Depression has many forms...

Depression can range from being mild to moderate to severe and be present in many age groups, cultures and genders. Depression can be acute, gradual, short-lived, chronic or cyclical. Co-morbid anxiety has also been found to exist in half of severely depressed clients.

Historically, depression was considered to originate in the gut. Some writers referred to it by other names such as melancholia, sadness, loss and reactive depression with others considering it was due to a serotonin deficiency in the brain. Nowadays the view is that difficult life events and lack of support can lead to some people developing depression, we call this bio-psycho-social factors. Whatever its origins, depression can affect clients in various ways. Depression can cause low mood, irritability, shame, guilt, apathy and numbness, memory, concentration difficulties, loss of interest, sleep disturbances, social withdrawal, tiredness, fidgeting, under-activity, comfort or under eating. Due to fluctuating hormone levels females can be at risk of depression during menstruation, perinatally, peri-menopausal and during the menopause.

The NICE Guidelines (2009 & 2018) recommend counselling for mildly-moderately depressed clients. Some of the counselling skills used by counsellors with clients are derived from the Person-centred, Psychodynamic and Cognitive Behavioural (CBT) approaches. Other approaches can be used also according to what training the counsellor has undertaken and is competent in delivering including monitoring and reviewing clients’ mood scales, exploring issues causing depression, completing safety plans with clients, and exploring clients’ support systems.

GP/Mental Health Services are beneficial alongside counselling for assessment, diagnosis and additional management of depression. Severe depression can be life threatening in some cases where an individual has developed suicidal thoughts, a plan and/or intent to end their life. Sometimes in severe cases individuals may require for some time intensive Home Treatment support or (where necessary) a period of inpatient admission within Adult or Children’s Mental Health Services to help stabilise their depression in order to aid their safe recovery.

Many services exist for individuals to reach out to for help and support for problems and issues for mental health which are provided by suitably trained professionals. This includes along with counsellors, GP’s/Mental Health Key Workers/A&E/Assessment-Crisis Teams/Home Treatment Teams/Voluntary Community Organisations.

There are various free 24-hour free telephone numbers in Northern Ireland which are available to everyone at risk of potential or actual self-harm or suicide or danger. These are:

Life line 0808 808 8000
The Samaritans 116 123
Childline 0800 1111
Emergency services 999

Furthermore, if you or someone you know is at risk of danger/self-harm/suicide/in need of safeguarding there are a range of services you can contact. These are:

PSNI 999
Central Gateway 0800 783 7745 (free from landlines only 9-5)
The Out of Hours Regional Emergency Social Work Service for NI (028) 9504 9999
For the ROI HSE Helpline Text HELLO to 50808

It is important people realise no matter how depressed or distressed they are feeling or if they are suicidal they are not alone, help is available as outlined above.