Depression

We recognize that depression is complex with multiple influences. Effective treatment, therefore, needs to be identify and address all the physical, emotional and behavioural elements of depression.

A life without depression

We recognize that depression is complex with multiple influences. Effective treatment, therefore, needs to be identify and address all the physical, emotional and behavioural elements of depression.

 

What is Depression?

Depression is a mental health disorder classified as a “mood disorder”, which manifests as feelings of intense low mood, hopelessness, worthlessness and a marked decrease in motivation and enjoyment in activities.      

It is important to differentiate between feeling depressed in mood and depression as a disorder. Everyone feels depressed in mood from time to time, but it can only be diagnosed as a disorder when it becomes chronic (every day for over two weeks) and has a noticeable impact on functionality in daily life.

Causes & Symptoms of Depression

What Causes Depression?

Depression is notorious in its ability to affect anyone. There is not always an obvious reason why someone develops depression but there are certain risk factors that can increase vulnerability to developing a depressive disorder:

  • Genetic component: family history of depression or other mental illness.
  • Upsetting or stressful life event(s).
  • Chronic illness.
  • Trauma.
  • Chronic stress.
  • Abuse.
  • Adverse childhood experiences.
  • Low self-esteem.
  • Giving birth (postnatal depression).
  • Alcohol and substance misuse.
  • Loneliness.
  • Loss (of role, job, status, money, relationship etc.).


People often describe the onset of their depression as a “downward spiral”.  This metaphorically portrays how one negative event or experience can trigger intense low mood which results in social isolation, a decrease in self-esteem, loss of sleep and “spiralling” until they show much of the presentation of a depressive disorder.

 

Symptoms of Depression

Depression is experienced differently by everyone. It often has a gradual onset, meaning many people realise they feel depressed, without the realisation that they are actually experiencing depression as a disorder rather than solely as a mood.

Depression affects our core belief system, leading to negative biases in the way we interpret ourselves, others and our world. 

The physical, emotional and behavioural symptoms listed below are all associated with depression, but to have a depressive disorder, you do not need to feel all of these things, they are merely indicative of what someone with depression may be experiencing:

Physical:

  • Medically unexplainable pain or headaches.
  • Constipation.
  • Fatigue or lack of energy.
  • Lack of libido.
  • Menstrual cycle changes.

Emotional:

  • Intense low mood.
  • Sadness.
  • Feelings of worthlessness.
  • Feelings of hopelessness.
  • Feelings of guilt.
  • Frustration.
  • Lack of enjoyment in previously pleasurable activities.
  • Lack of motivation.
  • Low self-esteem.
  • Negative views of self, future, and world.
  • Anxiety or worry.
  • Suicidal ideation.

Behavioural:

  • Social isolation.
  • Decreased standard of personal hygiene.
  • Changes to appetite.
  • Changes to sleeping pattern.
  • Self-harm.
  • Irritability.
  • Difficulties in decision-making.
  • Slow movement and speech.
  • Neglecting hobbies.

 

Warning Signs of Depression:

The warning signs vary from person to person and will also depend on the capacity that you know the person in. Depression can be an invisible illness and can sometimes manifest in unexpected or difficult ways. Remember that no one chooses to be depressed and their experience of the disorder is unique to them. If you suspect that they may be vulnerable from self-harm or suicide, it can be helpful to ask them directly. Talking about suicide can encourage openness and help the person to feel heard and understood while enabling you to discuss how to keep them safe. 

Warning signs vary for everyone.  Here are some common signs of depression to look for if you think you might be depressed.

  • Social isolation.
  • Irritability.
  • Evidence of self-harm.
  • Evident low mood.
  • Change in appetite.
  • Change in sleeping pattern.
  • Consuming or using more substances than usual.
  • Experience of stressful life event, trauma, or abuse.
  • Evident lack of energy.
  • Evident lack of enjoyment or attendance in typically pleasurable activities.
  • Neglected appearance or personal hygiene.
  • Lack of motivation.

Depression Treatment

Treatment for depression is either talking therapy, medication, or a combination of the two.

The first line talking therapy for depression is Cognitive Behavioural Therapy (CBT) which aims to help you challenge and restructure unreasonable negative views that you hold about yourself, others and the world.  Schema therapy is also an effective treatment which helps you understand the way your early childhood experiences impact your mood today. 

Although medication can be good at treating symptoms, they do not target the cause of the depression, which is why the combination of therapy and medication is usually the most effective line of treatment.

Individual programmes are tailor-made to each patient’s needs and progress. The following provides a guide to the typical building blocks of our day treatment programmes, all of which include a number of weekly 1:1 sessions with members of the MDT.

  Full-day Programme Half-Day Programme
Days  Monday to Friday Monday to Friday
Hours 7 - 8 hours per day 4 - 5 hours per day
Programme length Up to 4 weeks Up to 4 weeks
Detailed group therapy 5 - 6 sessions 3 - 4 sessions
Daily meals Lunch/snacks Lunch/snacks

We provide the following therapies and interventions. These may be delivered on a 1:1 or group basis by members of the MDT.

Psycho-education Cognitive behaviour therapy (CBT) Mindfulness
Relapse prevention Self-esteem / resilience  Movement
Peer Led Support Dialectical Behaviour Therapy (DBT) Food preparation / cooking
Applied relaxation Art / drama Interpersonal therapy
Social issues Family therapy Schema

 

Treatments are available at the following locations

Schoen Clinic Chelsea

Our Address
Schoen Clinic
Centre for Mental Health Chelsea
13a Radnor Walk
Chelsea
London SW3 4BP
General Telephone Enquiries
0203 146 2300
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Specialists

Dr James Woolley

Consultant Psychiatrist BSc(Hons) MBBS MRCP MRCPsych PGDip (CBT)

Depression
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Dr Samantha Cobb

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Adjustment Disorders
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Dr Niraj Arora

Consultant Psychiatrist

Depression
Anxiety
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Dr Werner Kierski

Psychotherapist DProf. MA, MBACP (Snr. Accred.), ISST

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