There are a variety of mental health conditions, all with different presentations, however, they are all generally characterised by a combination of abnormal thoughts, perceptions, emotions, behaviours, and relationships with others.

The most common form of mental health conditions are depression, bipolar affective disorder, schizophrenia, and other psychoses. Other conditions that would also fall into this spectrum would be dementia, intellectual disabilities and developmental disorders such as autism.

Depression is a common mental disorder and one of the main causes of disability worldwide. Globally, the World Health Organisation estimate that 300 million people are affected by depression.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) V a major depressive disorder needs to have five (or more) of the following symptoms to be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

It is of note that that symptoms that are clearly attributable to another medical conditions cannot be considered.

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, Prevention programmes have been shown to reduce depression, both for children (e.g. through protection and psychological support following physical and sexual abuse) and adults (e.g. through psychosocial assistance after disasters and conflicts). or a suicide attempt or a specific plan for committing suicide.

Furthermore that:

• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The episode is not attributable to the physiological effects of a substance or to another medical condition.

It is of note that responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should also be carefully considered. This decision inevitably requires the exercise of clinical judgment based on the individual’s history and the cultural norms for the expression of distress in the context of loss.

• The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
• There has never been a manic episode or a hypomanic episode.

Mild to moderate depression can be effectively treated with talking therapies, such as cognitive behaviour therapy/psychotherapy. Antidepressants can be an effective form of treatment for moderate to severe depression but are not considered to be the first line of treatment for cases of mild depression.

Mental health and happiness are intrinsically linked and although there is evidence that suggest that our genes influence about 50% of the variation in our personal happiness the other 50% can be accounted for by our daily activities and the conscious choices we make and by our environment and income.

There is a wide range of proven actions we can take to boost happiness, both for ourselves and others. Action for Happiness, a movement whose patron is the Dalai Lama have categorised into 10 areas that they consider are vital for happiness and is taken from their book 10 Keys to Happier Living.

Giving

Caring about others is fundamental to our happiness. Helping other people is not only good for them, it’s good for us too. It makes us happier and can help to improve our health. Giving also creates stronger connections between people and helps to build a happier society for everyone. And it’s not all about money – we can also give our time, ideas and energy. So, if you want to feel good, do good!

Relating

Relationships with other people are the most important thing for our happiness. People with strong relationships are happier, healthier and live longer. Our close relationships with family and friends provide love, meaning, support and increase our feelings of self-worth. Our broader social networks bring a sense of belonging. So, it’s vital that we take action to strengthen our relationships and make new connections.

Exercise

Body and mind are connected. Being active makes us happier as well as being good for our physical health. It instantly improves our mood and can even lift us out of a depression. We don’t all have to run marathons – there are simple things we can do to be more active each day. We can also boost our well-being by spending time outdoors, eating healthily, unplugging from technology and getting enough sleep!

Awareness

you ever felt there must be more to life? Well good news, there is! And it’s right here in front of us. We just need to stop and take notice.

Learning to be more mindful and aware does wonders for our well-being, whether it’s on our walk to work, the way we eat or in our relationships. It helps us get in tune with our feelings and stops us dwelling on the past or worrying about the future – so we get more out of the day-to-day.

Trying Out

Learning affects our well-being in lots of positive ways. It exposes us to new ideas and helps us stay curious and engaged. It also gives us a sense of accomplishment and helps boost our self-confidence and resilience. There are many ways to learn new things throughout our lives, not just through formal qualifications. We can share a skill with friends, join a club, learn to sing, play a new sport and so much more

Direction

Feeling good about the future is really important for our happiness. We all need goals to motivate us and these have to be challenging enough to excite us, but also achievable. If we try to attempt the impossible this creates unnecessary stress. Choosing meaningful but realistic goals gives our lives direction and brings a sense of accomplishment and satisfaction when we achieve them

Resilience

All of us have times of stress, loss, failure or trauma in our lives. How we respond to these events has a big impact on our well-being. We often cannot choose what happens to us, but we can choose how we react to what happens. In practice, it’s not always easy, but one of the most exciting findings from recent research is that resilience, like many other life skills, can be learned

Positive Emotions

Emotions – like joy, gratitude, contentment, inspiration, and pride – don’t just feel good when we experience them. They also help us perform better, broaden our perception, increase our resilience and improve our physical health. So, although we need to be realistic about life’s ups and downs, it helps to focus on the good aspects of any situation – the glass half full rather than the glass half empty.

Acceptance

No one’s perfect. But so often we compare a negative view of ourselves with an unrealistic view of other people. Dwelling on our flaws – what we’re not rather than what we’ve got – makes it much harder to be happy. Learning to accept ourselves, warts and all, and being kinder to ourselves when things go wrong, increases our enjoyment of life, our resilience, and our well-being. It also helps us accept others as they are.

Meaning

People who have meaning and purpose in their lives are happier, feel more in control and get more out of what they do. They also experience less stress, anxiety, and depression. But where do we find meaning and purpose? It might come from doing a job that makes a difference, our religious or spiritual beliefs, or our family. The answers vary for each of us but they all involve being connected to something bigger than ourselves

If you or someone you know is going through a bout of depression, then is vital that they get professional help. Accessing your local GP can be the first step or use some of the contact details below

UK Resources

There are several phone helplines in the UK. These free helplines are there to help individuals when they are feeling down or desperate and unless it says otherwise, they’re open 24 hours a day, every day.

Samaritans – for everyone – Call 116 123 – Email jo@samaritans.org

Campaign Against Living Miserably (CALM) – for men – Call 0800 58 58 58 – 5 pm to midnight every day

Papyrus – for people under 35 – Call 0800 068 41 41 – Monday to Friday 10 am to 10 pm, weekends 2 pm to 10 pm, bank holidays 2 pm to 5 pm. Text 07786 209697. Email pat@papyrus-uk.org

Childline – for children and young people under 19 – Call 0800 1111 – the number won’t show up on your phone bill

The Silver Line – for older people  – Call 0800 4 70 80 90

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