Managing Depression

We all feel down sometimes, for lots of different reasons. If low mood doesn’t go away after a couple of weeks or gets in the way of your daily life, you may have depression. It’s a common mental health problem and anyone can be affected, but people with long-term conditions and disabilities like spina bifida and hydrocephalus may be at higher risk. The good news is that with the right treatment and support, most people make a full recovery. So, if you think you may be depressed, don’t delay getting help. 

When you’re living with spina bifida and hydrocephalus, problems linked to the condition itself – like bladder or bowel issues – can affect your mood. Getting support to manage physical challenges may be an important step to addressing your worries.  

Call the SBH Scotland Helpline on 03455 211 300 or you can fill in this form to get in touch with our support team

Symptoms of depression

Depression can range from mild to severe and can affect the way you feel and the way you behave. There are lots of possible symptoms and signs – below are some of the most common.

You may feel:

• sad, low and hopeless
•  irritable, frustrated and restless
• guilty and worthless
• empty and numb
• low in confidence
• tired all the time

In your daily life, you may:

• find it harder to look after yourself, including taking any medicines you need
• avoid social events
• lose interest in activities you usually enjoy
• have trouble thinking clearly or making decisions
• eat less than usual and lose weight, or more than usual and gain weight
• sleep more or less than usual
• have aches and pains that aren’t caused by an obvious physical problem
• cry more than usual
• have lots of negative thoughts
• try to cope by using tobacco, alcohol or other drugs, or self-harm in other ways
• take your frustration out on loved ones

See your doctor if you’ve had these symptoms for two weeks or more, especially if you’re self-harming, as this can be very dangerous.

If you feel really low and have suicidal thoughts, it’s important to get emergency support for your mental health– call an ambulance, go to your nearest A&E or call the Samaritans for free on 116 123.

What causes depression?

There isn’t a single cause, and doctors can’t always work out why someone develops depression. Sometimes, a few different factors can combine to cause it, including:

• physical conditions and disabilities, such as spina bifida and hydrocephalus
• difficult childhood experiences
• stressful events in your life now
• family history
• other mental health problems
• lifestyle factors, such as poor sleep or diet

Why are people with spina bifida and hydrocephalus at higher risk of depression?

There are a number of possible reasons:

• ongoing physical health problems, including pain, mobility issues and the need for frequent hospital stays
• the cognitive effects of spina bifida and hydrocephalus, which can affect how you manage your emotions, process information and cope with challenges
• social factors, including negative attitudes and discrimination, the built environment, and issues with work, money and benefits
• emotional factors, such as poor body image and low self-esteem.

These reasons can all feed into each other. For example, long periods in hospital can affect your ability to work, while pain and mobility issues make it harder to do things that might help your mental health, such as exercising and getting out to see friends. Many people become very resilient to the challenges of living with spina bifida and hydrocephalus, but anyone can find it hard to cope if the challenges outweigh their resources.

Treating depression  

Effective treatment often involves a combination of techniques, and it may take some time to find out what works for you. Try not to be disheartened if progress seems slow. It may be helpful to track your mood so you can get a more accurate view of what helps, and anything that makes depression worse. You could ask someone close to you to help you identify any changes – others may notice things you don’t.

How your GP can help

Always see your GP if you think you’ve had symptoms of depression for two weeks or more. They can evaluate you and may refer you for a talking treatment such as cognitive behavioural therapy (CBT), for free on the NHS. The Scottish government has set a target that nobody should wait more than 18 weeks to start a talking treatment once referred.¹ Your GP may also prescribe medication if they think it may help you.

People with cognitive issues may benefit from being treated by a neuropsychiatrist – a mental health specialist who also looks at differences in the brain. Your GP can refer you.

Getting private support
Some people choose to pay for talking treatment. If you’d like to do that, you can find a therapist through an accredited organisation such as COSCA (Counselling and Psychotherapy in Scotland) – or ask your GP for their recommendations.

Practising self-care

Alongside any treatment from a healthcare professional, self-care is also important for managing depression. There are five basic types of self-care.

1. Physical self-care involves taking care of your body, including:

• getting good sleep and practising a relaxing bedtime routine 
• eating a balanced and healthy diet 
• going to the GP when you need to
• exercising in a way that you enjoy and works for you
• avoiding nicotine, alcohol and other drugs

2. Social self-care is about connecting with other people. It’s different for everyone, but may involve:

• joining a club
• having a quiet dinner out with a friend or getting together with a group of friends
• volunteering – helping others and feeling part of a community are both positive for your mental health. There are lots of options for volunteering in a way that works for you.
• connecting with others online – for example, through social media or support group forums. While it’s not a substitute for real-life socialising, it can be useful when getting out is difficult

SBH Scotland has social groups you can attend. Find out more about our groups here.

3. Mental self-care focuses on your mind. It may include: 

• meditation and breathing exercises to help you manage stress
• learning about something that interests you
• starting a new hobby
• trying to set small goals for yourself

4. Emotional self-care is about making sure you can identify and deal with your emotions. Talking treatments can help with this but there are also things you can try yourself, such as:

• talking to loved ones about your feelings 
• practising self-compassion – try to talk to yourself the way you’d talk to a good friend
• finding simple strategies that help when you’re feeling down or stressed – such as journaling time, listening to guided meditations or having a relaxing bath

5. Spiritual self-care is about understanding you’re part of something bigger and having a deeper sense of connection with yourself – you don’t necessarily need spiritual beliefs to practise it. It may involve: 

• trying to understand yourself – your strengths, weaknesses and what’s important to you
• identifying your values and being guided by them
• spending time in nature, taking time to notice what’s around you and feel a sense of awe
• practising gratitude – there’s evidence that taking time to focus on the positives in your life gratitude may help to improve mood. For example, once or twice a week, you could try writing a list of things you’re grateful for – including small, everyday things

Be kind to yourself

It isn’t always easy to practise self-care when you’re feeling low, especially if you have physical symptoms as well. But even small changes can make a difference to your wellbeing.

Talk to friends and family about ways they could support you – they’re likely to benefit too. For example, perhaps a friend could be a regular swimming buddy or learn to meditate with you, or a family member could help with some healthy batch-cooking.

Your GP can also support you with lifestyle changes – for example, with guidance on diet and activity. Check with them before you start any new form of exercise, to make sure it’s safe for you.

Finding more support 

For more support, you can get in touch with our support team.

Scottish Action For Mental Health (SAMH) has lots of advice on coping with depression. To help you understand more about your mental wellbeing, try their wellbeing tool.