Psychotherapist John-Paul Davies explains what depression is, how it can feel, the self-help steps that help and why working with a therapist could open up a much-needed conversation

Every person reading this article will have some sort of relationship to the concept of depression. Whether that’s through lived experience, witnessing the depression of a friend or loved one or questioning if the tough time they are currently going through themselves, is in fact depression.

As Psychotherapist John-Paul Davies explains on Happiful’s podcast, while the initial route for diagnosing depression should be through a visit to your GP or a Psychiatrist, depression is a condition he encounters regularly in his practice. He’s eager to share how common it is and to underline the constant possibility for change and a different way of being.

“Depression is very understandable based on our physiology, our environments, the media and the type of world we live in. It’s a very human response to somebody’s early life, to current circumstances and grief,” John-Paul notes.

“There are most definitely ways we can move through it, albeit it's a gradual process, but never think that because of what’s happened in the past that you can’t change in the present. There’s always hope and things that we can do to help ourselves.”

So what is depression?

“I would say that as human beings, we're at our happiest when we're in the middle band of feelings, which you might describe as ‘calm and alive’,” John-Paul explains. “However, it’s not always possible for human beings to be in that place. If we go above that ‘calm and alive’ band we might be overly aroused, fearful or angry. If we fall below, then we can feel hopeless, helpless, apathetic and in despair. There can be a lack of physical movement that goes with that feeling too. And I think for me, depression is a situation where somebody has a tendency to fall below ‘calm and alive’.”

The impact of depression, he notes, can be far-reaching too. “Depression can have a profound adverse impact, unfortunately on all areas of life for people,” John-Paul shares. “But there can be a range of depressive experiences, some people experience it mildly while, for other people, it's something that's been around clinically quite severely for months or even years in their lives.”

What can you do to help yourself?

As well as seeking support from your GP, John

What is it, why does it happen, and what signs should I be looking out for? We share everything you need to know about passive suicidal ideation

Passive suicidal ideation is something that many of us experience, but few seriously talk about. Perhaps the thought has crossed your mind, “I wish I could just fall asleep and not wake up,” or “I wish I could die, so I don’t have to deal with this.” These are examples of passive suicidal ideation and, while they are not active plans, and often focus on ways in which someone may die rather than actively cause their own death (such as thoughts of death through an accident or natural causes, rather than suicide), these thoughts can be not only worrying, but can lead to engaging in riskier behaviour without being conscious of it.

Suicidal ideation isn’t an isolated event – it can be a symptom of other mental health issues, such as severe depression, or manic depression for those with a bipolar disorder diagnosis. Here, we’ll explain more about the different types of suicidal ideation, warning signs to look out for, and, crucially, how to then find help.

What’s the difference between passive and active suicidal ideation?

Having suicidal thoughts is a spectrum. For some people, these thoughts may be active: they think about suicide, and may have developed a plan for what they will do. They want to die. For others, it may be passive: they wish they were dead or could die, but do not have any concrete plans.

Neither kind of suicidal ideation should be dismissed. You are still at risk of harm if you have passive suicidal thoughts.

Intent and motivation can change quickly, meaning you may not feel at risk now, but that could change before you realise it or have time to seek help. Studies have suggested that if you experience high levels of depression and suicidality, thoughts of passive and active ideation have the potential to become more severe and dangerous. Experiencing physical illness, a significant decline in your mental health, or an unpredictable event (losing your job, a particularly bad day, fighting with a loved one) could trigger your thoughts to become active.

How many people experience passive suicidal ideation?

Passive suicidal thoughts are more common than many of us realise. Worldwide, around 9% of us will experience suicidal ideation at some point in our lives. Within the past 12 months, that sat at around 2%. One US study found that 4% of adults aged 18 and over have thought about suicide, with those aged 18–25 the most likely to have had such thoughts within the past 12 months.

As of 2020, around 10 in every 100,000 deaths were contributed to suicide in England. For men, that rate was much higher (15.3 per 100,000) compared to women (4.9 per 100,000). Men aged 45–49 have the highest suicide rate (23.8 per 100,000). Worldwide, the World Health Organisation estimates that one in every 100 deaths is a result of suicide.

All this to say, suicide is something that has touched many lives, and it’s something that we need to take seriously.

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When the time comes to end a course of antidepressants, many people face concerns about what’s next. So we’re laying out what to expect

“I have experienced anxiety since childhood and developed depression in my 20s, after the birth of my second child. Following my divorce, I became more affected, at times struggling to cope with my work which involved travelling around the UK delivering training in, ironically, mental health and exercise. Eventually, I went to my GP, who recommended antidepressants and counselling.”

Sarah Bolitho’s story is likely to sound familiar to many. In the UK, the latest NHS statistics from January to March 2021 show that there were 20.2 million antidepressant drugs prescribed, a 1% decrease from 20.5 million items in the previous quarter, and a 3% increase from 19.6 million items for the same quarter in 2019/20. They’re incredibly common, and yet mental health stigma means that there are often unanswered questions about the experience floating around.

One such question is what to expect when you end a course of antidepressants? The length of time an individual will need to take antidepressants varies from person to person, and while one may take them for up to six months, another may continue to take them for five years, or more. But how can you tell when the right time to stop taking them is for you? What should you expect? And how can you do it safely? Read on to find out. But, first, we need to take some time to get to know what we’re dealing with.

What are antidepressants?

“Antidepressants are medications prescribed for depression, anxiety disorders, obsessive-compulsive disorder (OCD), and some other mental and physical health conditions,” The Royal College of Psychiatrists tells us. “There are almost 30 different kinds of antidepressants. We don’t know for certain how antidepressants work, but they affect the activity of certain chemicals in our brains called neurotransmitters. These pass signals from one brain cell to another. The neurotransmitters most affected by antidepressants are serotonin and noradrenaline.”

And antidepressants can make a huge difference in individuals’ lives. A six-year study by the NIHR Oxford Health Biomedical Research Centre, that looked at the results of more than 500 trials, found that around 60% of people respond to the drugs by two months, with about a 50% reduction in their symptoms.

When is the right time to stop?

From week five of taking them, Sarah recalls feeling more positive, and she noticed that her symptoms were reducing. She had also started counselling at this point, and was gradually starting to identify areas in her life that needed to change, and develop new coping skills. She continued to take the medication for about three years before she decided to speak to her GP.

“I was concerned about coming off the medication, as I was not sure if I would experience depression again, or what the effects of withdrawing would be,” she shares. “I am thankful that I was given good advice to do this slowly – I’m so glad I took the time, as it gave me the confidence that my symptoms were gone and that I could cope.”

According to The Royal College of Psychi

Seasonal affective disorder, low mood and depression associated with autumn and winter, can make the months ahead challenging, so learn how to spot the early signs

Summer came to a sudden end this year, bringing with it grey clouds, cool spells, and plenty of rain. Of course, after the heat we experienced in July and August, a drop in temperature is perhaps welcomed, but as we set our sights on the challenges this particular winter season is due to bring, it’s fair to say that the promise of cosy winter days in, curled up with hot drinks, isn’t quite cutting it.

Adding onto that, seasonal affective disorder (SAD) affects approximately two million people in the UK and 12 million people across Europe, the NHS reports. Sometimes called ‘winter blues’, SAD is categorised as a drop in mood and energy prompted by darker, winter weather. It runs across a wide spectrum. For some, it’s mild, for others it can lead to depression, anxiety, sleeplessness, and low self-esteem.

There are a number of treatment avenues available, from so-called ‘SAD lamps’ to medication. And if you think you’re experiencing it, it’s a good idea to speak to your GP or a mental health professional.

As we’re just tipping over into the autumn and winter months, learn the early signs of SAD, so that you can take action before it settles in.

1. You can trace your feelings

If you’ve started to feel low, can you trace when those feelings began, or when they intensified? Was it with the change of the seasons?

You might also want to think back over the years. In general, are there any patterns that you can pick out? Do you often struggle with a certain time of year, and does that time come with additional challenges (for example, a stressful period at work, difficult dates following bereavement, etc.), or is the common theme the weather?

It might be worth starting a record of your low mood, as you might find that it’s boosted on periodic sunny days, which might be a sign that you’re experiencing SAD.

2. Easy tasks start feeling harder

It feels as though, all of a sudden, the things you used to be able to do with ease take a lot more effort, and you’re feeling the brunt of it. Perhaps it’s at work, where getting through to the end of the day feels like a massive chore, or around the home where the things that you used to quickly tick off your to-do list now sit there undone.

When we’re struggling with our mental health, performing to our full capacity is easier said than done, and it can take a lot more out of us to do the things that once came easily.

3. Your sleep is disrupted

A common side effect of SAD, our sleep patterns tell us a lot about our overall wellbeing. Have you noticed that your sleep hasn’t been quite the same since the weather changed? It could be that you’re waking up in the mi

Breakups are rarely easy. But what if moving on after a relationship isn’t as easy for you as it is for others?

Ending a relationship can be… tough. Perhaps you’ve drifted apart and things have ended amicably; maybe communication had broken down, or your emotional connection has faded over time. Infidelity, money troubles, toxic or excessive jealousy, trouble making things work long-distance – there are more reasons than you can count for a relationship to end. Yet, for many of us, that doesn’t make the healing process any easier.

The average American adult will experience three major relationship breakups during their lifetime, taking six months to get over each fully. Yet, according to research, on average we give ourselves just four days to ‘wallow in sadness’ (or rather, grieve for the relationship we have lost) immediately after it has ended. For those ending a more long-term committed relationship like a marriage, studies have estimated it can take up to 18 months to feel ready to move on.

So, why do some of us seem to be more affected than others when it comes to moving on from our relationships? And could taking longer to ‘get over’ your ex be a sign of something more serious?

Relationship breakups: What’s normal?

The end of a relationship can come with huge life changes. If you shared a home, you may find yourself needing to move; if you shared bills, you’ll need to take another look at your finances. If things weren’t amicable, who gets to ‘keep’ your shared friends? And that’s not even touching the emotional turmoil that can leave you feeling anxious, angry, sad, overwhelmed, bitter, confused, hurt, and heartbroken.

While there’s no ‘right’ or ‘wrong’ way to experience a breakup with someone, there are aspects which can make it feel easier for both of you. You may feel more able and ready to move on if:

• Your relationship broke up face-to-face. Ghosting, or being rejected by text, call, or email can stop you from having the chance to express yourself and your feelings, and have a final opportunity to go through things together. This can stop you from feeling able to move on, as you may feel like you have unfinished business, or too much has been left unsaid.
• You both had the chance to be honest. Having a real reason for the ending of a relationship (without things going into too much detail, or feeling too brutal) can help to create a sense of catharsis. You may still be unhappy, or may not even fully agree with that reason, but knowing the why can be a big help in moving on.
• You had a clean break. When one partner tries to hang on, insists on ‘fixing’ or ‘saving’ your relationship, or even tries to argue that your reasons or feelings that have led to this breakup aren’t valid, it can cause more harm than good. Even if you want to remain friends (something 60% of us manage, according to one 2017 study), it can be easier if you don't.
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