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You may use drugs to help you to deal with the symptoms of your illness, or you may use them because they make you feel good for a while. However, using drugs can have a long term negative effect on you. The possible long term effects include:
•Needing to take more to get the same effect
•Feeling like you have to take the drug (‘dependence’)
•Withdrawal symptoms – including feeling sick and feeling cold, sweaty or shaky
•Having sudden mood changes
•Having a negative outlook on life
•Loss of motivation
•Doing less well at work, school, college or university
•Problems with relationships
•Borrowing or stealing money from friends and family
•Being secretive.

Generally speaking, using drugs can mean it takes longer for your mental health to get better. Drugs can make you more unwell and can make you more likely to try and harm yourself or take your own life.

Using drugs could give you a mental illness that you didn’t have before. For example, recent research has shown that cannabis can increase your chances of developing schizophrenia.

•Drugs can make the symptoms of mental illness worse. Also, some scientists think that certain drugs can make it more likely for you to develop a mental illness. For example, recent research has shown that using cannabis may be linked to developing schizophrenia.
•If you have a mental illness and use drugs, doctors sometimes call this ‘dual diagnosis’.
•There are many reasons why you might use drugs. Some people use them to try and deal with the symptoms of their illness. This is called ‘self-medication’. Other people take them at social events or to feel calm.
•Drugs can make your mental illness worse in the long term. It can mean that your illness is harder for doctors to treat and you may find it hard to work or find stable housing. However, you can get help if you have dual diagnosis.
•Mental health and drug services should work together to give you the support you need.

The first step to getting treatment is to see your GP. They should rule out any physical problems which might cause symptoms of depression.

Common treatments for depression include:

Talking therapies

Talking therapy is available on the NHS, from private healthcare providers and sometimes from charities. You will meet a trained therapist for a fixed number of sessions. Sometimes this will be with a group of people with the same diagnosis as you.

There are many different types of talking therapy. According to the National Institute of Health and Care Excellence (NICE), cognitive behavioural therapy (CBT) is one of the most effective therapies for depression. It should normally be available in your area.

Other common therapies include:
•Psychodynamic therapy,
•Problem-solving therapy,
•Interpersonal therapy, and
•General counselling.

These therapies may not be widely available in your area but it is worth asking your GP about them if you are interested.

Computerised cognitive behavioural therapy (CCBT)

Computerised cognitive behavioural therapy (CCBT) is a relatively new way of treating mild to moderate depression. It is a way of learning CBT techniques online through a computer. You will complete regular sessions to learn new ways to deal with your depression.

In a lot of areas, the NHS uses CCBT programmes such as ‘Beating the Blues’, ‘COPE’ and ‘Overcoming Depression’. One of these, or something similar, may be available free of charge through your GP.

Antidepressants

Your doctor might offer you an antidepressant. You may need to try different types before you find one that works for you. Antidepressants can have unpleasant side effects and can affect other medicines you are taking. It is important to talk to your doctor before you stop taking them, because stopping suddenly can cause problems.

Exercise Therapy

Having good physical health and exercising can help with depression. Some GP surgeries will put you in touch with local exercise schemes. These might sometimes be called ‘exercise on prescription’.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a procedure sometimes used to treat severe depression. In this treatment, an electrical current is briefly passed through your brain while you are under general anaesthetic. ECT is only offered if other kinds of treatments have not helped and your depression is very severe.

Transcranial Magnetic Stimulation (TMS)

TMS involves using magnetic fields to try to change the way the brain works. Scientists think that this could help people with depression and does not cause any major safety concerns.

Complementary/ Alternative Therapies

Complementary therapies are treatments which are not part of mainstream medical care. They can include aromatherapy, massage, mindfulness, meditation and yoga. These are aimed at improving your emotional well being.

What causes depression?

Nobody knows exactly what causes depression. This section looks at some of the things that might increase your risk.

Your body

Scientists think that if you have depression, some of the chemicals in your brain are out of balance. In particular, having lower amounts of a chemical called ‘serotonin’ in your brain may cause depression.

Changes in your hormones can affect your mood. These changes might be particularly noticeable for women during pregnancy or menopause.

The family connection

Depression seems to run in families. This could be because:

a) it is passed down in your genes, or

b) you have experienced other people’s low moods.

Your background or situation

Problems during your childhood might cause depression. Bad experiences can lead to you thinking negative thoughts about yourself or about the world.

Stressful events, including problems at home, a breakup, the death of someone you know, or losing your home or a job can also affect your mood. Doctors sometimes call these ‘triggers’ or ‘triggering events’ if they think that these problems have caused your depression.

Lifestyle

Good food, exercise and hobbies can make it less likely that you will become unwell. Having other illnesses or using drugs or alcohol might make it more likely. There is more information on these things below.

Food

If we eat badly then we may be at risk of physical health problems like obesity, heart disease and diabetes. In the same way, the things we eat may affect our moods and our risk of becoming mentally unwell. Some people deal with their depression by eating high-fat and high-sugar foods. This is called ‘comfort eating’, and it can make things worse in the long term.

Some top tips include:
•Eat regularly throughout the day,
•Drink plenty of water,
•Try to avoid too much caffeine – tea, coffee and chocolate,
•Try to keep a healthy weight,
•Eat fruit, vegetables and wholegrain cereals,
•Don’t drink too much alcohol.

If you have depression, eating well will probably not have an instant impact on your mood. However, it might make you feel better in the long term.

Exercise

Exercising regularly can help your mood. Finding something that you enjoy doing is important so that you will want to keep it up. Exercise may also help you to get to sleep. Getting proper sleep is important for your mental health.

You can try increasing the amount of exercise you do gradually. The amount you can do will depend on your age, physical health and your fitness. We have listed some options below:
•Going for a walk
•Cycling
•Gardening
•Jogging
•Playing a sport
•Going to the gym

In some areas, you may be able to get ‘exercise on prescription’ from your GP. For example, you could get some free sessions at a local gym.

Drug and alcohol use

Using drugs can affect the way your brain works. Scientists think that this can have long lasting effects on you. Regularly drinking too much alcohol may also cause depression.

There is more information on drugs and alcohol in our ‘Drugs, Alcohol and Mental Health’ section.

Other illnesses

You may feel low if you have a physical illness. This risk might be higher if you have a long-term or life-threatening illness. Some people with brain injuries and dementia will also have changes in their moods.

What are the different types of depression?

You might have heard a number of terms used to describe depression. In this section, we explain what some of these terms mean.

Clinical depression

Clinical depression is a very common term but it is not a diagnosis. It just means that a doctor has given you a diagnosis.

Depressive episode

Your doctor might say that you are going through a ‘depressive episode’. This is the formal name that doctors give depression when they make a diagnosis. They may say that you are going through a ‘mild’, ‘moderate’ or ‘severe’ episode.

Recurrent depressive disorder

If you have had a number of ‘depressive episodes’, your doctor might say that you have ‘recurrent depressive disorder’. Again, they may say that your current ‘episode’ is ‘mild’, ‘moderate’ or ‘severe’.

Reactive depression

If your doctor thinks that your depression was caused by stressful events in your life, they may say that it is ‘reactive’.

Dysthymia

Your doctor might diagnose you with dysthymia if you have felt low for several years but have never had symptoms that would be enough to diagnose depression.

Manic depression

Manic depression is a different illness to depression. It is also known as ‘bipolar disorder’. People with this illness have severe highs (mania) and lows (depression).

Psychotic depression

If you are severely depressed, you may start to hallucinate or believe things that aren’t true. This is called ‘psychosis’. For example, you might start to hear voices that say that you are worthless and that things will never improve, or you may start to believe that someone is poisoning your food.

Post-natal depression

Postnatal depression is a common illness which affects between 10 to 15 in every 100 women who have had a baby. You may get symptoms that are similar to those in other types of depression.

Seasonal affective disorder (SAD)

This type of depression affects you at the same time of year, usually in the winter. The symptoms are similar to depression but you may sleep more rather than less. You might also eat more carbohydrates like chocolate, cakes and bread.