Depression: Signs, Symptoms, and Support


(upbeat music) – Thanks everybody for coming today. My name is Sue Forber, I
work for Depression Alliance which is a national charity for people affected by depression. And as Andy said, I used to work for Dorset Mental Health Forum, who I’ll be mentioning later in my talk. I should have been doing
this talk with a colleague from the Mental Health Forum, Jane Carey, unfortunately Jane couldn’t be here today, she’s had a family bereavement, so she sends her apologies. I really want to congratulate
the uni on holding this fantastic week of events. I think it’s really encouraging. If I was being a student again
it would certainly make me want to come to this
uni, I know that much. If you would like a copy of the slides, I’m very happy to email them
to anyone that wants them. I’ve put my card on the table over there which has got my email address on there. So just drop me a line
if you’d like the slides and I’ll send them across to you. So, depression is obviously
an emotive subject, and I won’t be the only
person in this room who’s experienced depression. If something that I touch
on just makes you feel a bit wobbly or vulnerable,
please feel free to do whatever you need to do to feel better whether that’s leaving the room, just, standing at the back for a while, it’s absolutely fine. We’ll be touching on suicide, and again, I won’t be the only person in the room who’s been affected by suicide, so, please just feel free
to look after yourself. And I will hang around at the end if anyone wants to talk to me one to one. So, I don’t have a clicker so I have to keep doing this. So if any of you can identify with this, I think one of the things
about depression is, often it’s hidden, you
can’t necessarily tell if somebody has depression. And I know I’ve experienced
depression on and off throughout my adult life,
and I’m very good at, that’s mine, just see the
smiley face at the top, and that was me, I was very good at hiding and wearing a mask. And wearing a mask is, we do that for all sorts of reasons,
partly ’cause of the stigma of mental health issues
that still persist. But also I think sometimes
we do it to keep our own negative emotions away from ourselves. It’s a way of trying to keep them at bay, but you can’t do that
for too long, you know they will always catch
up with you in the end. I’ve learned really through
the years that actually, we all have times when things in our lives make us feel very, very sad, very upset and we need to feel that,
and it is OK to feel that, and the feelings do go away. So learning to just feel how we feel has been really important for me. So masks, yeah, we do wear them but, I know for me it was
a huge sense of relief when I just gave up wearing
that mask and just thought no I am gonna be myself and I’m gonna be sad at some times but that’s OK. So some facts and figures
about depression first, it’s very common, the most common mental health condition is
mixed anxiety and depression they often go together. About one in five of us will
be affected by depression. I did a quick count of
the room and I think there’s about 30 of us here, so that’s six of us in our lifetime
we will know what it’s like to feel depression. Now women are twice as likely as men to be diagnosed with depression. But that doesn’t mean to say that women suffer twice as much depression, I think it’s much harder
for men to ask for help. Men always are socialised to be strong, not to show vulnerabilities. And it’s much harder, I
think for men to be open. And sadly the way that depression in men can manifest itself is, if
you look at the suicide rates, three quarters of suicides are men. Which is something that we should all be trying to do something about. In 2012 had nearly 6000
suicides in the UK, and 77% of them were men. And indeed suicide is
the single biggest killer of men under 35 in the UK, so it’s quite a startling
figure, and actually if you bring it down
to a younger age group, if you look at 20 to 24 year olds, there were five male suicides for every female suicide in 2012, so it becomes a real issue for young men and I’ll be just mentioning
that again in a little while. However, the important,
positive news is that 80% of us will make a full
recovery from depression within four to six months, and that is whether or not you get any treatment. So it tends to be quite a
self-limiting condition. And obviously there are
all sorts of different treatments and support and help available which I’ll be talking
about, but even if you don’t go anywhere near a mental health service, or your GP and you just kind
of battle on through it, chances are you will make a full recovery. So that’s really important to note. However I don’t want you to
think that means you shouldn’t bother to ask for help
because why suffer needlessly, you know there are lots of
ways to treat depression which mean that you can make
it a much shorter episode than it would otherwise be. So 80% of people will
make a full recovery, but that leaves 20%, those 20% are likely to still
be depressed two years later which is an awful long time
to be really struggling. There are all sorts of
different kinds of help, support, treatment, these days. It used to be, and I think
in some areas of the country is still the case that you’ll get offered antidepressants very, very
quickly if you go see a GP. I have taken antidepressants on and off through my life, and I
would never say to anyone don’t try them, I found it
very difficult to manage the side effects, and
that’s true of a lot of psychiatric drugs that
sometimes the side effects are worse than the actual symptoms. And I had to try three different
kinds of antidepressant ’til I found one that
really worked for me. But these days when you
go to your GP and you are diagnosed with depression,
the first line of treatment is supposed to be a talking therapy. So rather than give you drugs,
they’re supposed to start by offering you a talking treatment. So it might be counseling, or, more likely it might be
cognitive behaviour therapy, which has got a really
strong evidence base. So that’s what would happen. But outside of the NHS,
there’s all sorts of other ways that you can treat and
alleviate depression. And one of the best things
for me has actually been peer support, has actually
been the support of other people who know what it’s like to go through depression, and who can help and encourage you, remind you that this isn’t gonna last forever. You will get better, and
just give you that support. Without you having to
tell you your whole story over and over again because they know what it feels like, and
I’ll be coming back to peer support a bit later. I talked about medication. Exercise is really important as well as, for mild to moderate depression. Moderate exercise is as effective
as taking antidepressants. It doesn’t mean you have to
sign up and run a marathon, it can just be walking, it
can be doing some gardening, it can be playing out in
the fields with your kids, it can be a whole roster
of things, but it’s as important to think
about your physical health and how that can help your mental health. And then ecotherapy, that’s
a bit of a jargon word really but it’s about
kind of using the outdoors as therapy, so it can be
gardening, it can be hiking, it could be anything that
takes you out into nature and that again has got
a growing evidence base that that does really work for depression. Obviously we’re here at
the uni, so I wanted to focus in on students and depression. And, you know, NUS did
some research last year and an incredible 92% of that survey respondents had experienced mental distress. Only 20% considered that they
had a mental health problem, so there’s quite a nice
distinction there between saying, yes I’ve experienced mental distress, but it doesn’t necessarily
mean I see mysef as having some sort of
ongoing mental health problem. 13% had suicidal thoughts,
and as you would expect the main causes of distress among students are coursework, exams, which, obviously can be a very anxious time,
and financial difficulties. I was lucky enough to
go to uni when we had such things as grants. (laughing) And I didn’t have to pay
tuition fees and so on. And I really admire you
guys here who are students for having to get yourselves into debt to pursue higher education. I think times have really changed. Sadly over 25% of those students haven’t told anyone about
their mental distress. And if there’s one thing
I’d like you to take away from today really, it is that
please talk to each other, it’s OK to talk about mental health. You don’t have to be an expert. You can make a difference
just by asking someone how they are, it’s really
not rocket science. Continuing on the student theme, in spring 2007 and 2011, the number of students who took their own lives actually rose by 50%, quite a startling number. And that was even though
the whole student body had only risen by 14%, so
clearly the last few years has been a real challenge
for some students. And it’s another good
reason why universities like Bournemouth are trying to
really take care of students. And then the Priory
Group which is a private mental health provider did some research at the start of this year with
students, and they found that 43% of first year students
just didn’t feel comfortable talking to another student
about mental health it just wasn’t something that
they felt would be acceptable. And in the third year
almost three quarters of the students had been
diagnosed with depression that they talked to,
so, it is a huge issue and it’s really important that both students and staff and universities as a
whole take it seriously just like Bournemouth is doing. So what are the signs and
symptoms of depression? So this is the way that a doctor will diagnose depression. We use the word depression very loosely, we say oh I’m really depressed because my parcel from Amazon didn’t turn up. What am I gonna do? That isn’t depression. But we use that term very loosely. But the way that a doctor will
diagnose clinical depression, is that you need to have five
or more of these symptoms and they have to have
lasted at least two weeks. The first one is that you
are feeling low or sad for most of the day, and for most days. And that you’ve lost interest
and pleasure in things. And I know that when I get
episodes of depression, I really notice that
things that I love doing, I just have no interest in doing anymore, and I feel very, very unmotivated
really to do anything. Decreased energy or increased fatigue. And that can go along
with having sleep problems which I’ll come to in a minute. Loss of confidence or self esteem. When I’m very low I feel
that I have to withdraw from other people ’cause
otherwise I will be inflicting myself on them, I feel like
I’m really bad company, and I must just keep away
from everyone because I’m just not a good person to be around. So I withdraw myself. And that can become a vicious circle. Feeling guilty about
things that I have done or I haven’t done, and just
feeling not good about myself, feeling like I’m not a good person. And recurrent suicidal thoughts or acts. Sometimes you’ll hear people saying, oh people that talk about
suicide they don’t do it. That is not true, and a lot of people who talk about suicide and express suicidal
thoughts will go on to attempt or indeed complete suicide. So please do take it
seriously if anyone tells you that they’re feeling suicidal,
we have a fantastic service in this country, the Samaritans, and I know Andy’s very involved with the Samaritans at here in
Bournemouth aren’t you? There’s the phone line,
there’s obviously your GP, there’s the university
health centre here, but, please take suicidal talk seriously if you come across it. Other signs and symptoms
are poor concentration or slowed thinking, and
I know that when I first became very depressed
I really just thought I was completely going
mad because I couldn’t string a sentence together and I couldn’t get my thoughts into order. But that is a symptom of depression. Either agitation or slowing
of movement or speech. So some people do become very restless, they can’t settle, they’re
moving around a lot. Other people will just slow
right down, and I know, again, for myself I will be
very slow, I’ll walk very slowly talk very slowly. Disturbed sleep and disturbed appetite, they can go either way. Some people will sleep as
much as they possibly can, but when they wake up they’ll
still feel totally exhausted, other people won’t be able
to sleep and they’ll be lying awake in the middle
of the night churning thoughts over and over in their head. And the thing with appetite,
some people will comfort eat, some people will have no
appetite and they’ll start to lose weight. So you can see that quite a
lot of symptoms of depression are also symptoms of physical conditions. And sometimes it will
really surprise someone to be told, actually you’ve got depression because the symptoms can be so physical. And the last one there
is very very rare, but, there is a condition
called psychotic depression where people will lose
contact with reality, they’ll have delusions or hallucinations. But I have to say that is extremely rare. So that’s all the signs and symptoms. But it is really important
to come back to the fact that it’s normal to recover, and I don’t think we hear that enough,
you know, I don’t think we tell other people that enough. You will recover, there is hope. So just hang on to that thought as well, and then if you can
ever, ever help a friend who’s feeling depressed,
you can just remember to say to them, that you will recover, and I know you’re gonna
recover, I really believe it, because they may not feel that themselves. Now at this point of the
talk if Jane was here she was gonna tell you
about her own experience. Because she’s not here today I thought I’d tell you a little bit
about what happened to me, and what’s come out of it. I am, as I mentioned
earlier, I went to uni, I went to Southampton
University in the ’80s. I was a very academic person. I did a master’s degree,
and then I launched myself into a career, and through my student days I did have episodes of feeling very low. I did have glandular
fever which didn’t help ’cause that kind of took a chunk out of my first degree, and I missed
quite a lot of work. But I just kind of muddled on through it, and came out and did my master’s, went into work. But I was one of those people that really thought that it was
important to have a kind of career ladder and work
your way up the ladder, and that’s what I did. And it was difficult because I had these periods where I felt very negative
about myself more than anything, but I carried on ’cause I
thought that that’s what you needed to do, until I couldn’t. And I did wear the mask
and the smiley face and do all the, be really
efficient at everything, and very perfectionist
which I’m working on, I’m trying to not be a
perfectionist anymore. But what happened to me that
stopped it all was that I had the worst episode when
I’d just got married, I’d just moved to a new job, a promotion, and we’d moved house. And so on paper you
would say what on Earth has this woman got to be depressed about? She’s got this fantastic
job, she’s got a marriage, she lives in this lovely country cottage. And I stood in the kitchen
of that country cottage saying to my new husband, I want to die, I just want to die. I left him, I left him after
seven months of marriage because I felt I was ruining his life, and I thought he should have
a normal person in his life, so I said, no no, we need to separate, I left Alfie Kohen, I
was off sick for a year, I was working in local
government at the time in a social services department,
and I tried to go back to work at the end of that year because I needed the money, my
sick pay ran out basically, but within two weeks I was off sick again. My doctor and my mental
health worker had said to me, you’re not well enough to go back, but I was determined to try, but it didn’t work. And so during that year, that 18 months, I lost my home, my marriage and my career. And it was tough, I
spent most of that year under the duvet, I rarely went out, I didn’t answer the
door to people, I rarely answered the phone to people. And I look back now and I just think how hideous it must
have been for my husband and my family and my friends. But that is what it’s like. Gradually, gradually,
gradually I started to feel better, I was getting
help, I was on medication, I was getting counseling,
and I had friends, I was living with a friend who
had had depression herself, so she knew what it was like. And I gradually came back
into the light of day. The hardest bit was
the loss of confidence. Although I felt better in
myself, I just felt like well I’m a write-off. My job had been, my contract had been terminated on the grounds of incapacity. And just that phrase just
made me feel like I was this officially incapable person. So the idea of trying
to get back into work was really, really daunting. I was very, very lucky
that my husband had stayed in the background being my friend, supporting me through this,
and we got back together which was the best thing that happened. And we had a little boy
who was 15 on Monday, which I can’t believe,
I can’t believe he’s 15. Although all of that side of
my life really turned around, I was still just terrified of the idea of trying to work again. And one of the things
I get very cross about with the current government
is this obsession that everyone needs to get back to work. There is evidence to show
that work can be good for our mental health, but, it has to be the right job, the right
employer, and the right support. And sadly, often work
is the cause of people’s mental health problems. So it’s not straightforward to just say everyone needs to get back to work. I wanted to get back
to work because I was, had had a successful
career, but I just thought I’ll never get back there. And one day in our local
paper I saw an advert for a job, once a fortnight on a Saturday. Working in a cafe in a
mental health clubhouse which is a kind of
peer-led, user-led model of a kind of social club for people with mental health problems. And in the advert it said,
“Personal experience of “mental health problems will
be considered an asset.” And I read this and I thought, well you don’t see that
in many job adverts! And once every fortnight on a Saturday, my husband can look after my son, yeah I’m gonna go for it. Just dip my toe back in the water. And I was lucky enough to get that job. And that job led to another job within Dorset Mental Health
Forum, I ended up as a senior manager at Dorset
Mental Health Forum, and now at the Depression Alliance, working on a national project which I’ll tell you about in a minute. And so my life has really
turned around, and, I’m very, very grateful
for what happened to me. Depression has made me a better person, I think I’m a lot kinder,
more compassionate, more thoughtful about other people, I’m not on that kind of, I must do well, I must achieve treadmill. I realised that I was trying
to make my dad proud of me by having that career ladder
thing, but my dad was dead, so he was never gonna say
to me “Well done Sue.” But unconsciously, that’s
what I was trying to do, I was trying to make him proud of me. So I was forced to stop
and change, but it was the best thing that could
have happened to me. And now I’m lucky enough
to be doing this job, And I love my job, I
just feel so fortunate. And it’s shown me that
there is always hope. When I was at my lowest
I wouldn’t have believed, if someone had said to
me, in 15 years time, you’ll be talking at Bournemouth Uni about depression and
about hope and recovery, and here I am, so if you
know anyone that’s in despair through depression, just
say to them, there is hope, and I will hope for you even
if you can’t hope for yourself. And support then for depression, as I mentioned I
work with Depression Alliance. The leading charity in this country for people affected by depression. There’s other mental
health charities as well, I should mention, so obviously Mind is the largest mental health charity, and they’ve got a really good
website, lots of really good downloadable publications and so on. So give them a mention. Friends in Need I’m gonna
talk about in a minute, but that’s the project that I work on with Depression Alliance,
and I am hoping to get some of you interested
in that in a second. Samaritans, I’ve mentioned,
really important. They are a lifesaver. And it is important to say,
I mentioned in the context of suicide, you don’t have to be
feeling suicidal to ring them. You really don’t, and
that’s a bit of a myth. They’re just a listening
ear, whatever’s going on in your life. CALM, the Campaign
Against Living Miserably. That’s a charitable organisation which is aimed at men. And they’re really worth looking up. They have a fantastic website, and, by the way I have got a
resources thing that I can email you as well with all
of the URLs and everything for all these organisations
if you want it. But they run a thing called the CALM Zone which is from five ’til midnight every day and it’s a phone line, so again, they started off being aimed at young men, but they kind of broadened
to act with any age. But they’re a really good organisation. Student Minds is a national
peer-led organisation. They’re worth having a
look on their website. And then there’s Students
Against Depression, which is a bit smaller,
but they do have a presence on some uni campuses. But they’ve got some really
good advice for students who are struggling. And Time to Change, got your
fantastic balance there. I’m lucky enough to
have been involved with Time to Change since the start which is eight years ago now, and
I’m really really pleased that the student’s union
here is going to be signing the Time to Change Pledge tomorrow. I would have loved to be here
for that, and unfortunately, I was invited, but unfortunately
I can’t be here tomorrow. But it is really important
to challenge stigma and discrimination, and
you don’t have to be wielding a placard to do
that, it’s as simple as just talking about mental health,
talking about emotion as a starting point. And I have got some
little cards on the table from Time to Change. Friends in Need, so this is
the project that I work on for Depression Alliance. And it’s a peer-support community. We have a website but it’s
not all about being online, you can chat to people online
at any time of day or night, it’s a fully moderated
site so it’s a safe space. You can be completely
anonymous, you can create a username and an avatar,
or you can just be yourself. It’s entirely up to you. But you can talk to other
people who know what it’s like to be struggling with depression. But it doesn’t end there. What we’re trying to do
with Friends in Need is encourage people to set
up groups and meet ups to just do social stuff,
so, have a coffee together, go see a film, go to a gig. But just with a group of friends who know what it’s like to feel
depressed, so you don’t have to explain why you might be a bit quiet or why you might wanna
leave halfway through because you’ve just
had enough because your energy levels are really low. And I’d love if any of you here today wanted to get a group
going here on the campus. And I would help you to do that. I live in Norfolk, and I
work from home in Dorset, so no trouble to me to
come and work with you to get a Friends in Need
group off the ground. Over on the table I’ve got
flyers, and I’ve got wristbands, like this please do take them, and
if any of you would like to think about doing something on campus, if you see me at the
end or drop me an email, I’ll be really delighted. Again, if Jane was here
she would talk about Dorset Mental Health Forum which is very close to my heart because they were so much a part of my recovery. But they are a Dorset-wide
charity run by and for people with mental health problems. And they’ve got a display
stand in the reception area today here on campus, so
worth going to see them if you can. But they run all sorts
of different activities, different ways of supporting people, and they’re part of the
Recovery Education centre which is like a virtual college. Anyone can go on their courses,
they’re free of charge, but they’re all about
mental health, well being, how to look after yourself,
well being tool kits. Fantastic stuff they do. So they’re really worth knowing about. And Andy, did you want
to say anything about the support that’s available on campus for the student wellbeing. – Yes, yes I can indeed. I just really hope we,
say by Friends in Need, by all means, if you’re a student here, by all means link through
me and I’ll link to Sue we’ll talk about setting up a network. I’m on the Bournemouth University’s Student Health and Wellbeing Board. We are very, very passionate about supporting student’s mental
health and wellbeing. So in addition to counseling services, and chaplaincy services,
and any other outreach being held in this building,
chaplaincy’s upstairs along there. We also have services
where we direct you to local organisations
like Steps 2 Wellbeing, self encouragement, and we can also have other ways in which we
can ensure you have the proper links through to mental health. So if you got any
questions, just link through to the Health and Wellbeing centre here, and I hope you all email me I will direct you to
where you can get help. – Thanks Andy. So, to recap then, we’ve looked at the signs and symptoms of
depression, the fact that sometimes it can be a
surprise to be diagnosed with depression ’cause
the symptoms can be quite physical. We’ve looked at some of the statistics, and the real importance of being aware of suicide risk and taking care of people if we’re worried about them. We’ve talked about the
different forms of treatment and support that are available, and then we’ve looked at peer-support and the, the offer to try and get
something going here on campus for people to get together, although, we have Depression Alliance,
we don’t turn people away if they’ve got anxiety or OCD or a diagnosis of
schizophrenia, we don’t mind, as long as they kind of
identify with the fact that they feel depressed from time to time. So we’re very happy for
people to join Friends in Need whether they’ve been personally
affected by depression or whether it’s somebody in
their family or a friend, but it’s just really to
break down the loneliness and the isolation that often goes with mental health problems. And particularly depression,
I think ’cause you just do withdraw yourself and shut
yourself away very easily. So I’m gonna finish
out, I’m really happy to have been invited to talk to you. If anyone has any questions I’m happy to take questions now or talk
to you one to one at the end, but thank you very much for having me! (applause)

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