DEPRESSION AND ANXIETY
 
Many South Africans of all races, areas, sex, and cultures can suffer from depression and anxiety, so if you are one of those people you are not alone and there is help for you.
Did you know that most people who are depressed don’t get treatment? 1 in 10 people will have depression in their life, but most people do not get the help they need even though treatment can help take the depression away.
People often don’t seek help because: • Depression is often not seen as a real illness • Many people blame themselves and think they are weak • People are scared and too embarrassed to ask for help • And finally, depression is often not spotted or seen as another illness.
 
What is Depression?
Depression is an illness, that involves your body, your mood and your thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things and the world. Depression is not the same as ordinary, everyday blues or sadness that we all feel sometimes, it is not a sign of weakness, and it cannot be wished away. People with depression cannot just “pull themselves together” and get better. Without treatment symptoms can last for weeks, months, or years.
 
Types of Depression
A person with major depression feels very sad and down most of the time and this affects their work, and sleeping, how much or little they eat, and how little they now enjoy things they used to enjoy like soccer, TV, music, church and community events. (See Symptom list) When their down mood is swopped with very high or overly excited or manic feelings and behaviour, this is called bipolar disorder (which used to be called manic-depression). Sometimes the mood changes happen fast, but most often they happen slowly over a few days or weeks.
Symptoms
Not everyone who is depressed or manic will have every symptom. Some people only have a few symptoms, others will have many.
Depression signs: • Sadness most of the time. Feeling anxious, or "empty" mood • Feelings of hopelessness, about life • Feelings of guilt, or feeling helpless. • Loss of interest or pleasure in hobbies and activities that were once enjoyed, • Early-morning awakening, or oversleeping • Losing weight by not eating or gaining weight by over eating. • Less energy than usual, tired all the time, being "slowed down" • Thoughts of death or suicide; suicide attempts • Restlessness, irritability, or anger. • Difficulty concentrating, remembering things or making decisions • Physical symptoms that don’t respond to treatment, such as headaches, stomach pain, back pain, chest pain even if you have had it checked by a doctor.
Bipolar Symptoms: • Excited or fast thinking and talking. • Irritable, angry and cross mood. • Thinking very fast and talking so fast others cannot understand you. • Little need for sleep. • Feelings of power, greatness, or more importance than other people you know. • Reckless behaviour with no thought of what will happen. • Extreme anger. • Abuse of alcohol or drugs. • Extreme cases of hearing or seeing things that isn’t there. • Delusions, believing things that aren’t true, may happen.
Causes of Depression
Depression has many possible causes and is often brought on by a mixture of different factors. Sometimes a specific event may lead to depression; other times depression comes on for no apparent reason that you can see, even for people whose lives are going well.
 
Some possible reasons include: External events: the break-up of a relationship, a traumatic event, financial worries, loneliness, legal problems, retirement, and grief can all result in depression. Family History: Having close family who have had depression sometimes means you are more likely to have depression as well. Depression is also believed to be caused by an imbalance of brain chemicals. Medical illness, including strokes, HIV and AIDS, TB and other health problems, can also cause depression, as can some medications, like treatment for high blood pressure, birth control pills, and steroids. Many people with HIV also have depression but depression is a separate illness and you do not have to suffer from depression as well as HIV and AIDS. People with HIV and AIDS can still get treatment for depression.
 
Treatments Depression is one of the most treatable mental illnesses and 8 out of 10 people get totally better. You will need to have a complete medical check up to make sure there are no other medical causes for how you are feeling.
Anti-depressants
Eight out ten of people with depression will make a good recovery on anti-depressants. If one medicine doesn’t work for you, try another one. Anti-depressants don't work quickly - for most people, it takes 2-3 weeks to start feeling better. It is very important not to stop taking the pills and to give them a full chance of working. They may cause mild side effects like a dry mouth, sickness, headache, or dizziness but these usually pass in a week or two. Never mix medications of any kind – prescription ones from the hospital, or pharmacy with, over-the-counter, or with borrowed – never you must consult your doctor first. Always tell your doctor if you are pregnant or have any other illness. Call your doctor if you have a question about any medicine or if you have a problem or go to the clinic.
Psychotherapy or talk therapy
Psychotherapy (or talk therapy) with a psychologist, social worker, or counsellor gives people the skills to cope with their illness and the stress it causes.
 
Support Groups
Support Groups are a very good way to get support and advice from people who know how you feel because they have felt the same way themselves. Support groups are run by patients for other patients as a safe place where you can share experiences and help. (Call SADAG 0800 20 51 21 for contacts in your area)
 
Self help
Self help can help you cope better and last for a long time. Here are some things you can do: • Understand what depression is – the more you know, the better you will cope. • Do things to keep yourself busy your mind - it can be of great help if the mind can be occupied by an interest or hobby, or by reading a book or watching a TV programme or film. • Avoid substances like smoking, drugs and alcohol. • Break large tasks into small ones, and do what you can as you feel able to do something small every day. • Try to be with other people and to talk about how you feel; it is usually better than being alone and secretive. • Don’t hide away and stay alone, see people, do things that may make you feel better like going to a movie, a sports match, or having tea with a friend.  
 
Remember: depression is not part of you, it is caused by symptoms. These symptoms cause you to feel, think and act differently to normal. Once depression goes, things will be different. • Let your family and friends help you. Don't be afraid to ask for help if you need it. Expect your mood to improve slowly feeling better takes time.
 
Anxiety
We all know what it feels like to be nervous and anxious – the butterfly feeling in the stomach before a date, the tension when your boss is angry, and the way your heart beats fast and hard when you get a fright or are in danger. Anxiety can help us cope but for people with an anxiety illness, this emotion can be damaging if it is there all the time.
 
Panic disorder
Panic attacks involve short times of terrifying fear, along with many physical symptoms your heart may pound, you may feel dizzy, feel sick, feel out of breath, and feel scared, fingers or legs tingle, pain in your chest. These can happen often and unexpectedly when there is no reason for the fear and panic. Most people with panic disorder feel scared about having another panic attack and avoid places in which they believe these attacks are likely to occur again.
Treatment can help most people who have this illness. It is very important for the person who has panic disorder to get information about the problem, and the type of treatments that are able to help them. Who suffers from panic disorder? The disorder typically begins in young adulthood, but older people and children can be affected. Women are ill with it twice as often as men. The disorder can also be passed down if another family member had it. Symptoms In the beginning the first panic attack seems to come from no where while a person is doing some every day activity like being in a taxi, sitting at work, or shopping. Suddenly, the person feels very frightened and terrified this usually lasts only a few minutes, but may feel longer. The symptoms do disappear over an hour or so. People who have had a panic attack feel like they have been hit by some terrible, illness or are "going crazy". Often people who are having a panic attack go to a hospital for help in case it is a heart attack. The first panic attacks may occur when people are under a lot of stress, from a lot of work or exams, for example, or from the death of a family member or close friend. The attacks may also follow surgery, a serious accident, illness or childbirth. Too much caffeine, the use of drugs or some medicines can also cause panic attacks.
Panic attack symptoms: • Sense of being very scared by fright or terror • Racing or very fast noisy heartbeat • Chest pains • Dizziness, light-headedness • Sickness • Difficulty breathing • Tingling or no feeling in the hands • Hot Flushes or shaking cold. • Sense of not being right. • Fear of losing control, going "crazy", or doing something embarrassing • Fear of dying Coping with Panic 
 
Remember that although your feelings and symptoms are very frightening, they are not dangerous or harmful. • Understand that what you are feeling is only a very strong feeling of your body’s normal behaviour to stress. • Don’t fight your feelings or try to wish them away. The more you are willing to deal with them, the less frightening they will become. • Remain concentrating on the present, where you are and who is with you and that you are fine. Don’t worry about what may happen to you. Get help and read about your illness. • Focus on and carry out a simple and easy things, talk to a friend on the phone, go to the shops, talk to a neighbour, friend or colleague,  concentrate on counting backwards from 100 in 2's or snapping a rubber band on your wrist to bring you back to the present.

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