You need professional help immediately if you are thinking actively about suicide. You also need professional help if you have more than three of the following symptoms:
- depressed mood
- guilt feelings
- loss of interest and pleasure
- tension, nervousness
- physical symptoms of anxiety
- low energy level
If the depression has not let up after two or more weeks, if you are losing weight, if you are having difficulty sleeping -particularly if you wake early in the morning in an agitated state and can’t get back to sleep – you will not get better without help. If the depressive symptoms are this severe, you will need antidepressant medication. You will have difficulty focusing on psychotherapy unless you feel better. Therapy is hard work.
Recently, early and adequate treatment with anti¬depressants has been recommended to eliminate the above symptoms of depression in most cases. This minimizes the number of recurrences, and the illness is less likely to become chronic. Psychotherapy alone is usually not enough.
Or you may have the opposite symptoms – you may sleep and eat excessively, may be unable to keep up with your work or home schedules, and may have little interest in pleasures you used to enjoy. Again, you need help. If you are experiencing intense anxiety, guilt you can’t shake, or you are isolating yourself from friends and colleagues, consult a doctor or a counsellor. Talking to a therapist alone is not the solution here. You will need to start taking an antidepressant before you are able to use therapeutic help. Don’t be embar¬rassed to tell family and friends that you are going through a rough period and need extra support.
Sometimes, depression can become so severe that you feel flat, numb, and cut off from any feelings. The world seems black and awful, you feel miserable and are afraid you are going crazy. You may see suicide as a possible solution. You may develop psychotic symptoms such as delusions, fixed ideas with no basis in reality – you may be convinced that you have a terminal illness, or that you have committed a terrible sin. You may experience hallucinations, hearing voices condemning you. You may feel deeply agitated and unable to keep still.
This is a very serious condition and you need help immedi¬ately. Let someone you can depend on know how bad you feel, and ask for help. You can go to the local A & E depart¬ment, where there is a psychiatrist on call. Sometimes local hospitals have a crisis unit with staff specially trained to evaluate the severity of a condition like yours. You will certainly need to be started on medication and seen regularly. Voluntary admission to hospital may be suggested.
Knowledge can help you get the support you need. There are lots of resources available, but tapping into help that works for you is important. Sometimes, when you’re depressed, you feel hopeless, as if nothing will change. This is not true. Time and care will make you feel better. To get the right care, you can use the same strategies you would use if you needed a good financial advisor or a good music teacher. Assess credentials, find out what to look for by reading or through the Internet, choose someone you like and ‘click’ with, and continue to do your homework, getting counselling, taking medication, using self-help strategies -whatever is right for you.