A year ago today it emerged that the much-loved actor and comic Robin Williams had died in an apparent suicide after a long battle with severe depression.
He's not the only person who has struggled with the illness. One in ten of us will experience depression at some point in our lives. Depression affects people of all ages in different ways and can produce a variety of emotional and physical symptoms, including feelings of helplessness, hopelessness and anxiety.
Williams' death has highlighted how important it is for people to have access to help and information on depression.
If you think you may have depression or are struggling to manage your mood, below are some actions you can take.
Know the symptoms of depression
Depression produces a variety of symptoms but can still be hard to spot. People can often feel sad, hopeless or fed-up, but these feelings tend not to go away in cases of depression.
The Depression Alliance recommends that if you experience four or more of the following nearly every day for over two weeks, it is worth talking to someone or visiting your GP:
- Feeling tired, sad, or not being able to enjoy things that are usually pleasurable or interesting
- Loss of confidence and self-esteem
- Difficulty concentrating and making decisions, avoiding others and becoming isolated and lonely
- Undue feelings of guilt/ worthlessness/ helplessness or hopelessness
- Sleeping problems and/or finding it hard to function at work/college/school
- Noticing a change in appetite, or loss of sex drive and/ or sexual problems
- Physical aches and pains
- Thinking about self-harm
- Thinking about suicide and death
Connect with other people
Sam Challis, information manager for the mental health charity Mind, said it is important to open up about any worries you have surrounding your mental health, perhaps by confiding in a close friend or family member.
Mr Challis said lots of people find online forums such as Elefriends really helpful, particularly if they are unable to confide in friends or don’t have strong social networks.
Elefriend is a supportive online community where users can share their feelings and experiences with each other.
The Depression Alliance also runs a supportive community network called Friends in Need for people with depression. It helps people connect with others online, through their network and in their local area.
Look after yourself
Some people with depression find making lifestyle changes such as exercising more, reducing the amount of alcohol they drink and eating healthily benefits them.
Mr Challis said: “Exercise is known to be as effective for treating mild to moderate depression as antidepressants, and research by Mind has shown that exercise outdoors in natural environments is of particular benefit.
“Simple self-management techniques such as maintaining regular sleeping patterns, eating well, avoiding alcohol and drugs, and simply talking to friends and family about how you feel can all help.”
A spokesman for mental health charity SANE stressed the importance of avoiding drugs and alcohol if you have been instructed to by your doctor. He said: "Your doctor is likely to advise you to avoid drugs and alcohol and these are known to make depression worse. There can be a temptation to use them as a short-term palliative, but it is wise to resist."
Know what treatments are available
Talking treatments, such as cognitive behavioural therapy (CBT) and counselling, are sometimes used in cases of moderate depression.
CBT takes in account events in a past that may have shaped you as a person but concentrates mainly on changing the way you think, feel and behave now. It teaches you to challenge and overcome negative feelings, such as feelings of helplessness.
Counselling helps people think about the problems they are experiencing in order to find a way to deal with them. Your GP can refer you for talking treatments, which are available on the NHS.
In more serious cases, medication or a combination of medication and talking therapies may be recommended by your doctor. Charity Rethink Mental Illness has lots of information on treatment options on their website and the NHS have more information about options available here.
SANE's spokesman said treatments can also help to improve a person’s motivation and their ability to take an interest and enjoy things.
"There is also growing evidence that mindfulness-based therapies, which are based on meditation techniques, can be useful," he added.
“The act of taking the first step can feel daunting, but you should remember that depression is extremely common and people can and do recover from this condition.
“The sooner you receive the help that you need, the better your chances are of making a good recovery.”
Know who to contact for support
Samaritans is a registered charity that provides confidential, emotional support for anyone feeling in anyway distressed and can be contacted 24 hours a day, seven days a week on 08457 90 90 90. If you don’t want to speak over the phone, they can be contacted by email at firstname.lastname@example.org. Volunteers endeavour to respond to emails within 12 hours.
Children, teenagers and adults up to the age of 35 experiencing suicidal thoughts can contact the national confidential helpline HopeLineUK on 0800 068 41 41 between 10am and 10pm Monday to Friday, or between 2pm and 5pm at the weekend. You can also send a text to 07786 209697.
SANE’s helplinecan be contacted on 0845 767 8000. It is open every day of the year from 6pm to 11pm and provides emotional support and advice about local services for people affected by mental illness, as well as their friends and family.
Campaign Against Living Miserably (CALM) has a helpline open between 5pm and midnight, every day of the year, specifically for men who need emotional support. They can be contacted on 0800 58 58 58 or by text on 07537 404717. You can also speak to them via webchat between 6 and 9pm every day.
For information, advice and support, Mind’s infoline can be contacted on 0300 123 3393 between 9am and 6pm Monday to Friday.
Know when to see a doctor
If the way you are feeling continues to interfere with everyday life, Mr Challis said it is important to seek medical help.
“It’s worth consulting a health professional, usually a GP to begin with, who will be able to outline different options for treatment,” he explained.
“If you find yourself at crisis point or are considering suicide, it is important to act straight away by calling Samaritans or getting yourself to A&E where you can be seen by a psychiatrist.”
If you contact your GP but are worried you have not been listened to, consider seeking a second opinion.
Mark Winstanley, CEO of Rethink, said: “Some GPs are better at dealing with mental health than others and if you don’t feel listened to, try booking an appointment with another doctor and taking someone you trust with you for support.
“You may also want to think about writing down how you are feeling and showing it to your GP if you find it hard to express how you are feeling.”