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Depression

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What is depression?

People often refer to themselves as being depressed, but that can be different from the depression that health professionals talk about. The mental health condition called depression is an almost constant state of low mood and a loss of interest or pleasure in activities that used to be enjoyable. Life becomes flat and grey, and nothing seems fun, exciting, or enjoyable anymore. In more severe cases, the person may believe that life is no longer worth living. Common symptoms of depression are:

  • Feeling low, down in the dumps, miserable
  • Feelings of worthlessness, helplessness, and hopelessness
  • Lack of energy, easily tired test
  • Lack of enthusiasm, difficulties with motivation
  • Loss of interest and pleasure in normal activities
  • Lack of appetite and weight loss
  • Loss of interest in sex
  • Difficulty sleeping, or sleeping too much
  • Poor concentration, memory, and decision making
  • Thoughts of suicide and/or death.

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Why do I feel this way?

There are many situations that can trigger depression, including loss of a loved one, loss of a job, a traumatic event, and relationship difficulties. But most of the time depression isn’t caused by just one thing. A history of depression in the family and particular thinking patterns (like always focusing on the negative side of things) can make it more likely that someone might develop depression, but it doesn’t mean they definitely will.

Sometimes people shift between periods of depression and periods of feeling more ‘wired’ and ‘hyper’ than during normal periods of happiness. Does this sound like you? If so, read more about bipolar disorder.

You’re not alone

Depression is common in Australia, and at least 1 in 5 of us will experience a period of depression in our lifetime. It’s also common in veterans and serving members. For example, depressive disorders affect around a quarter of Vietnam veterans [1], a third of Gulf war veterans [2], and one in five current serving members [3]. Depression is a very distressing and disabling condition which all too often ends in suicide. Left untreated, periods of depression tend to last longer and happen more often, so it’s important to get help.

Feelings of guilt

A lot of people with depression suffer from strong feelings of guilt. After deployment, you might feel guilty that you survived while others did not; it might be about what you had to do to survive; it might be related to things you did in a combat situation that conflict with your values. Sometimes you can feel guilty because you’re trying to apply civilian or peacetime standards to a combat situation, but the nature of military operations means that sometimes those standards aren’t really relevant and there’s no acceptable or ‘good’ option. For some veterans, these guilty feelings can be very damaging and can get in the way of recovery. It can be painful to deliberately think about it, but challenging the thoughts and beliefs that relate to your guilt can help make it less intense and upsetting.

Some veterans develop depression because they find that the experience of combat, or serving in the military, shatters their idea of the world being a fair and safe place. It may take time, and the sharing of your experiences and thoughts with supportive and understanding people, to come to terms with these experiences and restore your core values and beliefs.

What treatments can help?

Effective treatments for depression are available. Most people will respond quite quickly to professional psychological treatment for depression, which is sometimes combined with anti-depressant medication to help you manage some of the feelings associated with your depression.

One of the most effective treatments for depression is cognitive behavioural therapy (CBT). This approach recognises that the way we think and act affects the way we feel. With the help of a therapist or counsellor, you will learn:

  • a step-by-step approach to problem solving to help you manage day to day challenges.
  • how to challenge your negative thinking, so you can get a more balanced and helpful view of yourself, other people, and situations.
  • strategies to help you get back to your routine and enjoying your usual activities.

Another effective psychological intervention for depression is interpersonal therapy (IPT). This approach aims to help you understand how interactions with other people can contribute to or worsen depression, and learn new ways of relating to people.

Where do I get help?

  • A GP is always a good place to start when trying to overcome depression, as he or she can make referrals for specialists, and support your efforts with medications if necessary.
  • This website has information on a range of professional care that is available to current and former serving members.

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Self-help resources

Below is a list of internet and other written resources that may help you, together with the treatment recommended by your doctor.

  • The High Res website and app offers range of interactive tools and self-help resources that help serving and ex-serving ADF members and their families manage stress and build resilience.
  • Written materials for you and your family are available from websites such as beyondblue or Black Dog Institute.
  • There are also internet based self-help programs available, like MoodGYM and E-couch.
  • Useful books include Mind over mood: A cognitive therapy treatment manual (Padesky and Greenberger, 1995) and Feeling good: The new mood therapy (Burns, 1999).

Depression and older veterans

There are several reasons that depression might develop later in life, like deteriorating physical health, loneliness, and loss of loved ones. Unfortunately, older people who are feeling depressed often don’t do anything about it. Some don’t want to worry their family or friends, and others don’t believe in talking about mental health or don’t want to admit they’re not coping. Many older people (and their friends and family) wrongly assume that symptoms of depression like having trouble sleeping, unexplained pain, concentration or memory problems, or loss of interest in life, are simply a normal part of ageing. The good news is that depression can be treated no matter your age, so if you’ve noticed a change in your physical health, memory, or behaviour that you can’t explain, speak to your GP about it. You can find out more at Black Dog Institute.

I heard once that Winston Churchill called his depression “The Black Dog”. I think it’s more like a heavy black cloud that settles all around you. It feels like a lead weight on your shoulders and you can’t see through it. All you can see it blackness. I didn’t know what it was until a few months ago. Read Josie’s full story here.

 

[1] O'Toole, B. I., Marshall, R. P., Grayson, D. A., Schureck, R. J., Dobson, M., Ffrench, M., . . . Vennard, J. (1996). The Australian Vietnam veterans health study: III. Psychological health of Australian Vietnam veterans and its relationship to combat. International Journal of Epidemiology, 25, 331-339.

[2] Black, D. W., Carney, C. P., Forman-Hoffman, V. L., Letuchy, E., Peloso, P., Woolson, R. F., & Doebbeling, B. N. (2004). Depression in veterans of the Firt Gulf War and comparable military controls. Annals of Clinical Psychiatry, 16, 53-61.

[3] McFarlane, A. C., Hodson, S. E., Van Hooff, M., & Davies, C. (2011). Mental health in the Australian Defence Force: 2010 ADF Mental Health and Wellbeing Study: Full report. Canberra: Department of Defence.

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  • There are different types of treatment – if you don’t feel like one is working, talk to your doctor about other options.

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