Depression and learning disability
Depression is a common mental disorder that causes people to experience depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
Depression is different from feeling down or unhappy. Unhappiness is something which everyone feels at one time or another, usually due to a particular cause. A person experiencing depression will experience intense emotions of anxiety, hopelessness, negativity and helplessness, and the feelings stay with them instead of going away.
Depression can happen to anyone. Many successful and famous people who seem to have everything going for them battle with these feelings. Depression also affects people of every age.
Half of the people who have depression will only experience it once but for the other half it will happen more than once. The length of time that it takes to recover ranges from around six months to a year or more.
Living with depression is difficult for those who suffer from it and for their family, friends, and colleagues. It can be difficult to know if you are depressed and what you can do about it.
For people with learning disabilities the same issues can lead to depression that affect all of us. Things like a lack of social networks, loss such as bereavement or change of support staff, realising they have fewer opportunities such as being able to work or have a family can all lead to us feeling depressed.
- Tiredness and loss of energy
- Sadness that doesn’t go away
- Loss of self-confidence and self-esteem
- Difficulty concentrating
- Not being able to enjoy things that are usually pleasurable or interesting
- Feeling anxious all the time
- Avoiding other people, sometimes even your close friends
- Feelings of helplessness and hopelessness
- Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual
- Very strong feelings of guilt or worthlessness
- Finding it hard to function at work/college/school
- Loss of appetite
- Loss of sex drive and/or sexual problems
- Physical aches and pains
- Thinking about suicide and death
Depression can happen suddenly as a result of physical illness, experiences dating back to childhood, unemployment, bereavement, family problems or other life-changing events.
Examples of chronic illnesses linked to depression include heart disease, back pain and cancer. Pituitary damage, a treatable condition which frequently follows head injuries, may also lead to depression.
Sometimes, there may be no clear reason for depression but, whatever the original cause, identifying what affects how the person feels and how you feel and the things that are likely to trigger depression is an important first step.
Types of depression
There are several types of depression, some of which are listed below.
- Mild depression
- Major depression
- Bi-polar disorder
- Post-natal depression
- Seasonal Affective Disorder (SAD)
Research suggests that people with learning disabilities are more likely than the general population to experience a mental health issue such as depression. Factors such as fewer psychological and material resources to deal with adversity and lack of meaningful activities in their lives can increase the chances of people with learning disabilities developing depression (Feeling Down improving the mental health of people with learning disabilities, 2013).
Whilst around 6% of the mainstream population experiences depression in any one year (NHS), studies suggest that up to 20% of people with learning disabilities will experience depression (Sikabofori and Anupama, 2012).
See our A-Z on mental health for more information about this.
The first step in getting treatment will normally be to visit the GP who will ask a number of questions about how depression is affecting the person mentally and physically. The first appointment can feel difficult so it might be helpful if the person writes down what they have been experiencing before they go. Some people find it helpful to take a friend or family member.
Our Feeling Down guide can help with this as it includes space to write how the person is feeling physical and mentally and questions they may want to ask the GP.
It is important that the person and their doctor agree how best to treat the issues. Being as open as they can about their symptoms and how they are affecting them will really help. The GP may suggest they see a specialist such as a mental health nurse, psychiatrist or psychologist.
For mild depression, medication is not recommended because the risks could outweigh the benefits. The GP has guidelines for treating depression and these recommend 'watchful waiting' initially, to see if the depression goes away.
There are several different kinds of talking therapy. Their GP can advise them about which they might find most helpful.
In the past counselling was not often offered to people with learning disabilities as it was not felt that they would benefit from it. Thankfully this outdated way of thinking is being addressed and Improving Access to Psychological Therapies are working to ensure that counselling is offered to people with learning disabilities and that it is offered in an accessible way.
You can find out more about IAPT here http://www.iapt.nhs.uk/silo/files/learning-disabilities-positive-practice-guide.pdf