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Coping with depression and feeling down

Man feeling low

Depression can be successfully treated

It is very common for people with heart conditions to feel down or develop depression. Feeling down for some of the time is a natural reaction as you learn to accept, and adapt to, your illness. However, if you are feeling low for most of the time you could be depressed.

Some people feel there is a stigma attached to being depressed or are afraid of what other people will think of them. Sometimes people do not realise they are depressed, especially when they have been feeling the same for a long time.

Depression can be successfully treated, so it is important to recognise if you are depressed and to let someone know how you are feeling. If you have a heart condition, maintaining your health is often dependent on you being proactive. This is  more difficult if you have symptoms of depression or are feeling depressed. By addressing depression you will quickly feel the benefit and increase your quality of life.

Symptoms of depression

Depression affects your mood and how you feel about life - you may feel as if there is no point in anything. It can make you feel as if you don't want to get up in the morning or as if you don't want to go out or see family or friends. Often depression creeps up over a period of time.

Common symptoms of depression include:

  • Persistent sadness or crying spells
  • Loss of interest in life
  • Mood swings: feeling short-tempered / irritable or easily upset
  • Tiredness and loss of energy
  • Loss of confidence and self esteem
  • Difficulty concentrating
  • Not being able to enjoy things that are usually pleasurable or interesting
  • Feelings of guilt or worthlessness
  • Changes in appetite / weight gain or loss
  • Feelings of helplessness and hopelessness
  • Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual
  • Lack of energy / motivation
  • Being less aware of others and more inward looking
  • Physical aches and pains
  • Loss of sex drive or sexual problems
  • Avoiding other people, sometimes even your close friends
  • Thinking about suicide and death

If you have any of these symptoms for over 2 weeks and they are affecting how you cope with day-to-day life then you should let someone know how you are feeling. Your GP or practice nurse are both good people to speak to as they will also understand about your chest, heart or stroke condition.

Try not to bottle up your feelings. It may be hard, at first, to talk about how you are feeling but remember doctors are used to talking about emotions and are skilled at recognising and treating depression.

Treatment for depression

Talking therapy © Crown Copyright 2009

Talking to a trained professional can be helpful

Treatment can include 'talking therapies' and antidepressant drugs. Sometimes a combination of both will be suggested. Your doctor may also recommend that you make changes to your lifestyle to help improve your mood.

  • Sometimes further support may be needed, e.g. from your doctor or nurse. Most people won't need to see a psychiatrist unless their depression is very severe or they are suicidal. You may also be referred to the community mental health team for support.

Talking therapies

There are lots of different types of therapies which involve talking about how you feel. Some, e.g. cognitive behavioural therapy (CBT), have been proven to be particularly helpful if you are depressed.

  • CBT is a form of therapy which focuses on how you think about yourself, the world and others as well as how your thoughts and actions affect your feelings. CBT can help you to change how you think (cognitive) and what you do (behaviour). Telephone and face-to-face CBT services are available from some support organisations as well as the NHS. Living Life to the Full provide a free web-based CBT course.
  • Counselling is another talking therapy which involves talking about your feelings / problems with a trained counsellor. Your counsellor will listen to you, support you and help you deal with how you are feeling. Some GP practices have a counsellor working from their surgery. Otherwise your GP should have a list of local support agencies and counsellors. Some agencies offer low-cost counselling depending on your financial situation.

Depression is a very personal experience: you are the only one who truly knows how you are feeling and what you are going through. Different forms of talking therapy suit different people. It is important that you feel safe and comfortable with your therapist and that you can talk openly about how you are.

Antidepressant drugs

These balance the chemicals in the brain responsible for these feelings. There are different types used depending on your symptoms and medical history. Antidepressants are not the same as tranquilisers and they are not addictive. However, their use has to be monitored and they should not be stopped suddenly.If your doctor suggests antidepressants make sure you arrange a further appointment to see how things are.

Taking antidepressants does not have to be a long-term solution. Many people are helped through a difficult time in their lives because antidepressants allow them a temporary platform to stand on until they can come to terms with their situation. They are then able to cope better and move on when they have adjusted to issues affecting them.

Coping with depression

  • Try to accept that you may have good and bad days: recovering from depression takes time.
  • Getting outside if you can and having some fresh air can help.
  • Eat as healthy and varied a diet as you can.
  • Try to avoid alcohol; it will bring your mood down and can make sleeping patterns worse.
  • Try not to worry if you don't sleep. Read, listen to the radio or watch TV. Your body is still resting by lying down.
  • When you are low it can be difficult to make decisions - talk to those people you trust.
  • Try not to bottle up your feelings - use the support around you.
  • Relaxation, yoga, tai chi and reflexology are examples of additional ways to increase your feeling of well being and reduce stress.
  • Remember that depression can be treated and these unpleasant feelings will lift.

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