness and helplessness
• Low self-esteem
• Tearfulness
• Feelings of guilt
• Feeling irritable and intolerant of others
• Lack of motivation and little interest in things
• Difficulty making decisions
• Lack of enjoyment
• Suicidal thoughts or thoughts of harming yourself
• Feeling anxious or worried
• Reduced sex drive

Physical

• Slowed movement or speech
• Change in appetite or weight (usually decreased, but sometimes increased)
• Constipation
• Unexplained aches and pains
• Lack of energy or lack of interest in sex
• Changes to the menstrual cycle
• Disturbed sleep patterns (for example, problems going to sleep or waking in the early hours of the morning)

Social

• Not doing well at work
• Taking part in fewer social activities and avoiding contact with friends
• Reduced hobbies and interests
• Difficulties in home and family life

Causes of Unipolar Disorder

There is no single cause of depression, and people develop depression for different reasons.

Depression has many different triggers. For some people, upsetting or stressful life events, such as bereavement, divorce, illness, redundancy and job or money worries, can be the cause. Usually, different causes combine to trigger depression. For example, you may feel low after an illness and then experience a stressful life event, such as bereavement, which leads to depression.

People often talk about a 'downward spiral' of events that leads to depression. For example, if a person's relationship with their partner breaks down, they are likely to feel low, they may stop seeing friends and family, and they may start drinking more. All of this can make them feel even worse and trigger depression.

Some studies have suggested people are more likely to get depression as they get older and that it is more common among people who face difficult social and economic circumstances.

Depression is complex and a number of things can increase the risk of developing it.

Stressful life events

Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events happen, you have a higher risk of becoming depressed if you stop seeing friends and family and try to deal with problems on your own.

Illness

You may have a higher risk of depression if you are diagnosed with a chronic or life-threatening illness, such as coronary heart disease or cancer.

Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems.

Even a minor head injury can damage the pituitary gland, which is a pea-sized gland at the base of the brain that produces thyroid-stimulating hormones (chemicals). This can cause a number of symptoms, such as fatigue and a decreased interest in sex, which can lead to depression.

Personality traits

You may be vulnerable to depression due to certain personality traits, such as low self-esteem or being overly self-critical. This may be due to genes you have inherited from your parents, or your personality or early life experiences. These can all have a profound effect on the way you think about yourself in later life.

Family history of depression

Research shows that some genes increase the risk of depression after a stressful life event.

Giving birth

Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as the added responsibility of a new life, can lead to postnatal depression.

Social isolation

Becoming cut off from family and friends may increase your risk of depression, or it may be a response to feeling depressed as the downward spiral takes hold.

Treatment of Unipolar Disorder

Treatment for depression usually involves a combination of medicines and talking therapies. The treatment you receive will depend on the severity of the depression you have.

Mild depression

If you are diagnosed with mild depression, it may improve by itself. In this case, you will have another assessment after two weeks to monitor your progress. This is known as watchful waiting.

Antidepressants are not usually recommended as a first treatment for mild depression.

Exercise seems to help some people. While your progress is being monitored, your GP may refer you to a qualified fitness trainer for an exercise scheme.

Talking through your feelings may also be helpful. You may wish to talk to a friend or relative, or your GP may suggest a local self-help group.

Your GP may recommend self-help books and computerised CBT.

Chronic mild depression (which is present for two years or more) is called dysthymia. This is more common in people over 55 years old and can be difficult to treat. If you are diagnosed with dysthymia, your GP may suggest that you start a course of antidepressants.

Moderate depression

If you have mild depression that is not improving, or you have moderate depression, your GP may recommend a talking treatment or prescribe an antidepressant.

Severe depression

If you have severe depression, your GP may recommend that you take an antidepressant, together with talking therapy. A combination of an antidepressant and CBT usually works better than having just one of these treatments.

You may be referred to a mental health team. These teams are usually made up of psychologists, psychiatrists, specialist nurses and occupational therapists. They often provide intensive specialist talking treatments, such as psychotherapy.

Medicines

The medicines used in treating depression will be eihter SSRIs (such as Citalopram), TCAs (such as Imipramine) or MAOIs (such as Phenelzine)

Talking therapies

Talking therapies will include the following: CBT, IPT and counselling

Videos talking about Unipolar Disorder

NHS Choices video on Unipolar Disorder
Laurie talking about CBT
Carol talking about CBT
Four people talking about mental health issues