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01-16-2014, 02:00 PM
(This post was last modified: 09-01-2022, 01:02 AM by Fearless Community.
Edit Reason: Fixed Encoding
)
This might seem inappropriate to some, but remember this is a community with a very diverse user base, lots of people facing lots of differences in life, and maybe this thread will help someone out, that's the intention of it. The information isn't originally mine, but has been collated here in the hopes it might help someone facing a difficult time, after all computer issues aren't the only thing someone might need to talk about.
I thought I would do a write up of my information on the matter of depression and share it with everyone. This information is by no means everything to know, but it’s a good starting point.
Anyway, in this “guide” style write up, I’m going to look at the following things:
1. Symptoms, Types And Diagnosis Of Depression.
2. Explanations Of Why We Get Depressed.
3. Ways of Dealing With Depression.
4. A Final Word And Some Links.
I also think it’d be cool if people would use this thread as a place to talk about depression and those who used to be depressed but are now happier can share their story, and those who just want to talk about their issues can safely do so. Please note that it may not all apply to you and I certainly don’t expect many people to read it all, but you will find that the more of it you read the better your comprehension and understanding of depression will become. It’s likely that this increased knowledge will help you in dealing with it.
1. Symptoms
I think that when people consider the symptoms of depression, they tend to only consider the low mood and sadness. But there are other symptoms too, some are listed below. It’s important to note that having all or none of these symptoms does not give a decisive overview of your well being, they are just guidelines. Please remember, if you are worried about your mental well being then do not be afraid to seek face-to-face professional help.
• Disruption in sleep, not just in terms of insomnia but it can also be over sleeping.
• A change in appetite, either a loss of it or an increase due to “comfort eating”.
• Loss of drive and a drop in motivation are also common
• Low self-esteem, a lack of confidence and negative thoughts/views.
• A drop in energy and activity levels.
• Suicidal thoughts/tendencies.
Obviously, we all go through one or more of these from time to time, which it’s important you see these only as a guide and not a definite diagnosis.
Types and Diagnosis
There are 3 main types of depression:
• Unipolar or Major Depression :- this is the typical view of depression, and is a mix of the above mentioned symptoms for a continued period.
• Chronic Depression :- A milder form of depression then Unipolar, where less of the guideline symptoms are required to be diagnosed.
• Bipolar or Manic Depression :- This involves “ups and downs”. A patient goes through bouts of mania, an extremely elevated mood, and periods of low, depressive feelings.
A doctor will analyze a patient, using criteria similar to the above symptoms, as long with guidelines set out by mental health organizations, such as DSM and ICD. I won’t write about them here, but it’s easy to find more information on them on the web.
In terms of professional help with diagnosing depression, the reliability of was found to be fairly good, with researchers using test-retest methods to look how the diagnostic of a depressive person changed on different days, and they also looked at how the diagnostic skills of professionals differed. This is important, because you need to ensure that doctors are all making the same sort of diagnosis as each other, so that the chance of someone being wrongly diagnosed is minimal. Otherwise, it can be an issue, for example, the validity of diagnostic is challenged by the skill of the doctor. A GP, whilst well trained, is not an expert in depression. It is much easier for them to just say the person is depressed and give them anti-depressants as it is quick and convenient. Therefore someone could wrongly be diagnosed. Also, it’s hard to measure the symptoms of a patient, for example, they could just be a naturally lazy person as opposed to developing low energy levels. The issue is that there is no point trying to deal with depression if it’s not what you’re suffering from and can result in underlying issues/causes being over looked.
2. Why/How We Get Depressed
There are 3 main approaches to explaining depression. If you’ve read my other work on addiction, then you should already be familiar with them. These 3 approaches are known as biological, cognitive, and behaviorist models. I will look at them to help understand different reasons of what causes depression, but the behaviorist theory is combined with some parts of the cognitive theory, which will be explained later on.
Biological Model
Genetics
This is the idea that your genetics cause your depression. Research by Gershon has found evidence suggesting that depression is up to 3 times as likely in families with a history of the disorder then compared to the general population. Also, research by Allen found, through work on identical twins compared to non-identical twins, that the concordance rate for Bipolar Depression is about 70%, which is very high. Unipolar, on the other hand, is about 40%. Similar research has found results that support these findings. However, there are obvious issues with this research. For example, Allen’s research was done in the 70’s, where it wasn’t easy to distinguish between identical and non-identical twins. It had to be done based on aesthetics only, not DNA. Also, environment may be a factor, since identical twins tend to live much closer lives, i.e. sharing rooms or friendship groups. However, work by Wender et al found evidence to support genetics being more important than environment. He looked at sufferers of depression that were adopted and found that their biological parents were 8 times more likely to be depressed then their adopted parents. So it’s likely that genetics do play some role in depression, but it is not a deciding factor.
Permissive Amine Theory
This theory is based on evidence that the level of Nor-Adrenaline (NA) affects mood, where too much NA causes mania and too little causes depression. However, this isn’t all there is to it. Kety, who created the Permissive Amine Theory, concluded that Serotonin was also very important. He believed that Serotonin controlled the level of NA. So, a high level of serotonin would stop the NA from fluctuating, and that low Serotonin meant NA would fluctuate and thus cause the change from bouts of depression to bouts of mania, which we would recognize as bi-polar depression.
Evidence from both Bunney and Kety has shown abnormal NA levels in sufferers of depression. However, it could be that the abnormal NA levels are a result of the mood changes, rather than the NA causing them. This is obviously a big issue for the theory and is hard to either prove or disprove. Another major issue with it is that not all depression sufferers show reduced levels of these chemicals, so it clearly can’t be the only aspect to depression.
Hormones
Hormones are thought to be important in explaining one possible reason why women are much more likely to become depressed. If we look at things like PMS and PND, we see that the hormone levels in women often change. It’s thought that this constant change could be affecting mood in some way, which suggests the Permissive Amine Theory is much more complex then what is described above.
Behaviorist-Cognitive Model
Here we see a combination of the cognitive approach with the behaviorist approach. I will look at a purely cognitive model afterwards, which has a wider range of theories and is more expansive then this approach.
Learned Helplessness
Seligman performed a study in which dogs were given shocks to their feet. There were two groups, as to compare what would happen in the two scenarios that follow. In the control group, the dogs could jump a barrier to escape the shocks, but the other groups barrier was too high for them to jump. For better understanding, I’ve attached a picture of what one group could do to escape the shocks.
Later on, in a follow up study, both groups were now put in a box with a barrier they could jump over. Most of the dogs from the group with the high barrier first time round made no attempt to avoid the shocks. Their past experience had taught them they had no control of the shocks. They had learnt to be helpless.
So how does this apply to humans? Well, work by Hiroto showed that similar results can be seen in a study on humans, but using a loud noise instead of electric shocks. Again, one group had no control the first time via a “broken” volume switch, but then had control the second time, yet most of these still failed to even try to use the volume switch. Whilst this theory does have good evidential support, it lacks the full explanation of depression. For example, not everyone becomes helpless in these situations, and it does not explain why those who blame themselves would suffer from depression, since blaming yourself would imply you see the control as your own and therefore aren’t in a state of learned helplessness.
Cognitive Model
Abramsons Attribution Theory
Abramson et al took the idea that for every experience we have in life, we try and account for using attributions. He believed that depression was because of the way some people attributed their failures. The main 3 attribution variables are listed below, with a look at how depressed people have attributions that are thought to be responsible for their depression.
• Internal or External Attribution :- This is who the person blames for their failures. I.e. In a test, internal is blaming self, external could be blaming the paper.
• Stable or Unstable Attribution :- Stable is the idea things will stay the same and not get better, unstable is the idea that they can get better.
• Global or Specific Attribution :- Global is when you apply the failure to all situations, and specific is when you see it as one off. I.e. I lost this time, so I’ll lose every time.
Obviously, a depressed person would have an internal, stable, global attribution outlook. This means that when they experience a failure, they blame themselves for it, think their current state won’t change, and that the outcome will always be like this. The theory is similar to the Learned Helplessness theory, and you can see the cognitive influence. However, the theory doesn’t explain why some people have such negative attributions. Some research has suggested it’s due to a certain sort of childhood, but this isn’t a full idea and is hard to prove.
All these approaches cover various attributions towards what causes depression, and it's widely agreed that depression is due to multiple factors from all the models. For example, the biological model indicates evidence of a genetic predisposition towards depression, and provides one explanation of why some of us can never get depressed where others struggle greatly with it.
3. Treating Depression
Anti-Depressants
These are by far one of the most infamous treatments for depression, and there are 3 common types. I’ll look at each one below, as well as information on their side effects so you can have a good idea of the pro’s + con’s of each one. Each one is thought to work in the synapse, which I have attached a link to a basic picture of, if you find it helpful.
http://www.histology-world.com/photo...n_synapse2.jpg
I won’t go into detail on how the synapse works, but if you don’t know the basics you may benefit from a quick search on it.
When I talk about side effects and effectiveness of the drugs, it’s more about in general for that type of drug, and is by no means specific to every drug. Furthermore, the information on side effects is by no means complete. It is more a quick indication of the common and more serious ones, but there are many more out there, so you should consider looking at a full list of potential side effects before taking any of these antidepressants.
Also, keep in mind these are aren’t all the categories of drugs, rather the 3 main ones which other types seem to be either derived from or very similar too.
Overall, these drugs all take a few weeks to work, rather than being instant like you might assume. This leads us to suggest that they work in a more complex way then we think, since we don’t know exactly how they work. The above information is simply the generally accepted way that they think the drugs work. But they tend to be quite cheap and easy to take, as opposed to some of the other methods I’ll look at. They have been shown to be effective in the short term, but they seem to have a very high relapse rate. I’ll address this in more detail later on.
Cognitive-Behavior Therapy (CBT)
The aim of CBT is ‘cognitive reconstruction’. The therapist and the client work on recognizing and dealing with the negative beliefs of the client. The exact style of CBT vary depending on the therapist, but they all tend to follow the same sort of pattern, where they teach the client to:
1. Be aware of their negative and ‘automatic’ cognitions.
2. Understand the link between thoughts, mood, and behavior.
3. Work on replacing/modifying biased thoughts with realistic ones to remove the clients distorted thinking and views.
The therapist will set the client ‘homework’ in which they set clear, achievable, and realistic goals, such as socializing, challenging automatic thoughts, etc. This helps bring the therapy into everyday life rather than just the therapeutic sessions. Also, the client is encouraged to ‘get out there’ in the way of enjoyable activities, such as sports, going to the cinema, etc. Exercise, in particular, has been found to be very useful in helping sufferers of depression and is recommend by most CBT therapists. CBT is by far one of the most common psychological treatments for a range of issues, not just depression. A good therapist and a dedicated client can see amazing results and I recommend it to anyone suffer from depression.
CBT vs. Drugs
This is an important aspect to the treatments, which is most effective. Here are the results of a study done by Hollon, where he compared 16 weeks of SSRI’s with 16 weeks of CBT. He also did a third variable, in which he maintained the SSRIs. Here the results are seen in the table.
Evidently, CBT has the lowest relapse rate, which means people are less likely to become depressed again after 16 weeks of treatment. Where as in drugs, we see a staggering three quarters of the participants relapsed. This indicates that whilst anti-depressants can be a palliative way of dealing with depression, meaning they deal with the symptoms of depression, but they do not deal with the root causes of the issue
Electro Convulsive Therapy (ECT)
ECT is by far the most controversial treatment of any psychological disorder. The therapy involves electrical currents being passed through the brain for a few seconds, which leads to seizures that usually last for about a minute. This treatment process occurs a few times a week and normally lasts for about a month. It is considered to be the ‘last resort’ style treatment, but is performed on about 10,000 patients each year. Research has shown it to be effective, but some patients claim they had damaged memory from the treatment, and some accounts have described it as “worst then rape”. Cognitive processing is also slowed after treatment, as well as anxiety and fear being present in about a third of patients.
Clearly, in this therapy, it’s hard to tell whether the benefits truly out weight the costs and I would recommend you avoid this unless you feel it completely necessary.
4. A Final Word
Although I have studied depression extensively, I strongly recommend that you seek out face-to-face medical advice if you feel that you are suffering from depression. It might be hard to do, but I would recommend you speak to either your GP or a specialized therapist. If you want to look at getting help online, here are a few sites to get you started:
http://www.findthelight.net/ An online support group
http://www.online-therapy.com An online version of CBT and other therapies.
http://www.samaritans.org/ A very helpful site to find skilled people that you can talk to for free.
You can no doubt find more online, but I thought I would share a couple with you to help get you started. Also, here is a link to a book of self-help for depression, titled “Anxiety & Depression Workbook for Dummies”. It may sound like an amateur book, but it was written by two fully qualified professors and it’s worth a read through if you want to tackle your depression via a cognitive/behaviorist approach:
http://www.megaupload.com/?d=VZSPXXXX
If you have any questions, post them in this thread. Or, if you would rather keep them private, send me a message on my profile. I will try to get back to you as soon as I can.
Just remember although it might seem like it's the end, it isn't, there is help out there, and you are not alone, I can guarantee you people do make it through, and that your experiences are relevant, just because someone has been through worse does not make you weaker or what you've been through any less important.
Thanks for taking the time to read this. Z.
I thought I would do a write up of my information on the matter of depression and share it with everyone. This information is by no means everything to know, but it’s a good starting point.
Anyway, in this “guide” style write up, I’m going to look at the following things:
1. Symptoms, Types And Diagnosis Of Depression.
2. Explanations Of Why We Get Depressed.
3. Ways of Dealing With Depression.
4. A Final Word And Some Links.
I also think it’d be cool if people would use this thread as a place to talk about depression and those who used to be depressed but are now happier can share their story, and those who just want to talk about their issues can safely do so. Please note that it may not all apply to you and I certainly don’t expect many people to read it all, but you will find that the more of it you read the better your comprehension and understanding of depression will become. It’s likely that this increased knowledge will help you in dealing with it.
1. Symptoms
I think that when people consider the symptoms of depression, they tend to only consider the low mood and sadness. But there are other symptoms too, some are listed below. It’s important to note that having all or none of these symptoms does not give a decisive overview of your well being, they are just guidelines. Please remember, if you are worried about your mental well being then do not be afraid to seek face-to-face professional help.
• Disruption in sleep, not just in terms of insomnia but it can also be over sleeping.
• A change in appetite, either a loss of it or an increase due to “comfort eating”.
• Loss of drive and a drop in motivation are also common
• Low self-esteem, a lack of confidence and negative thoughts/views.
• A drop in energy and activity levels.
• Suicidal thoughts/tendencies.
Obviously, we all go through one or more of these from time to time, which it’s important you see these only as a guide and not a definite diagnosis.
Types and Diagnosis
There are 3 main types of depression:
• Unipolar or Major Depression :- this is the typical view of depression, and is a mix of the above mentioned symptoms for a continued period.
• Chronic Depression :- A milder form of depression then Unipolar, where less of the guideline symptoms are required to be diagnosed.
• Bipolar or Manic Depression :- This involves “ups and downs”. A patient goes through bouts of mania, an extremely elevated mood, and periods of low, depressive feelings.
A doctor will analyze a patient, using criteria similar to the above symptoms, as long with guidelines set out by mental health organizations, such as DSM and ICD. I won’t write about them here, but it’s easy to find more information on them on the web.
In terms of professional help with diagnosing depression, the reliability of was found to be fairly good, with researchers using test-retest methods to look how the diagnostic of a depressive person changed on different days, and they also looked at how the diagnostic skills of professionals differed. This is important, because you need to ensure that doctors are all making the same sort of diagnosis as each other, so that the chance of someone being wrongly diagnosed is minimal. Otherwise, it can be an issue, for example, the validity of diagnostic is challenged by the skill of the doctor. A GP, whilst well trained, is not an expert in depression. It is much easier for them to just say the person is depressed and give them anti-depressants as it is quick and convenient. Therefore someone could wrongly be diagnosed. Also, it’s hard to measure the symptoms of a patient, for example, they could just be a naturally lazy person as opposed to developing low energy levels. The issue is that there is no point trying to deal with depression if it’s not what you’re suffering from and can result in underlying issues/causes being over looked.
2. Why/How We Get Depressed
There are 3 main approaches to explaining depression. If you’ve read my other work on addiction, then you should already be familiar with them. These 3 approaches are known as biological, cognitive, and behaviorist models. I will look at them to help understand different reasons of what causes depression, but the behaviorist theory is combined with some parts of the cognitive theory, which will be explained later on.
Biological Model
Genetics
This is the idea that your genetics cause your depression. Research by Gershon has found evidence suggesting that depression is up to 3 times as likely in families with a history of the disorder then compared to the general population. Also, research by Allen found, through work on identical twins compared to non-identical twins, that the concordance rate for Bipolar Depression is about 70%, which is very high. Unipolar, on the other hand, is about 40%. Similar research has found results that support these findings. However, there are obvious issues with this research. For example, Allen’s research was done in the 70’s, where it wasn’t easy to distinguish between identical and non-identical twins. It had to be done based on aesthetics only, not DNA. Also, environment may be a factor, since identical twins tend to live much closer lives, i.e. sharing rooms or friendship groups. However, work by Wender et al found evidence to support genetics being more important than environment. He looked at sufferers of depression that were adopted and found that their biological parents were 8 times more likely to be depressed then their adopted parents. So it’s likely that genetics do play some role in depression, but it is not a deciding factor.
Permissive Amine Theory
This theory is based on evidence that the level of Nor-Adrenaline (NA) affects mood, where too much NA causes mania and too little causes depression. However, this isn’t all there is to it. Kety, who created the Permissive Amine Theory, concluded that Serotonin was also very important. He believed that Serotonin controlled the level of NA. So, a high level of serotonin would stop the NA from fluctuating, and that low Serotonin meant NA would fluctuate and thus cause the change from bouts of depression to bouts of mania, which we would recognize as bi-polar depression.
Evidence from both Bunney and Kety has shown abnormal NA levels in sufferers of depression. However, it could be that the abnormal NA levels are a result of the mood changes, rather than the NA causing them. This is obviously a big issue for the theory and is hard to either prove or disprove. Another major issue with it is that not all depression sufferers show reduced levels of these chemicals, so it clearly can’t be the only aspect to depression.
Hormones
Hormones are thought to be important in explaining one possible reason why women are much more likely to become depressed. If we look at things like PMS and PND, we see that the hormone levels in women often change. It’s thought that this constant change could be affecting mood in some way, which suggests the Permissive Amine Theory is much more complex then what is described above.
Behaviorist-Cognitive Model
Here we see a combination of the cognitive approach with the behaviorist approach. I will look at a purely cognitive model afterwards, which has a wider range of theories and is more expansive then this approach.
Learned Helplessness
Seligman performed a study in which dogs were given shocks to their feet. There were two groups, as to compare what would happen in the two scenarios that follow. In the control group, the dogs could jump a barrier to escape the shocks, but the other groups barrier was too high for them to jump. For better understanding, I’ve attached a picture of what one group could do to escape the shocks.
Later on, in a follow up study, both groups were now put in a box with a barrier they could jump over. Most of the dogs from the group with the high barrier first time round made no attempt to avoid the shocks. Their past experience had taught them they had no control of the shocks. They had learnt to be helpless.
So how does this apply to humans? Well, work by Hiroto showed that similar results can be seen in a study on humans, but using a loud noise instead of electric shocks. Again, one group had no control the first time via a “broken” volume switch, but then had control the second time, yet most of these still failed to even try to use the volume switch. Whilst this theory does have good evidential support, it lacks the full explanation of depression. For example, not everyone becomes helpless in these situations, and it does not explain why those who blame themselves would suffer from depression, since blaming yourself would imply you see the control as your own and therefore aren’t in a state of learned helplessness.
Cognitive Model
Abramsons Attribution Theory
Abramson et al took the idea that for every experience we have in life, we try and account for using attributions. He believed that depression was because of the way some people attributed their failures. The main 3 attribution variables are listed below, with a look at how depressed people have attributions that are thought to be responsible for their depression.
• Internal or External Attribution :- This is who the person blames for their failures. I.e. In a test, internal is blaming self, external could be blaming the paper.
• Stable or Unstable Attribution :- Stable is the idea things will stay the same and not get better, unstable is the idea that they can get better.
• Global or Specific Attribution :- Global is when you apply the failure to all situations, and specific is when you see it as one off. I.e. I lost this time, so I’ll lose every time.
Obviously, a depressed person would have an internal, stable, global attribution outlook. This means that when they experience a failure, they blame themselves for it, think their current state won’t change, and that the outcome will always be like this. The theory is similar to the Learned Helplessness theory, and you can see the cognitive influence. However, the theory doesn’t explain why some people have such negative attributions. Some research has suggested it’s due to a certain sort of childhood, but this isn’t a full idea and is hard to prove.
All these approaches cover various attributions towards what causes depression, and it's widely agreed that depression is due to multiple factors from all the models. For example, the biological model indicates evidence of a genetic predisposition towards depression, and provides one explanation of why some of us can never get depressed where others struggle greatly with it.
3. Treating Depression
Anti-Depressants
These are by far one of the most infamous treatments for depression, and there are 3 common types. I’ll look at each one below, as well as information on their side effects so you can have a good idea of the pro’s + con’s of each one. Each one is thought to work in the synapse, which I have attached a link to a basic picture of, if you find it helpful.
http://www.histology-world.com/photo...n_synapse2.jpg
I won’t go into detail on how the synapse works, but if you don’t know the basics you may benefit from a quick search on it.
When I talk about side effects and effectiveness of the drugs, it’s more about in general for that type of drug, and is by no means specific to every drug. Furthermore, the information on side effects is by no means complete. It is more a quick indication of the common and more serious ones, but there are many more out there, so you should consider looking at a full list of potential side effects before taking any of these antidepressants.
Also, keep in mind these are aren’t all the categories of drugs, rather the 3 main ones which other types seem to be either derived from or very similar too.
Overall, these drugs all take a few weeks to work, rather than being instant like you might assume. This leads us to suggest that they work in a more complex way then we think, since we don’t know exactly how they work. The above information is simply the generally accepted way that they think the drugs work. But they tend to be quite cheap and easy to take, as opposed to some of the other methods I’ll look at. They have been shown to be effective in the short term, but they seem to have a very high relapse rate. I’ll address this in more detail later on.
Cognitive-Behavior Therapy (CBT)
The aim of CBT is ‘cognitive reconstruction’. The therapist and the client work on recognizing and dealing with the negative beliefs of the client. The exact style of CBT vary depending on the therapist, but they all tend to follow the same sort of pattern, where they teach the client to:
1. Be aware of their negative and ‘automatic’ cognitions.
2. Understand the link between thoughts, mood, and behavior.
3. Work on replacing/modifying biased thoughts with realistic ones to remove the clients distorted thinking and views.
The therapist will set the client ‘homework’ in which they set clear, achievable, and realistic goals, such as socializing, challenging automatic thoughts, etc. This helps bring the therapy into everyday life rather than just the therapeutic sessions. Also, the client is encouraged to ‘get out there’ in the way of enjoyable activities, such as sports, going to the cinema, etc. Exercise, in particular, has been found to be very useful in helping sufferers of depression and is recommend by most CBT therapists. CBT is by far one of the most common psychological treatments for a range of issues, not just depression. A good therapist and a dedicated client can see amazing results and I recommend it to anyone suffer from depression.
CBT vs. Drugs
This is an important aspect to the treatments, which is most effective. Here are the results of a study done by Hollon, where he compared 16 weeks of SSRI’s with 16 weeks of CBT. He also did a third variable, in which he maintained the SSRIs. Here the results are seen in the table.
Evidently, CBT has the lowest relapse rate, which means people are less likely to become depressed again after 16 weeks of treatment. Where as in drugs, we see a staggering three quarters of the participants relapsed. This indicates that whilst anti-depressants can be a palliative way of dealing with depression, meaning they deal with the symptoms of depression, but they do not deal with the root causes of the issue
Electro Convulsive Therapy (ECT)
ECT is by far the most controversial treatment of any psychological disorder. The therapy involves electrical currents being passed through the brain for a few seconds, which leads to seizures that usually last for about a minute. This treatment process occurs a few times a week and normally lasts for about a month. It is considered to be the ‘last resort’ style treatment, but is performed on about 10,000 patients each year. Research has shown it to be effective, but some patients claim they had damaged memory from the treatment, and some accounts have described it as “worst then rape”. Cognitive processing is also slowed after treatment, as well as anxiety and fear being present in about a third of patients.
Clearly, in this therapy, it’s hard to tell whether the benefits truly out weight the costs and I would recommend you avoid this unless you feel it completely necessary.
4. A Final Word
Although I have studied depression extensively, I strongly recommend that you seek out face-to-face medical advice if you feel that you are suffering from depression. It might be hard to do, but I would recommend you speak to either your GP or a specialized therapist. If you want to look at getting help online, here are a few sites to get you started:
http://www.findthelight.net/ An online support group
http://www.online-therapy.com An online version of CBT and other therapies.
http://www.samaritans.org/ A very helpful site to find skilled people that you can talk to for free.
You can no doubt find more online, but I thought I would share a couple with you to help get you started. Also, here is a link to a book of self-help for depression, titled “Anxiety & Depression Workbook for Dummies”. It may sound like an amateur book, but it was written by two fully qualified professors and it’s worth a read through if you want to tackle your depression via a cognitive/behaviorist approach:
http://www.megaupload.com/?d=VZSPXXXX
If you have any questions, post them in this thread. Or, if you would rather keep them private, send me a message on my profile. I will try to get back to you as soon as I can.
Just remember although it might seem like it's the end, it isn't, there is help out there, and you are not alone, I can guarantee you people do make it through, and that your experiences are relevant, just because someone has been through worse does not make you weaker or what you've been through any less important.
Thanks for taking the time to read this. Z.
![[Image: JrWpsNC.png]](https://i.imgur.com/JrWpsNC.png)
![[Image: fgfcrai.png]](https://i.imgur.com/fgfcrai.png)
.
![[Image: H9hqjyZ.png]](https://i.imgur.com/H9hqjyZ.png)
