In my psychiatric career thus far, I have encountered well over 500 people who have suffered with depression. There are several different forms of depression, but no single cause. Most experts agree that there seems to be a mixture of biological, psychological and social factors that contribute to this illness. Irrespective of the type or cause of depression, I have found that most sufferers experience common dilemmas in their efforts to recover from it. Getting over depression is never easy, but it helps to understand a few key things before embarking on the road to recovery.

1. You are not alone.

The World Health Organisation reports that depression is one of the leading causes of disability worldwide, affecting somewhere around 121 million people. leading cause of disability world wide. Yet despite its near epidemic proportions, it is not an illness that many sufferers readily admit to. This, in large, is probably due to the attitude society still holds towards illnesses of the mind and emotional states. But in the UK alone, for example, it has been estimated that depression affects nearly 1 in 10 people, or 10% of the population at any given time (Mind National Association for Mental Health). So if you think about it, you probably already know someone who is suffering depression too, whether or not you knew it!

2. You are not an illness.

You are not depressed, nor are you a depressive. You have an illness, and it is called depression. This illness does not define you as a person, any more than diabetes or any other illness would. Because depression can have such a profound effect on characteristics associated with personality (i.e. thought processes, motivation levels, attitude, etc.), many people begin to integrate their sense of self with the symptoms. Depression makes you think negatively, but you are not negative. It takes away your motivation and energy levels, but you are not a lazy person! Try not to identify yourself with the illness. If you weren’t depressed, no doubt you would act and think differently than you do at the moment.

3. There is help, but no quick fixes.

Generally, for moderate to severe depression, the best treatment is a combination of medication and talking therapy. Sometimes, in the case of milder depressions or those that are caught early on, either medication or counselling on their own can be helpful. However, they both take time to work, so be patient. If you were able to rewind and view your life as if it were a movie, you’d see that you most likely became depressed gradually, over a long(ish) period of time. Getting better will also be gradual. Each small step in your improvement might not be noticeable at first, but collectively the positive effects will be felt somewhere down the line.

4. There are a few things you should know about treatment though…

Medications – They don’t work for everyone, but they can have a profound effect for many. However, there is no real way to know which one will work for whom. Your doctor will prescribe one based on the symptoms you report, and the only way forward is to wait and see. Antidepressants take a minimum of 2 weeks before they even begin to work, and they must be taken every day in order to be effective. Usually, any uncomfortable side effects begin to dissipate around this time too. The usual protocol is to increase the dose of the medication to its maximum until the desired effect is achieved. If that doesn’t work, the doctor will likely switch you to another one. Medication should only ever be used under the guidance of an experienced physician.

Counselling – There are many different forms of psychological therapy. Like medication, there is no calculation to decipher which one will work for whom. However, the more you research the different types of counselling, the more likely it is that you will find one that suits your personality. Sometimes, it may come down to what is available to you in your community.

5. Your doctor (or mental health care provider) is not God.

Yes, they probably do ‘know’ a lot more about the ‘technical’ aspects of depression than you do. But they are not the expert on you. Depression is not the same for everyone, and behind the illness is a real person – YOU! Don’t be afraid to ask questions when you don’t understand, or to disagree when you don’t feel that something is working. You have a right to be an active participant in your own care, and to be fully informed of the reasons a particular treatment is being prescribed. Most professionals will want to work with you as part of the team. There are rare circumstances (usually life and death) where your right to refuse might be waived, but most times your wishes will be honoured. If you don’t feel able to assert yourself, it is often helpful to elicit the help of someone else (another professional, a friend, or a relative) to act as an advocate.

If you have a bad experience with one professional, do not let that taint your view of mental health services in general. There are good and bad doctors, nurses, and psychologists, just as there are good and bad hairdressers, mechanics, and painters. A bad haircut would not put you off from ever going to another stylist, so don’t give up on your mental health because of a bad therapist either.

6. Trust yourself, but not too much.

It is vital that you listen to your ‘inner self’ in order to understand what it is that he or she needs to feel better. But it is also important to remember that, in the midst of a depression, what that inner self says is not always one hundred percent accurate or reliable. Depression makes you perceive things differently than you normally would. It can cause you to dwell and focus too much on certain (negative) things going on your life, while blinding you to anything else. People with depression are often unable to see beyond their emotions in the present. They believe that how they feel about something in this moment is how they have always felt and will always feel. This is simply not true. Think back to that high-school crush you truly believed, at that time, that you would love forever and never get over. When depressed, you will probably believe your own negative thoughts just as vehemently. The best way to counteract this bias is to discuss these thoughts with someone else, preferably a professional.

7. Motivation is an action, not a feeling.

Without trivialising how debilitating the inertia and lethargy of depression can be, it is important to realise that one of the quickest ways to start feeling better is to get busy. The smallest of steps, the tiniest of goals, once met, can have the greatest impact on your overall well being. Make a pact with yourself to have a shower every morning, or get out of the house every day even if for only 10 minutes. Or clean up that mess in the kitchen – maybe not in entirety, but spend 20 minutes on it at least. Do one thing every date. Regardless of whether or not you feel like it or not. Here’s a secret – you don’t have to feel like doing something in order to do it anyway. You don’t need motivation in order to get active. You get active first, and motivation follows closely behind.

8. Time really is the greatest healer.

No matter how bad it is now, it will not always be that way. Frequently, even without any treatment at all, most depressions will remit within six to twelve months of onset. So, even if you do nothing at all about it, your depression will not always affect you as deeply as it does right now. That being said, depression can be a recurring illness, and the sooner it is treated, the quicker it will remit – so don’t wait too long before getting help!