Depression and anxiety

We can all feel low or anxious from time to time, and it's not usually a cause for concern. But if these feelings aren't going away and they start to affect your daily life, you should seek help and support.

What is depression?

Depression is more common than many people realise – it affects 1 in 6 people. We all feel low or out of sorts every once in a while, but if these feelings last a long time or keep returning, or if they start to impact your day-to-day life, you should seek professional support because this could be depression.

Being depressed can show itself in many different ways and each person's experience will be different. Symptoms include:

• feeling less able to talk to people, needing to be quiet, preferring to be alone more than usual, or losing interest in things
• crying more than usual, or over things that wouldn't normally make you upset
• feeling pessimistic, hopeless or guilty
• having difficulty getting restful sleep – whether this means waking up early and not being able to fall back asleep or insomnia
• not wanting to get out of bed
• having difficulty motivating yourself to wash and dress, or not wanting to look after yourself
• changes in appetite
• not taking your medication as directed – whether this means not taking it at all or taking too much of it
• low sex drive
• drinking more alcohol than usual 
• feeling tired
• losing confidence in yourself and feeling life is pointless
• having suicidal thoughts.

It's important to remember that feeling consistently low isn't part and parcel of getting older – it's a sign that you're not feeling as well as you should be. Older people with depression usually experience more physical symptoms, such as tiredness, weight loss, and problems sleeping. These aren't trivial matters – they're crucial to your mental and physical health.

If you've experienced some of these symptoms on most days for 2-4 weeks, you should speak to a medical professional. Talking about your mental health can be daunting, but GPs are increasingly used to having these conversations. They won't judge you – they're there to help.

What is anxiety?

Anxiety is what we feel when we're worried, tense, or afraid about things that are currently happening, or things that we think could happen in the future.

A small manageable amount of anxiety from time to time is helpful – it forms part of our internal warning systems that alert us to danger or other threats. But anxiety becomes a problem when anxious feelings come on unexpectedly and feel overwhelming and unmanageable. If your anxious feelings become more constant and start to affect your daily life, seek help and support.

Symptoms of anxiety vary, but often include:

• feeling extremely nervous
• excessive worrying over small things
• being withdrawn
• feeling agitated and restless
• getting tired easily
• increased heart rate, chest pain, and abdominal pain
• problems with thinking and making decisions.

If you find yourself worrying all or most of the time, and you're experiencing physical symptoms such as a fast heartbeat, shaking or sweating, make an appointment with your GP. You can talk to your doctor or nurse in confidence. They won't judge you – they're there to listen and support you in getting the help you need.

It's not uncommon to feel low and worried at the same time and doctors are increasingly used to treating people who feel depressed and anxious.

What causes depression or anxiety?

We may start to develop the symptoms of depression or anxiety for several different reasons. We might start to feel out of sorts because of a change in our lives – perhaps we've just lost a pet, we've been diagnosed with a new health condition, or we're having to adjust to looking after somebody.

Or we might feel worried and stressed over something in our day-to-day lives, such as whether we'll be able to pay our bills or being fearful over events happening elsewhere in the world.

Sometimes, there may be no clear reason as to why these feelings have developed – maybe one day we’ve just noticed that something feels a little bit off, and we don’t feel our usual self.

Whatever the cause, struggling with our mental health isn't a normal part of getting older, and thinking about any potential causes of how we're feeling can help us to understand our feelings. Examples include:

• money or finance issues
• bereavement – losing your partner, relative or close friend
• relationship or family problems
• retirement
• disability or poor health
• housing issues, such as moving homes
• becoming a carer
• the time of year.

Many situations, including those listed above, can make anyone feel low or anxious, and not everyone who experiences these goes on to experience depression or anxiety. But thinking about any potential causes of the way you're feeling can help you understand your emotions and work out what you need to feel more like yourself again.

Everyone feels low and worried from time to time, but if you've not been feeling yourself for a while it's a good idea to talk to someone – like your GP, nurse or a trusted friend or relative. 

How are depression and anxiety diagnosed?

There are no specific tests used to diagnose someone with depression or anxiety, but your GP may perform some blood tests to check for other health conditions that share similar symptoms.

Your GP will need to get a good picture of the way you’re feeling mentally and physically. They'll ask you lots of questions about your symptoms and any changes you’ve noticed. They may use a questionnaire to help assess your symptoms.

It can be difficult to think about specific answers on the spot – the following suggestions might help you plan ahead for your appointment:

• Make a list of all your symptoms, whether they're worse at certain times of the day or on particular occasions, how long you’ve had them and how they affect your day-to-day life and relationship with others.
• Explain any circumstances that could be contributing to these symptoms and the way you feel.
• Take a list of all the medications you currently take, including any supplements or non-prescription medication.
• Be as open and honest as you can – remember that anything you say is confidential.

How is depression and anxiety treated?

It's important that you don't brush how you feel under the carpet and hope it sorts itself out – symptoms are likely to get worse if you don’t take action. If you broke your leg, you wouldn't just struggle on without help – you'd get it seen to as soon as possible. We need to look out for our mental health in the same way, and seek treatment if we need to. Just like many physical health conditions, mental health conditions like depression and anxiety can be treated.

There are several treatments available to help with your mental health – often a combination of treatments is needed.

If your symptoms are mild, your GP may take a 'wait and see' approach. They may give you some advice on how to cope with symptoms then see if symptoms improve within a few weeks.

Talking treatments

Talking treatments and therapies allow you to talk to a trained professional who can help you manage your thoughts and feelings and the impact they have on your mood and behaviour. This can be very helpful for people who are feeling low, anxious or out of sorts.

Examples of talking treatments include cognitive behavioural therapy (CBT) and counselling. The sessions may be one-on-one or in a group environment.

If you're considering talking treatments, be sure to mention any cultural, language or religious needs you have or any hearing or sight problems, so they can be addressed when arranging therapy for you.

Talking treatments are proven to work – and they can work particularly well for older people. You can refer yourself to see if your local service can help, or your GP or nurse can do it for you if you'd prefer. Even if you’ve tried them before and weren’t sure, you can give talking therapies another go. Talking therapies are available for free on the NHS.

Find out more about how talking can help

Applied relaxation

A trained practitioner can teach you muscle relaxation techniques to help you cope in situations where you feel anxious.

Medications (such as antidepressants)

Your GP may prescribe medications to help treat the symptoms of depression. There are a range of different types of antidepressants available and your GP should explain which is best for you. Antidepressants are often combined with talking treatments.

It can take up to 2 weeks for medications to start having an effect and you may need to continue taking antidepressants for several months to ensure a long-term recovery.

Be sure to continue with any prescribed medication or treatments as this is important for your long-term health and wellbeing. If your symptoms seem to be returning, let friends and family know and make an appointment to see your GP so any problems can be resolved quickly.

Is St John's Wort good for depression and anxiety?

St John's Wort is a herbal remedy that’s available without a prescription from health shops and pharmacies. It isn't recommended by doctors or the National Institute for Health and Care Excellence (NICE).

St John's Wort can cause serious side effects and interact with prescription medications, including anti-depressants.

How can I support my mental health?

If you're feeling low or anxious, it's important to remember that you're not alone. Mental health problems are more common than you might think. It’s estimated that 1 in 4 people live with a common mental health problem, such as depression or anxiety.

There are things you can do for yourself to help, including staying active in your community, joining a support group and doing things that boost your mental wellbeing.

Self-help groups

Meeting other people who understand what you’re going through can be helpful, especially if you’re feeling isolated or lonely. You can find a local support group by asking your GP, or by getting in touch with your local Mind. You can find your local Mind by using the directory on the Mind website.

Keep a regular social routine

There are a range of services in the local community where you can meet new people and learn new skills. This will give you something to look forward to, and prevent you feeling isolated or alone. Your local Age UK can help you find an activity or group that suits your interests.

What do I do if I’m worried that a relative or friend has depression or anxiety?

If you think a friend or relative is experiencing symptoms of depression or anxiety, try to talk to them about it.

You may feel uncomfortable bringing up a sensitive topic, especially if the person you're concerned about doesn't often talk about their emotions. Explain why you're concerned but avoid diagnosing their problem or pressuring them with lots of 'solutions'. 

They may be unwilling to talk about it, but let them know that you're willing to listen when they're ready.

There are various ways you can help them, including doing things like:

• Offering your support by listening and reassuring them that how they’re feeling can be improved.
• Staying in touch by calling them or visiting their home regularly – the risk of depression increases when people feel alone and unsupported.
• Encouraging them to make an appointment with their GP or another health professional. You could offer to go with them to appointments for moral support.
• Encouraging them to keep active and healthy, such as planning occasional outings to get them out of the house.

Supporting a relative or friend with depression can be rewarding, but it can be stressful and put a strain on your mental wellbeing. If you need support or information surrounding the difficulties you're experiencing, visit the Carers UK website or the Carers Trust website.

Find out more about getting help as a carer looking after a loved one