Depression and Disability
Feelings and Disability
Many people with long-term physical difficulties don’t like using the word ‘disabled’ about themselves but it is the word that the government uses to talk about people who have a long-term health problem. If you need to claim Benefits then it may be a ‘Disability’ Benefit or if an employer or a college treat you unfairly then it will ‘Disability’ law that is being broken. So we will carry on using this word here.
Everybody, disabled or not, goes through times when they feel ‘down’ or low in mood, sometimes for days or weeks at a time. Sometimes we know why we feel this way – losing somebody close, or having other things go on in our lives which we don’t want, for instance.
Because we can’t control everything that happens in our lives, bad things are bound to happen from time to time. What this means is that feeling down is ‘normal’. If someone close to you dies it can take many months to get over it but during this time your mind is working hard at getting used to the loss. At first, you may be sad all the time; gradually you are sad for less time and eventually you may be able to remember the person with fondness and even smile at good memories.
We call this feeling ‘grief’ and the process ‘grieving’. But other changes in our lives can make us feel the same way. Breaking up with a close friend, losing a job we like, and so on. While we are getting used to the changes, we will feel low.
Sometimes we don’t know why we are feeling this way but there is always a reason. Sometimes we are so used to trying to deal with what is making us feel low that we stop noticing it. When the feelings go on for a long time this can be puzzling for us, and for those around us who can see that there is something wrong.
Living with any type of disability is difficult. It can often seem that other people around you get what they want more easily. It may seem to you that there are things you would like to do that you will never be able to. Other people are not always kind if they know you are disabled. But because disabled people have to cope with these things every day, they sometimes stop realising how hard it is, begin to feel very down and sometimes don’t know why. If you get down sometimes, try to think how someone who is not disabled would feel if they suddenly became disabled and had to cope with all the problems you have to cope with all the time. You are probably doing very well to cope with all your problems.
Actually, a lot of people who become disabled, as a result of accidents for instance, do find it very hard to cope and get very down before they learn how to cope.
Even when we know why we are feeling low it is often helpful to talk about it to somebody else. Sharing problems with somebody you trust is usually a good idea, especially if they have experienced the same difficulties themselves. If that isn’t possible then you can sometimes find people who are trained to help.
So, if you feel down for a week or so, try:
To talk to someone else you trust about how you feel
To remember that what you are having to cope with is difficult
Not to get angry with yourself – remember that you are coping with something that some people couldn’t cope with at all
To treat yourself as sympathetically as you would want to treat somebody else who was going through the same thing.
To keep on meeting friends and doing the things you know you enjoy - even if you don’t really feel like it you will probably feel better afterwards.
Disability and Depression
If you feel low for more than a few weeks and you don’t know why; if you can’t tell yourself to ‘snap out of it’ or if the things that usually interest you don’t cheer you up then you may be experiencing what is often called ‘depression’ and you may need special help to start feeling better.
Most disabled people are not depressed and disabled people who become depressed do not stay depressed. This is another way of saying that it may not be the disability itself which causes depression but how people cope with it. If you become depressed it may be that you are having to cope with change or something new.
The difference between feeling down and feeling depressed is that when you are depressed, the feelings are deeper and last for longer. If you are down, you can often tell yourself to do things to make you feel better; that doesn't work when people are depressed because they lose interest totally.
This is list of what might happen if you or someone you know gets depressed.
Feeling sad nearly all the time
Feeling hopeless about your future
Feeling like a failure or feeling worthless
Not enjoying things you used to enjoy, losing interest in things you used to be interested in, losing interest in sex
Feeling that you are to blame for a lot of what goes wrong
Losing confidence in yourself Wanting to harm or kill yourself Crying or feeling like crying although you didn't cry easily before
Being restless a lot of the time
Lack of energy and feeling tired a lot of the time
Sleeping much more than usual or having trouble getting off to sleep
Feeling bad tempered a lot of the time
Wanting to eat a lot more or a lot less than usual
Not being able to concentrate as well as before, finding it very difficult to make decisions
Smoking or drinking too much. Relying on social drugs
If you have had a number of these problems for more than a couple of weeks, or if you know someone who seems to have these problems, then getting help from someone else is important.
Remember, becoming depressed is not being "silly" or a sign of weakness. There are always real reasons for becoming depressed and help is available.
You may be a part of a support group or be part of an organisation (such as Shine) which can help, so try this first.
Most people who become depressed go to their own doctor, who can make a further referral if specialist treatment is required.
Dealing with Depression
There are two main ways of dealing with depression:
* Talking about problems to a trained person
* Taking drugs called ‘anti- depressants' which are prescribed by a doctor.
Your doctor should be able to refer you to a counsellor or another suitable therapist who will be able to find out why you are depressed and help you to deal with it. When this is available, this is first thing to try.
You will probably need to see your counsellor every one or two weeks to begin with and you should expect to be seeing them for at least 6 months – feelings of depression tend to get better quite slowly but you can expect to get back to normal eventually.
If counselling is not available or if you are really depressed, your doctor might suggest you take anti-depressants.
It is true that taking pills will not solve problems but sometimes people are so depressed that they lack the mental energy to sort things out.
Anti-depressants will sometimes help by making you feel more like tackling problems. Sometimes you can take anti-depressants and have counselling at the same time but the type of antidepressant needs to be carefully chosen by your doctor for this to happen.
Most anti-depressants are not addictive and you can come off them quite easily when the time comes. You need to be taking them for 3 to 4 weeks before they start to work and you need to take them for at least 3 months before you can tell whether they are working for you. Doctors prefer depressed patients to keep taking them for 6 months.
Anti-depressants can make you feel peculiar or a bit poorly when you first start taking them but most people manage to cope. If you get severe problems you should tell your doctor. Do not increase or reduce the amount you take without discussing it with your doctor. Drinking alcohol or taking other drugs while you are taking anti-depressants can be dangerous – again, discuss this with your doctor.
When you feel the time has come to stop taking antidepressants, discuss this with your doctor. You will usually need to reduce the amount you take gradually.
How to help other people who become depressed.
People who become badly depressed can lose interest in helping themselves and they may have started to shut themselves away from other people. It may seem to you that they are not interested in being with you.
Underneath the depression though, there is usually a strong need to be close to others.
If they don’t seem interested in seeing you, try to show that you still want to see them. Listen to them if they want to talk about problems.
Being with a depressed person is often no fun – be prepared for their gloomy thoughts and lack of interest. Don’t tell them to “pull themselves together”. Being badly depressed means that they can’t do this.
Most important, accept that you may not be able bring them out of depression yourself and try not to feel responsible if you seem to be failing.
If you are worried, suggest that they go to see their doctor if they haven’t already been. If they won’t, don’t be afraid to tell someone else who can help, even if the depressed person seems not to want you to.
It is important that they get to see someone who can help without becoming too emotionally involved.
The person’s doctor, a teacher or a parent are people you could tell.
A depressed person may not want you to do this at the time, but may well thank you later when they can understand that you needed to help.
With thanks to Dr James Meikle, Consultant Clinical Psychologist