Many people find it hard to seek help for a mood disorder. In spite of a growing awareness of depression and bipolar disorder, misunderstandings persist – and these can deter people from seeking help as readily as they would for other more obviously ‘physical’ illnesses.
In this section we aim to lead you through the logical steps involved in seeking help, and to provide you with information and explanations of the different steps along the way.
We also recognise that for most people, ‘help’ involves a combination of approaches. So you’ll find information on both professional help and other forms of help.
Please note that the information in this section (or anywhere on this site) is not intended as a substitute for professional medical advice, so please see a qualified health provider if you have any health concerns.
- Kids Help Line – counselling and support provided for young people (to 24 years old) who are feeling depressed, sad, or lonely – or just need someone to talk to – 1800 55 1800
- Salvo Youth Line – (02) 8736 3293 (Sydney local call)
- Child Abuse Prevention Services – 1800 688 009
- Suicide Call Back Service – 1300 659 467
In an emergency you can also visit your local hospital’s emergency department.
When to seek Help
Everybody feels down or sad at times. But it’s important to be able to recognise when depression has become more than a temporary thing, and when to seek help.
The following are a list of the features that may be experienced by someone with depression.
- Lowered self-esteem
- Change in sleep patterns
- Change in mood control
- Varying emotions throughout the day
- Change in appetite and weight
- Reduced ability to enjoy things
- Reduced ability to tolerate pain
- Reduced sex drive
- Suicidal thoughts
- Impaired concentration and memory
- Loss of motivation and drive
- Increase in fatigue
- Change in movement
- Being out of touch with reality.
As a general rule of thumb, if your feelings of depression persist for most of every day for two weeks or longer, and interfere with your ability to manage at home or outside the home, then you would benefit from assessment by a skilled professional.
It’s also important to recognize that many of the above features could be caused by or related to other things, such as a physical illness, the effects of medications, or stress. A trained professional will help in assessing such things.
Allow yourself to seek help. Struggling on alone can prolong the depression.
When to seek help for bipolar disorder
If you have experienced an episode of mania or hypomania, it’s best to seek professional help as soon as possible. It may indicate that you have bipolar disorder, which, if left untreated, will likely involve further episodes of mania or hypomania. Bipolar disorder is not an illness which goes away of its own accord but which often needs long-term treatment.
- High energy levels – with the individual feeling ‘wired’ and ‘hyper’, extremely energetic, experiencing racing thoughts, talking more and talking over people, making decisions in a flash, being constantly on the go, and feeling less need for sleep.
- Positive mood – feeling confident and capable, optimistic, that one can succeed in everything, more creative, more happy and perhaps feeling ‘high as a kite’.
- Irritabililty – reflected in irritable, impatient and angry behaviours.
- Inappropriate behaviour– becoming over involved in other people’s activities, by increased risk taking (including over indulging in alcohol and drugs and gambling excessively), saying and doing outrageous things, spending more money, having increased libido; dressing more colourfully and with disinhibition.
- Creativity – experienced as ‘seeing things in a new light’, seeing things vividly and with crystal clarity, finding one’s senses are heightened and feeling quite capable of writing the ‘great Australian novel’.
- Mystical experiences – can be experienced by believing that there are special connections between events, that there is a higher rate of coincidence between things happening, feeling intensely at one with nature and appreciating the beauty of it and the world around, believing that things have special significance.
More extreme expressions of mania (but not hypomania) may have the added features of delusions and hallucinations.
Accurately diagnosing bipolar disorder is a task for a professional. A first step is to see your local GP, who will likely refer you to a psychiatrist for assessment and treatment.
Where to Seek Help
A good first place to start in getting help is to visit your local general practitioner (GP). Let him or her know if you think you might have depression or bipolar disorder. Your GP will either conduct an assessment of you, or refer you to someone else, such as a psychiatrist or a psychologist.
If you have depression, your GP may recommend some psychological intervention, such as cognitive behaviour therapy or interpersonal therapy, and might prescribe antidepressant medication to relieve some of the symptoms of depression.
Because mental health problems are common issues in general practice these days, many GPs are used to dealing with depression and other mental health problems. Some take a special interest in mental health issues and undergo additional training in the area. If you don’t feel comfortable talking to your own GP, find another one with whom you do feel comfortable. It is important that you feel comfortable talking about how you are feeling with your GP so they have as much information to help you as possible.
If you are having trouble tracking down such a GP, you could telephone general practices in your area to find out whether any doctors in that practice have a particularly strong interest in mental health and, if so, whether they are taking on new patients. (Ask to speak to the practice manager.)
beyondblue has a national listing of health practitioners with an interest and/or expertise in the treatment of depression and anxiety. This list is searchable by suburb and so is a useful way of finding practitioners in your local area.
Psychologists, psychiatrists and counsellors are other professionals trained to provide help for depression and mood disorders. You will need a referral from your GP to see a psychiatrist or a psychologist (and this will either eliminate or reduce costs).
Social workers, occupational therapists and registered nurses are also trained in mental health
Support group is a small group of people with a particular condition, such as depression, anxiety or bipolar disorder, who meet regularly to discuss their their experiences, their problems and their strategies for coping. Some support groups meet online.
What are the benefits?
Research shows that hearing from and sharing with others with similar experiences can be very helpful. A support group can provide the following gains:
- show you that you are not alone
- help develop new skills in relating to others
- permit you to ‘open up’ and discuss your situation and feelings
- give practical skills and advice – such as how to draw up and stick to a treatment plan
- provide new coping strategies – share your solutions and learn from others’ experience
- offer a safe place to sound off about frustrations of living with a disorder
- supply strategies for managing any stigma associated with your disorder
- strengthen motivation to stick with a treatment plan.
Support groups for family and friends
Family members/friends can also benefit from their own support group:
- they learn more about the disorder and become more constructively involved in recovery
- they hear of new strategies for coping, reducing stress and getting community resources
- they gain increased appreciation of the importance of sticking with a treatment plan.
Most people know that having a healthy diet is vital to good health. We tend to generally feel better when we eat well.
- Eat plenty of vegetables, legumes and fruits
- Eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain
- Include lean meat, fish, poultry and/or alternatives
- Include milks, yoghurts, cheeses and/or alternatives. Reduced-fat varieties should be chosen, where possible
- Drink plenty of water
- Limit saturated fat and moderate total fat intake
- Choose foods low in salt
- Limit your alcohol intake if you choose to drink
- Consume only moderate amounts of sugars and foods containing added sugars.
- avoiding alcohol
- avoiding caffeine if you’re sensitive to caffeine (however further research is necessary)
- increasing the amount of Omega 3 oils in your diet
- avoiding sugar (however further research is necessary).
Feeling tired and being less motivated in general are two very common symptoms of depression. This means that exercise is often the last thing that people feel like doing when they are experiencing depression. However, regular exercise has been shown to have very positive effects upon mental wellbeing. Whilst vigourous exercise releases endorphins (the ‘feel good’ chemicals that also alleviate pain) into our bloodstream, even gentle to moderate exercise increases serotonin, which has a number of benefits including lifting our mood and helping to counteract insomnia. The good news is that exercise doesn’t need to be strenuous for us to feel some of its many benefits.
How does exercise help depression?
- Increasing energy levels
- Helping to get a good night’s sleep
- Providing distraction from worries and rumination
- Providing social support and reducing loneliness if exercise is done with other people
- Increasing a sense of control and self-esteem, by taking an active role in the individual’s own recovery.
Evidence for the benefits of exercise in managing depression
- Numerous studies have shown that people who exercise regularly experience fewer symptoms of depression and anxiety than those who do not exercise regularly
- Several trials have shown that regular exercise of moderate intensity can be an effective treatment by itself for mild to moderate depression
- Two trials have found that 16 weeks of regular exercise is equally effective as an SSRI antidepressant medication in the treatment of mild to moderate depression in older adults who have been inactive
- Research also suggests that exercise can further assist depression in individuals with depression who have responded only partially to an antidepressant medication
- Both aerobic exercise (e.g. brisk walking, cycling or jogging) and resistance or strength training (e.g. weight-lifting) have been found to be beneficial for depression.
The National Physical Activity Guidelines for Australians recommend:
- a minimum of 30 minutes of moderate intensity exerciseon most, preferably all, days of the week (an example of ‘moderate intensity’ exercise is brisk walking where you notice a slight increase in breathing and heart rate)
- exercising for at least 10 minutes at a time – the 30-minutes total does not need to be continuous – you can combine short sessions of different activities to a total of 30 minutes or more each day
- being active in as many ways you can each day (e.g. use the stairs).
- Start slowly and build up gradually. For example, if you have not been exercising at all, start with a 10-15 minute walk each morning, and gradually increase this to 30 minutes per day
- Set short-term realistic goals for exercising each week (e.g. 3 x 20 minute walks per week). Plan to exercise at specific times of the day that fit in with your lifestyle and write your plan down
- You don’t have to join a gym – try a variety of different types of activities to find those that you enjoy (e.g. swimming, walking the dog, jogging whilst listening to music, riding a bike, gardening, bushwalking, yoga, weight-lifting)
- Give yourself a break – if you don’t stick to your exercise plan, simply start again from where you left off
- Remember that it can take time for the benefits of exercise to occur. (Most exercise studies showing a significant reduction in depression have examined exercise programs of at least 8 weeks).