Depression includes a number of associated mental symptoms characterised by the absence of a positive affect, low mood and a range of emotional, cognitive, physical and behavioural symptoms. Typically the mood and affect are unreactive to circumstances, remaining flat throughout the day. Others experience a gradual improvement through the day with a return to low mood on waking the following day.

The physical and behavioural symptoms may include:-

• tearfulness, irritability
• reduced sleep
• exacerbation of pre-existing pains and/or pains due to muscular tension
• lowered appetite
• fatigue and diminished activity
• agitation and marked anxiety

Other feelings include:-

• guilt, worthlessness and deserved punishment
• lowered self esteem
• loss of confidence
• helplessness

Cognitive changes include:-

• poor concentration and reduced attention
• persistent and recurrent negative thoughts about oneself
• mental slowing and rumination

Depression is often accompanied by anxiety. Depending on the number and severity of symptoms, a depressive episode may be specified as mild, moderate or severe.

For mild and moderate depression, psychological treatments specifically focused on depression can be as effective as drug treatments. If Depression is an issue for you then consider the benefits of The Wait Control process training programme. Please email or phone me for further information.

Further information from: Management of Depression. National Clinical Guideline No 23. www.nice.org.uk