What is depression?
Everyone feels distressed from time to time and that is normal. Many things change in adolescent years, physically, emotionally and socially and it is common for those changes to come with fluctuations in mood and well-being. However, when mental illness is beginning to have a significant inhibitory effect on daily life, it may indicate that depression is present and it is important to intervene.
Depression is a mental disorder that affects thought, well-being and behaviour. It is characterised by, among other things, sadness, lack of happiness, lack of interest and fatigue. Depression is very common and is considered to be the fourth largest health problem in the world. Everyone can get depression and it can occur at any time in their life. Depression is a disorder that usually occurs in cycles, where symptoms are present for a limited period of time, but then a symptom-less or symptom-free period occurs. Once people have experienced depression, there is an increased likelihood that they will have another depressive episode, although it is not certain that it will happen again. It is important to seek help to learn to cope with depression.
Many factors can affect whether an individual develops depression. In some cases, this occurs as a result of an event or shock, for example during a divorce, losing a loved one, a broken heart or bullying. The way people think and their attitude towards themselves, the future and the world can also encourage depression. Other factors that can have an effect are physical condition, stress, substance abuse, other mental disorders, physical illnesses and drug side effects. However, when depression develops, it is probably due to a combination of many of these factors and it may not necessarily be possible to point to any one obvious explanation.
A common misconception about depression is that those who appear to be happy cannot be depressed. People’s behaviour can vary greatly and the manifestation of depression is different. Depression can be so inhibitory that the person cannot attend to basic needs or daily tasks such as attending work or school. Others may be active in work, school, social life, sports or other things and, therefore, do not necessarily show that they struggle with depression. Then, it is possible that those who interact with the person do not notice their symptoms. That can be very dangerous because it is less likely that those who stand next to them will not realise that a problem exists and be able to assist them in getting help.
When a person is struggling with depression, it can be difficult for them to imagine that the situation can improve, but professional treatment for depression is effective and can greatly improve your well-being.
How does depression manifest itself?
Most people experience symptoms of depression at some time and this is perfectly normal, especially in adolescence. Each symptom alone can be explained by all sorts of factors and does not have to be due to depression. For depression to be present, many symptoms need to be present almost all day, almost every day. Many people think that depression symptoms need to be present for a long period of time for a depressive episode to be present, but it is enough to have experienced the symptoms for 2 weeks. Depression can appear in very different ways, so two people can both have enough and serious symptoms to be diagnosed with depression, even if they have only one symptom in common. There is always a need for a professional to diagnose depression and symptoms may be a sign that something else is going on psychologically. The number of symptoms and how long they last indicate whether or not depression is present.
The biggest characteristics of depression are the following two symptoms, one or both of these symptoms are always present in depression:
- Sadness: being in a depressed mood most of the day, often hard to find joy. Sadness is a symptom most people associate with depression, but it is not always present. Some people do not feel a great deal of sadness and still others experience emotional flatness where there is little emotion, neither positive nor negative.
- Lack of hobbies or pleasure: to be less interested in things that were previously exciting or to receive less joy and satisfaction from things that previously gave pleasure. It can be normal to lose interest, especially in adolescence when hobbies change, but it can be a sign of depression if nothing else takes over as a hobby or if very few things interest people. What is interesting and satisfying gives us life satisfaction and if little or nothing interests/satisfies, depression can be present.
Other depressive symptoms and manifestations that can be good to monitor both in yourself and others:
- Disturbed appetite: appetite is commonly reduced and eating little or rarely can be part of a reduced activity in depression. In some people, appetite in depression increases and they then eat increasingly more foods high in calories than usual.
- Disturbed sleep: having difficulty sleeping, for example, difficulty falling asleep, waking up often in the middle of the night, waking up and having difficulty falling asleep again, waking up early or sleeping too much.
- Fatigue or lack of energy are often associated with depression and is one of the reasons why it often reduces activity.
- Restlessness or moving more slowly than usual.
- Feeling guilty or worthless: many depressed people experience a bad conscience that can be caused from all sorts of things, often related to the situation and its consequences. Then, there are also thoughts that the person is worthless.
- Difficulties with concentration: often associated with depression and it can also manifest as forgetfulness. For example, when people forget what they were going to do during the day, they put something down and do not remember where, etc.
- Hopelessness: Depression is often accompanied by a great deal of disbelief that the situation, conditions and well-being can ever improve. Then, people have a hard time believing that the future could be brighter than the current situation.
- Reduced participation in school, work and/or social life: functional impairment is common in this way, when people reduce participation in what they usually do.
- Inactivity, lack of initiative: can occur in school, work, social life or in any area of life.
- Difficulty thinking clearly or making decisions
- Sensitivity: In depression, emotional reactivity often changes, which can result in sensitivity. Crying can occur easily or people may get upset or feel bad for little reason or for reasons that would not have triggered that response before.
- Repeated thoughts of death, suicidal thoughts or suicide attempts: when people feel bad it is common for such thoughts to follow. Despite them being common, they are always something to take seriously and it is very important to tell someone when such thoughts arise. You can read more about suicidal thoughts here.
This video was released in collaboration with the World Health Organisation and it is considered by many to provide a good metaphor for depression. In the video, depression is compared to a black dog that follows you.
Resources in Iceland
Depression – Resources in Iceland
If you feel that you are experiencing depression, a good first step is to let someone that you trust know. For example, a friend, family member, school counsellor or school psychologist. Often times, a great deal of relief comes with talking, and if it doesn’t, they can even assist you in seeking help. It is never too late or too early to seek help. Examples of the treatments available for depression in Iceland are cognitive behavioural therapy (CBT), behavioural activation, acceptance and commitment therapy (ACT), communication therapy and medication therapy. Sometimes when people seek help, they may not feel comfortable with the first therapist that they go to. Then, it is no problem to try others, and many do so.
Where to reach out to?
Health care clinics: When people seek help from professionals, the first point of contact is usually the health care clinic. The first step is to make an appointment with a doctor who can refer you to the appropriate person if the problem cannot be resolved. heilsugaeslan.is
School counsellor and school psychologists: Many schools have employed school counsellors or psychologists that you can reach out to.
1717 - Red Cross help line and internet chat: If you don’t want to talk to someone you know, you can call the Red Cross help line: 1717 , or go to 1717.is and talk to them online. No problem is too big or small for the help line or online chat. raudikrossinn.is
Mental health ward emergency reception: If the situation is acute or severe, do not hesitate to reach out to the mental health ward emergency reception at Landspíitali, where people with urgent mental health issues can go without having an appointment. The psychiatric ward emergency reception is located on the 1st floor of the psychiatric building at Hringbraut. The emergency reception is open from 12:00 to 19:00 on weekdays and from 13:00 to 17:00 at weekends and the telephone number is 543 4050. In case of an emergency outside these hours, you can reach out to the emergency department at Landspíitali Fossvogur. landspitali.is
National emergency number: 112
Psychologists' private offices: On the psychologist's website, you can search for psychologists who attend to a variety of problems, such as depression. sal.is
Psychiatrists' private offices: A number of psychiatrists conduct medical and conversational therapy for depression in their private clinics.
A more detailed list of resources in Iceland can be found here.