Chances are that in your lifetime you will be one of two people – depressed, or close to someone who is. For this reason, understanding depression is fast becoming a life skill. Here are 14 important insights.

1. Certain personalities are more prone to depression.

   Depression can happen to anybody, but those with depression are more likely to be introverted, creative or perfectionistic. Personality doesn’t cause depression but it can be a risk factor.

2. People with depression won’t necessarily look depressed.

   People with depression are often highly functioning and adept at concealing their depression from the world. It could be your doctor, dentist, teacher, best friend or the life of the party. Whether because of the stigma associated with depression, or because of their concerns about the impact on the people around them, many people with depression will be masterful at masking their illness publicly. This is further evidence that depression is not a sign of weakness. The strength and mental toughness it would take to carry on as usual would be enormous. Of course, sometimes the strongest act is asking for help.

3. Depression is a deficiency in chemistry, not character.

   Unfortunately, we live in a society where depression is still vastly misunderstood. It is a physical illness that effects mood and is no more a product of personality or character than cancer or diabetes. The only shame around depression is in the response of the ignorant.

4. The internal body clock is disrupted.

   The body has an internal body clock that uses signals in the environment to cue appetite, sleep and mood. In people with depression, this clock can be so severely disrupted, that a.m and p.m. are reversed. This means that sleep is disturbed, as morning is confused with night. When sleep is thrown off balance, so too are hunger hormones, hence the appetite and weight changes that often come with depression.

5. Depression changes the size of the brain.

   In research from Yale University, analysis of the brains of people with depression have shown an overproduction of a genetic ‘switch’. This genetic switch causes the loss of connections between the brain cells that regulate cognition and emotion, causing the brain to shrink in size. The more severe and longer-lasting the depression the greater the shrinkage. Antidepressants can help to reverse this.

6. Depression fades memory.

   Depression can really interfere with memory, particular the type of memory that deals with specific facts such as names or places. Part of the reason for this may be the tendency to over-generalise, which can compromise the ability to differentiate between similar experiences.

7. Blood test to diagnose depression.

   Up to now, the only way to diagnose depression was through self-reports or reports and observation. But that is set to change. Researchers have developed a blood test that may be used to diagnose depression and predict who will benefit from therapy. This will give way to the tailoring of more effective treatments.

8.  Mindfulness can reduce and protect against depression.

   Mindfulness can reduce and prevent depression adolescents (aged 13-20) and adults.

9. Depression ages you faster.

   Research has found that depression leads to accelerated cellular ageing and a heightened risk of ageing-related diseases such as heart disease, diabetes and cancer. People with depression have a shorter length of telomeres (a repeating DNA sequence found at the end of chromosomes). The more severe and longer-lasting the depression, shorter the telomere length the greater the ageing. Those who had previous episodes of major depression had shorter telomere length than those who had not experienced depression.

10. Exercise causes the same changes in the brain as antidepressants.

    An abundance of research has demonstrated that exercise alleviates symptoms of depression in the short-term, but also that it has a protective factor against developing depressive episodes in the future. In fact, a recent study has found that for mild to moderate depression, exercise has the same effect on the brain as antidepressants. Walking 30 minutes a day is enough to make a difference.

11. Gut bacteria play a role in depression.

    Increasingly, evidence is pointing to a powerful connection between the gut and the brain, with neurobiologists at Oxford University finding that gut microbiome play an important role in maintaining certain brain functions such as mood, emotion and appetite. Mounting evidence is suggesting a link between the gut health and psychiatric and neurological disorders such as anxiety, depression and autism. 

    Researchers at the University of Oxford have found that taking probiotics has an effect on anxiety and depression by influencing the neuroendocrine stress response and by altering the way people process emotional information.

12. Depression increases the experience of physical pain.

    Like the emotional pain isn’t enough, depression is also associated with physical pain such as headaches, backache, stomach ache, joint ache and muscle ache. Research has shown that depression and physical pain share a common chemical pathway in the brain and are influenced by the same neurotransmitters. In light of this, it has been suggested that depression and the painful physical symptoms that are associated with it should be treated together. Research has actually shown that a correlation between an improvement in physical symptoms and an improvement in other depressive symptoms. 

13. Antidepressants aren’t a magic pill.

    Depression can respond really well to treatment but the type of treatment that is most effective can differ from person to person. The best approach involves a multi-faceted approach that responds to the whole person – mental (therapy, emotional support, cognitive awareness, mindfulness); physical (exercise, diet); chemical (medication). Furthermore, antidepressants generally won’t have an immediate effect. Expectations that medication is a magic bullet can lead to disappointment and a further worsening of symptoms. Depression is treatable but can involve some trial and error of responses. Knowing this, and being patient and open to altering treatment is an important part of the way through depression.

14. Asking about depression or suicide will never make it worse – but it could save a life.

    Everyone has their ups and downs but if someone you know is acting unusual (mood, sleep and appetite changes, sadness, aggression, recklessness, more withdrawn), it might be something more. If you have any hunch at all that something isn’t right, it’s important to ask if he/she is depressed or suicidal, using direct language such as ‘suicidal/giving up on life’ rather than the lesser ‘hurting yourself’. People often avoid asking for fear it will plant the idea but it doesn’t work like this. The question might save a life. If the person is suicidal, seek immediate help from a doctor, hospital or suicide prevention helpline.

For those who have never had depression, the darkness is impossible to imagine. It can strike anybody and none of us can know when we, or someone we love, are about to walk through the middle of its very broad and undiscerning target.

Depression is a treatable illness. We are learning more about depression every day and a lot ground is being made in the search for effective treatments with minimal side effects. 

The more that can be understood about depression, the more it can be responded to with wisdom, respect, openness and compassion – it should never be responded to with anything less.

(A shortened version of this post was published on The Huffington Post UK.)

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