Treating Depression

Depression is not sadness. Sadness has a shape and a reason, and it lifts. Depression is the thing that arrives without an invitation, takes the colour out of everything, and then tells you convincingly that this is simply what life is now.

That last part is the cruellest feature of the illness: the symptom that tells you not to seek treatment for the illness. If you're reading this from inside it, hold on to one fact — depression is treatable, and the hopelessness is a symptom, not an assessment.

What depression actually looks like

It's more than low mood, and it often doesn't look like crying. Depression is a whole-body condition, and it shows up in ways people don't expect.

• Persistent low mood, or a flat numbness where feeling used to be
• Loss of interest or pleasure in things you used to enjoy
• Fatigue and heaviness that sleep doesn't touch
• Changes in appetite or weight, in either direction
• Sleep disturbance — often waking in the very early hours, unable to get back
• Difficulty concentrating, remembering, or making even small decisions
• Irritability, which is frequently how depression presents in men and in teenagers
• Feelings of worthlessness, or guilt that's out of proportion
• Thoughts of death, or of not wanting to be here

That last symptom needs a plain sentence rather than a careful one. If you are having thoughts of suicide, please call Lifeline on 13 11 14, or 000 in an emergency. You don't have to be in crisis to deserve help — but if you are, help exists right now.

You also don't need every symptom on that list, or a certain number of weeks, before your experience counts. "I don't feel like myself and I haven't for a while" is enough to bring to an appointment.

How common is it, really

Common enough that the person you'd least expect has probably been through it.

Depression is among the leading causes of disability worldwide, and a substantial proportion of Australians will experience it at some point in their lives. It affects people across every age, income and postcode — including people whose lives look, from outside, like there's nothing to be depressed about.

That's worth saying because so many people delay getting help on the grounds that others have it worse. Depression is not a competition, and it does not require a qualifying tragedy.

What treatment involves

There's no single correct treatment. What works is usually a combination, matched to how severe things are and to what fits your life.

Talking therapy is the foundation for most people. Cognitive Behavioural Therapy works on the thought patterns and behaviours that keep depression circling. Acceptance and Commitment Therapy focuses less on arguing with thoughts and more on building a life that matters to you alongside them. Where trauma sits underneath the depression, trauma-focused therapy may be part of the picture.

Medication — antidepressants — has a genuine role, particularly in moderate to severe depression, or where therapy alone hasn't been enough. It is not a personal failure to need it, and it isn't a life sentence either. Medication should always come with proper review, a conversation about side effects, and a plan. That's exactly what our medication support appointments are for, including safe, planned withdrawal when the time comes.

The lifestyle piece is real, and it is not a substitute for treatment. Movement has good evidence behind it. So does protecting sleep, which both suffers from depression and worsens it. So does staying connected to people, even when every instinct says to withdraw — especially then.

And the people around you matter enormously. Family, friends, a group, a clinician: the isolation depression manufactures is part of what keeps it going.

Getting help without the runaround

The most common reason people delay is not stigma any more. It's logistics — the sense that getting help involves a GP appointment to get a plan, to get a referral, to join a waitlist.

There's a shorter path. As a Mental Health Nurse Practitioner, Lindsay can assess, diagnose, provide therapy, and prescribe and review medication — in one place, with one person who knows your history. You don't need a GP referral or a Mental Health Care Plan, and Medicare rebates still apply. We've set out how the funding works in Medicare rebates for mental health.

Most Victorians reach mental health care through primary care rather than specialist services, which is how the state's system is designed — the Department of Health explains that structure in its overview of Victoria's mental health services. We're one of those first doors, and a direct one.

If you're supporting someone with depression

You cannot cheer someone out of depression, and trying is exhausting for you both.

What helps is steadiness. Keep inviting them, even when they keep saying no. Do concrete things rather than offering to do anything. Don't take the withdrawal personally — it's the illness, not a verdict on you. And ask directly about suicide if you're worried; asking does not plant the idea, and it may be the first opening they've had.

Look after yourself too. Supporting someone through depression can be hard at times, and you're allowed to get support of your own.

Where to start

Treatment works. Not always quickly, and not always at the first attempt — but the great majority of people with depression improve with the right support.

We see teens and adults for depression at our Gisborne and Woodend clinics, a short drive from Sunbury, or by Telehealth. Have a look at our counselling services, our fees and rebates, or refer yourself — no GP plan required.

Get in touch when you're ready.