Anxiety and depression fact sheet

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In Australia, about 2 million adults experience anxiety and 1 million adults experience depression each year. While it’s not uncommon for people to experience both conditions at the same time, it’s important to recognise that they are different conditions; each has its own causes, symptoms, and treatment options. The good news is that both are treatable, and with the right treatment, most people recover.

This fact sheet outlines the causes, symptoms, and treatments for both conditions. However, it does not cover depression associated with bipolar disorder as this is a distinct condition. For information on bi-polar disorder, contact beyondblue.

Download our other resources for information that focus specifically on antenatal depression, postnatal depression, and perinatal anxiety.

Anxiety disorders

What is anxiety?

Anxiety is a normal human emotion that helps protect you from danger. When you sense you are in danger, your body undergoes a number of changes. These include: the release of large amounts of the hormone adrenaline to make you more alert; an increase in your heart rate to help you move blood to the large muscles of your body; and an increase in your breathing rate to help you take in more oxygen. The purpose of these changes is to prepare you to fight or to take flight from threats – it is known as the ‘fight or flight’ response. A number of symptoms can occur as a result, including sweating, trembling or shaking, nausea, racing heart, cold hands and feet, dizziness, and pins and needles (1).

Everyone experiences anxiety at times however, some people experience excessive or irrational anxiety. When this occurs, you experience levels of anxiety that are out of proportion to the threat present or you experience anxiety when there is no real threat. This can be extremely debilitating; it can disrupt your day-to-day life and affect your ability to work, study, and socialise.

There are a number of different types of anxiety disorders (see Types of anxiety disorders, below). On average, one-in-three women and one-in-five men experiences an anxiety disorder at some point in their lives (2). Unfortunately, only about 18% of affected women seek help; however, with appropriate treatment and support, recovery is possible (3).

What causes anxiety disorders?

A combination of factors can cause a person to develop an anxiety disorder, including family history, environmental factors, personality traits, and biological factors.

FAMILY HISTORY

People with a family history of anxiety or mood disorders, or a lack of adequate coping skills are more likely to develop anxiety. They may be genetically susceptible, or they may ‘learn’ to respond in this way from family members (4).

ENVIRONMENTAL FACTORS

People who have experienced major life stresses, such as the death of a family member, a relationship breakdown, major financial difficulties, or long-term exposure to abuse/violence are more at risk. Uncertainties, and especially the threat of loss (such as the possible loss of a job, or a health scare), can also cause anxiety. Substance abuse has also been linked to the development of anxiety disorders in certain people.

PERSONALITY TRAITS

Some personality types appear to be more prone to developing an anxiety disorder. People who are nervous, emotional, or worry a lot are more at risk.

BIOLOGICAL FACTORS

Evidence suggests that people with abnormal levels of certain brain chemicals are more at risk of developing anxiety disorders (5, 6).

Types of anxiety disorders

GENERALISED ANXIETY DISORDER (GAD)

GAD is the most common anxiety disorder. People who have GAD experience excessive anxiety and worry about events or activities. If you have GAD, you may constantly worry about work, finances, health, household chores, and/or the wellbeing of family and friends (7). Your anxiety and worry is out of proportion to the actual risk of something going wrong.

Other symptoms include restlessness, feeling on edge, getting easily fatigued, having difficulty concentrating, experiencing ‘mind blanks’, irritability, muscle tension, and sleep disturbances (difficulty falling or staying asleep, or restless unsatisfying sleep) (8,9).

PANIC DISORDER

People with panic disorder have recurrent and unexpected panic attacks (see below) and worry persistently about when and where their next panic attack will occur. Up to 40 per cent of Australians experience a panic attack at some point in their lives but having a single panic attack does not necessarily mean you have panic disorder (10). Approximately five per cent of Australian adults experience panic disorder (11). Women are about two-and-a-half times more likely to develop the condition than men (12).

A panic attack occurs when you experience intense fear accompanied by strong physical symptoms of anxiety when there is no real danger. Symptoms include heart palpitations, sweating, hot flushes or chills, trembling or shaking, sensations of shortness of breath or smothering, choking sensations, chest pain or discomfort, nausea or gastrointestinal upset, dizziness or light-headedness, tingling or numbness, feelings of unreality or of being detached from yourself, fear of losing control or going crazy, and fear of dying (13).

Experiencing these symptoms may cause you to think you have a medical condition such as a heart problem. In fact, many people call an ambulance, visit an emergency department, and/or undergo extensive tests for other conditions, before an anxiety disorder is diagnosed.

If you have panic disorder, you may come to associate particular activities or locations with having a panic attack and start to avoid these situations. Common avoidances are travelling in aeroplanes, on public transport, or in other people's cars, and being in crowded locations and/or elevators. Over time, the number of situations you avoid can increase. This can place significant restrictions on your everyday activities (14).

SOCIAL ANXIETY DISORDER

People with social anxiety disorder, also referred to as social phobia, experience an excessive, persistent fear of being embarrassed, judged, or evaluated in public. The disorder commonly develops in childhood or adolescence and up to 11 per cent of Australians experience the condition at some point during their lives (15). Symptoms include heart palpitations, tremors, sweating, gastrointestinal upset, muscle tension, blushing, and confusion.

If you suffer from social anxiety disorder, you may try to avoid situations that cause fear, such as public speaking, initiating conversations, and eating or writing in public. This can impact on your day-to-day functioning and make it difficult for you to maintain employment and/or relationships.

OBSESSIVE COMPULSIVE DISORDER (OCD)

Almost three per cent of Australians experience OCD at some point during their lives (16). The condition is characterised by both obsessions (recurrent and persistent thoughts, impulses, or images) and compulsions (urges to perform certain mental or physical behaviours).

People with OCD perform certain behaviours or rituals, either rational or irrational, in order to reduce or remove the likelihood of a feared consequence. For example, if you are afraid of catching a disease after you touch something that might be contaminated, you may develop a compulsion to wash your hands repeatedly. Common obsessions people develop include the fear of contamination, the need for symmetry, pathological doubt, and the fear of developing a life-threatening illness (17). Compulsions may involve actions such as cleaning, checking, repeating, ordering, and hoarding, or the mental repetition of words, numbers, images, or thoughts (18).

POST-TRAUMATIC STRESS DISORDER (PTSD)

PTSD is an anxiety disorder that people develop after they experience a traumatic event. Traumatic events can include anything from natural disasters to violent crimes or car accidents. Women often experience PTSD following a physical or sexual assault, and some women experience PTSD following a real or perceived trauma during childbirth (19). Symptoms include repetitive, intrusive thoughts about the event, flashbacks and nightmares, insomnia, avoiding situations associated with the event, feeling emotionally numb, and social withdrawal.

Diagnosis

If you are experiencing symptoms of an anxiety disorder, visit your general practitioner (GP). They can establish that there is no underlying physical cause for your symptoms. Conditions that present similar symptoms to anxiety disorders are thyroid disorders, hypoglycaemia (low blood sugar), substance abuse, substance withdrawal, psychosis, and some heart conditions. Your GP will ask you questions about your medical history and your symptoms. If they suspect you have an anxiety disorder, they will discuss coping strategies and treatment options with you. They may also refer you to a therapist (psychiatrist, psychologist, or counsellor).

PSYCHIATRISTS

A psychiatrist is a medical specialist who has undertaken higher training in the field of psychiatry. Psychiatrists offer psychological therapies and physical treatments (medications). They are experts on the most appropriate medications to take.

CLINICAL PSYCHOLOGISTS

A clinical psychologist is a medical professional who has completed a degree in the field of psychology as well as a number of years under the professional supervision of another registered psychologist. They are not a medical doctor and, therefore, cannot prescribe medications. A clinical psychologist provides psychological therapies.

COUNSELLORS

Counsellors can have varying levels of training, from postgraduate qualifications to certificate courses. At present, there are no minimum training standards for people using the title counsellor, so it can be helpful to check their credentials. A counsellor provides psychological therapies.

Treatment options

There are a number of different treatment options available. The treatment that is most suitable for you will depend on the type of anxiety you're experiencing and the severity of your symptoms. However, if you have severe anxiety, a combination of psychological therapies and medication may be suitable.

COGNITIVE BEHAVIOUR THERAPY (CBT)

CBT is based on the notion that people develop negative, self-defeating patterns of thought and that these thought patterns can be unlearned. CBT is conducted by a therapist and usually consists of a series of sessions that take place over a number of weeks.

Studies have found that CBT is one of the most effective treatments for anxiety disorders, and it has the advantage of costing less over time and producing longer-lasting benefits than many other treatment options (20). A disadvantage of CBT is that it requires a certain level of commitment, in both time and energy/motivation. Also, it is not available face-to-face in all areas of Australia; however, it can be delivered online (see E-therapies, below).

During CBT, you learn to recognise the thought patterns that produce anxiety. Underlying most types of anxiety is the tendency to overestimate both the likelihood of a feared consequence and how bad it would really be if the feared consequence actually eventuated. You are encouraged to practice realistic thinking in order to evaluate the real level of the threat or risk that is causing your anxiety. Over time, you learn to use evidence to challenge unhelpful or unrealistic thoughts and fears.

Other techniques used in CBT include controlled breathing exercises and graded exposure. Graded exposure involves your therapist getting you to gradually confront situations that produce anxiety symptoms. For it to be successful, you have to remain in the situation until your anxiety has subsided and you must confront the feared situation repeatedly and frequently.

EXERCISE

Exercise is an important part of a treatment program for anxiety disorders. When you exercise, your body releases endorphins (chemicals that make you feel happier and calmer), resulting in a general sense of wellbeing. If you are limiting your activities due to an anxiety disorder, exercise can provide you with an opportunity to get out and confront your fears. If you have panic disorder, exercise can be helpful as it enables you to experience some of the physical symptoms of panic attacks (e.g., shortness of breath) in a controlled way (21).

E-THERAPIES

E-therapies are therapies that are delivered online. They can be just as useful as face-to-face services for people with mild-to-moderate anxiety (22). E-therapies tend to follow the same principles as CBT; they aim to teach you to identify and change the patterns of thinking and behaviour that may be preventing you from overcoming your anxiety. Generally, you work through the program yourself with some support from a therapist who communicates with you via phone, email, text, or instant messaging (social media apps). One of the benefits of e-therapies is that they are easy to access, which makes them suitable for people living in rural and remote areas. There are many free e-therapy programs available online. Visit the Australian Government’s website, www.mindhealthconnect.org.au for more information.

BREATHING CONTROL TECHNIQUES

Many people hyperventilate when they are anxious. This can exacerbate feelings of anxiety and produce symptoms of dizziness and tingling. Achieving a controlled breathing rate (taking 8-12 breaths per minute, and breathing in a smooth, light way) is very effective at reducing symptoms of panic and anxiety. Smooth, light breathing is more beneficial than deep breathing, which can accentuate feelings of anxiety and light-headedness.

For breathing control techniques to be effective, you should practise them several times a day when you are not particularly anxious. This makes it more likely that you will be able to implement them when you are anxious and perhaps not thinking clearly.

COMPLEMENTARY THERAPIES

A number of complementary therapies are used to treat anxiety disorders, including massage therapy, acupuncture, aromatherapy, yoga, meditation, and herbal remedies (passionflower, valerian, kava, St John’s wort). There is, however, a lack of research supporting the effectiveness and safety of some of these therapies (23).

It is important that you inform your health professional if you are using complementary therapies, especially if you are taking a herbal remedy as these can have their own side effects and they can interact with conventional treatments, such as antidepressants. Complementary therapies do not treat the underlying causes of anxiety.

MEDICATION

Prescription medications only relieve your symptoms and, like complementary therapies, do not address the underlying causes of your anxiety. Therefore, medication does not provide a long-term solution to anxiety disorders.

The medications most commonly prescribed for anxiety disorders are selective serotonin re-uptake inhibitors (SSRIs), a form of antidepressant. These medications typically take several weeks to start working and you may have to try several different SSRIs before you find one that is suitable. SSRIs should never be discontinued abruptly. It is common for the medications to cause some degree of nausea, headache, and even a slight increase in symptoms of nervousness initially. These symptoms usually subside after a week or so. Other side effects include insomnia, dry mouth, and, less commonly, drowsiness. If SSRIs do not prove effective, other types of antidepressants (e.g., tricyclic antidepressants, or monoamine oxidase inhibitors) may be beneficial.

Benzodiazepines (tranquilisers) were previously used to treat anxiety disorders but antidepressants are now the preferred option as benzodiazepines produce a sedative effect and can result in dependence or tolerance. However, benzodiazepines may be suitable for some people with severe symptoms, for short periods.

Beta-blockers can be used to treat the physical symptoms of anxiety (e.g., heart palpitations, and trembling). They can be helpful in controlling anxiety in public situations. Side effects can include tiredness, low blood pressure, cold hands and feet, dizziness, and sleep disturbances.

SOCIAL SUPPORT

Support from partners, family and friends can play an important part of the recovery process and help relieve feelings of isolation. They may provide social/emotional (e.g., understanding, listening, encouragement), physical (e.g., assistance getting help, transportation) and financial (e.g., paying bills, buying food) support. Other forms of help include support groups specifically for anxiety; allowing you to connect with people having similar experiences either in person or online. Online groups are good if you find it difficult to get out of the house (both mentally and/or physically) to attend meetings in person. These groups can also be a source of support for partners and other family members who are trying to understand their loved one’s condition.

RELAXATION THERAPY

Relaxation therapy is designed to help calm your body and mind. It includes breathing techniques, progressive muscle relaxation, and meditation (24). Over time, relaxation therapy can reduce the basic level of anxiety or tension you experience.

CAFFEINE REDUCTION

Caffeine is a stimulant that increases the amount of adrenaline in the body and can cause symptoms associated with anxiety. Caffeine is found in coffee, tea, chocolate, energy drinks, and some soft drinks.

Depression

What is depression?

People sometimes say they feel 'depressed'. What they generally mean is that at the time they are feeling 'down' or 'blue'. These short-lived feelings are quite normal and everyone experiences them from time to time. True depression, however, is quite different. It occurs when you experience a depressed mood for a period of two or more weeks, and you display a number of other symptoms. Depression is classified according to its severity. It can be mild, moderate, or severe.

Depression is a very common condition that affects people of all ages. Women are more likely to develop the condition than men (25). On average, one-in-five women and one-in-eight men experience depression at some time during their lifetime (26). A significant number of women are affected by depression during pregnancy (antenatal depression) and during the first year following childbirth (postnatal depression). Click here for more information about antenatal and postnatal depression.

It is quite common for a person with depression to also have an anxiety disorder; more than half of those who experience depression also experience symptoms of anxiety (27). Having an anxiety disorder increases the chances of longer and more frequent bouts of depression (28).

Symptoms

In addition to depressed mood, symptoms include:

  • Loss of pleasure or interest in most activities
  • Changes in appetite (increase or decrease)
  • Changes in weight (increase or decrease)
  • Changes in sleeping patterns (sleeping too much, insomnia, early morning awakening)
  • Decreased energy
  • Fatigue
  • Feeling worthless or guilty
  • Difficulty concentrating or thinking
  • Indecisiveness
  • Irritability
  • Loss of sexual interest
  • Recurrent thoughts of death or suicide.

These symptoms vary in severity from person to person. If you have mild depression, your symptoms will still allow you to function, although perhaps not as adequately as before. Severe depression, on the other hand, can disrupt your work, social, and domestic activities, and you may be at risk of suicide.

If you are having suicidal thoughts or if you are worried that a friend, family member, or loved one is suicidal, you should seek help immediately. For urgent help, call emergency services on 000, call Lifeline on 13 11 44, or go to your local hospital emergency department.

What causes depression?

There is no single cause for depression. Rather, it is generally caused by a combination of stresses, as well as socio-cultural, biological, and psychological factors.

SOCIO-CULTURAL FACTORS

  • Relationship breakdowns/difficulties
  • Being socially disadvantaged (i.e., living in poverty, being unemployed)
  • Stressful life events (e.g., the loss of a loved one, illness in your family, family separation, trauma)
  • Continuing difficulties in life (e.g., long-term unemployment, prolonged work stress, living in an uncaring or abusive relationship)
  • Adjustment to a life transition (e.g., marriage, parenthood, menopause, retirement)
  • A lack of stimulating activities in your life
  • Caring for someone with a chronic physical or mental disorder
  • Physical or sexual abuse as a child or adult
  • Being in residential care (i.e., being elderly or disabled)
  • Loneliness and/or isolation
  • Racism
  • Exploring or questioning your sexuality, or identifying as lesbian, gay, bisexual, transgender/transsexual, or intersex
  • Having a parent with a mental illness*(29)

BIOLOGICAL AND PSYCHOLOGICAL FACTORS

  • Having negative thought patterns (i.e., being pessimistic, having a tendency to worry a lot, being self-critical)
  • Having certain personality traits (i.e., being a perfectionist, being a worrier, being sensitive to personal criticism, having low-self-esteem or self-worth, being shy to the point of avoiding social situations)
  • Having an avoidant coping style (i.e., using strategies to avoid directly addressing stressful events)
  • Having an anxiety disorder
  • Having a chronic illness
  • Having abnormal levels of certain brain chemicals (e.g., serotonin) (30)
  • Having a family history of mental illness*

* People can inherit a tendency to get depression. If you have a biological parent with depression, your risk of developing clinical depression is about 40% (31). In addition, it is believed that the thinking patterns associated with depression can be learnt within families. However, having a parent or close relative with depression doesn’t mean you will automatically develop the condition. Your life circumstances, exposure to stresses, personality type, and ways of thinking and coping are likely to have an important influence (32).

Depression can also occur as a result of particular medications or underlying medical conditions (e.g., low thyroid function, stroke, Parkinson's disease, or dementia) (33). In addition, drug and alcohol use can lead to and result from depression. More than 500,000 Australians simultaneously experience depression and a substance abuse disorder at some point during their life (34).

Diagnosis

Depression is an illness that can be treated. To receive an accurate assessment and diagnosis, the best first step is to visit your GP. They will discuss your history and symptoms and will provide you with information about appropriate treatments. If necessary, they will refer you to other relevant health professionals such as a therapist (psychiatrist, psychologist, or counsellor).

CHOOSING A HEALTH PROFESSIONAL

Different health professionals and treatment styles suit different people. Finding a health professional you feel comfortable with and confident in is important. You may find it helpful to choose a health professional that belongs to a professional body such as the Royal Australian and New Zealand College of Psychiatrists (RANZCP), the Australian Psychological Society (APS), or the Australian Counselling Association (ACA).

Medicare rebates are available for some health professional visits related to the diagnosis and treatment of depression. Ask your GP about the Medicare rebates or contact Medicare Australia on 13 20 11.

Treatment

There are many different treatments available. The most effective one for you will depend on your situation and the severity of your depression. For example, if you are experiencing mild depression, you may find relief from exercise and/or complementary medicines. However, if you have moderate or severe depression, a combination of psychological therapies and medication may be more suitable.

COGNITIVE BEHAVIOUR THERAPY (CBT)

CBT is one of the most effective treatments for depression (35). It is psychological therapy that is based on the concept that the way you think affects the way you feel. CBT aims to teach you to identify negative thoughts and replace them with more realistic ones (36, 37). Common types of negative or distorted thinking include all-or-nothing thinking (if something is not perfect then it is a complete failure); ignoring the positives and focusing on the negatives of a situation (the 'glass is half empty' notion); catastrophising (exaggerating things so they become more serious than they really are), and personalisation (seeing yourself as the cause of negative events that are not really your fault) (38).

CBT involves you working with a therapist to identify and change your negative thought patterns (see Cognitive behaviour therapy, Anxiety section). If you are suffering from moderate-to-severe depression, you may be prescribed medication in combination with CBT. This is because CBT requires a commitment from you in terms of time and motivation, and the medication can help you feel well enough to attend therapy sessions.

INTERPERSONAL THERAPY (IPT)

IPT is a psychological therapy that uses elements of CBT. It is predominantly focused on identifying problems in your personal relationships. It helps you develop the skills you need to deal with relationship issues. The therapy encourages you to examine how you relate to and interact with important people in your life and it helps you recognise patterns in your relationships that make you more vulnerable to depression (39, 40). IPT is useful in situations where relationship conflicts, a relationship breakdown, or the loss of a loved one are significant contributing factors to your depression.

MINDFULNESS-BASED COGNITIVE THERAPY (MBCT)

MBCT is a psychological therapy that involves a type of meditation known as ‘mindfulness’, which teaches you to focus on what is happening in the present moment. It encourages you to concentrate on the things you are experiencing, whether they are pleasant or unpleasant, without making judgements. At first you focus on physical sensations, such as your breathing, but as your treatment progresses, you learn to focus on your thoughts and feelings. MBCT works by teaching you to recognise unhelpful thoughts and feelings, and develop a new relationship to them (41).

MEDICATION

Antidepressants are the most common type of medication used to treat depression. Often, they are used in combination with psychological therapies. Antidepressants work by changing the levels of certain chemicals in your brain (e.g., serotonin). Additionally, there is some evidence that antidepressants also play an anti-inflammatory role (42). Antidepressants can take from several weeks to two months to work fully, and it can take some time for you and your health professional to find an antidepressant and dosage that works well for you. Antidepressants are not physically addictive.

The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs). The advantage of SSRIs is that they are generally well-tolerated and have fewer side effects than some of the older types of antidepressants (i.e., tricyclic antidepressants). Side effects can include nausea, diarrhoea, sleep disturbances, headaches, dizziness, and reduced libido. These usually subside after a short time.

You need to continue taking antidepressants for some time once your symptoms improve. This is often referred to as maintenance therapy. It is very important that you do not stop your medication early (even if you feel well) as this can cause a relapse of the depression as well as unpleasant side effects. You should make all decisions about stopping your medication or changing your dose in conjunction with your GP or psychiatrist. The most common reason people stop taking their medication is unwanted side effects. If you are concerned about side effects, talk to your GP or psychiatrist. There may be ways side effects can be minimised or better managed. Some people may only need to take antidepressants for a short time (6 to 12 months), while others may need to take them on an ongoing basis (in the same way that a person with high blood pressure needs to take medication).

EXERCISE

Research suggests exercise can be as effective as psychological therapies and antidepressants in treating depression (43). It is thought that exercise alters your serotonin levels, increases your endorphins, and reduces your stress hormones, resulting in an improved mood and sense of wellbeing. Other benefits of exercise include improved sleep patterns, decreased isolation (particularly if you exercise with a group or in a team), reduced stress, and a distraction from negative thinking (44, 45). However, when a person is depressed they may not feel motivated enough to exercise. Enlisting friends to exercise with you or participating in a planned activity (e.g., a weekly team sports event) can help encourage you to exercise regularly.

SELF-HELP BOOKS

Evidence suggests that following a structured program from specific self-help books can help treat mild-to-moderate depression. This type of therapy is called bibliotherapy. The books provide information and homework exercises that you work through on your own. You can complete this with or without the help of a therapist, but bibliotherapy appears to be most helpful when a professional is involved (46). The books are generally based on CBT. The disadvantage of bibliotherapy is that most self-help books are not suitable for those with low reading level abilities and they require a certain amount of motivation.

You can borrow some of the more popular self-help books free of charge from the Women’s Health lending library. Visit www.womhealth.org.au/depression-books for details.

E-THERAPIES

E-therapies are computer and internet-based programs that offer self-guided forms of psychological therapy (see E-therapies, Anxiety section). Evidence suggests e-therapies are helpful in treating people with depressive symptoms, and that they can be just as effective as face-to-face services for people with mild-to-moderate depression (47, 48, 49). One of the most popular e-therapy programs available for people with depression is MoodGYM (www.moodgym.anu.edu.au).

REDUCING ALCOHOL AND DRUG USE

Many depression sufferers use alcohol and/or drugs (e.g., cannabis) as a way of dealing with their depression. While such substances might make you feel better temporarily, in the long-term, they tend to cause additional problems. If you have depression and you believe you may also have a substance abuse problem, you should discuss this with a health professional.

COMPLEMENTARY THERAPIES

A number of complementary therapies are used to treat depression. While the scientific evidence supporting the effectiveness of some is good, for others it is very limited. It is important that you inform your health professional if you are using complementary therapies as they can interfere with conventional therapies. Complementary therapies should not be solely relied on by those with moderate-to-severe depression. Those with mild depression should seek medical help if their symptoms do not improve with complementary therapies.

One of the most popular complementary therapies used for depression is the herbal remedy St John's wort. Studies assessing its effectiveness have produced inconsistent results, however it appears to be more beneficial for people with mild-to-moderate depression than those with severe or chronic depression (50, 51). St John's wort interacts with a large number of medications, including warfarin (a blood thinning drug), anticonvulsants, oral contraceptives, and antidepressants. For this reason, it is vital that you inform your doctor if you are taking it. Side effects include dry mouth, dizziness, constipation, gastrointestinal symptoms, and an increased sensitivity to the sun (52).

Some evidence suggests the following therapies can be helpful in treating depression: the amino acid S-adenosyl methionine (SAMe), folate supplementation, acupuncture, light therapy, massage, relaxation therapy, air ionisation (electrical devices that increase negative ions in the air), and yoga (53).

Other complementary remedies include herbs such as ginkgo biloba, vervain, and lemon balm, and treatments such as homeopathy, aromatherapy, natural progesterone creams, and supplementation with selenium, tyrosine, glutamine, and vitamins B1, B6, B12, C and D. However, there is currently no evidence to support these treatments for general depression (54, 55). Some promising findings suggest vitamin B6 might be helpful in treating women with hormone-related depression and vitamin D may help treat seasonal affective disorder (SAD or winter depression), but more research is needed to confirm these findings (56, 57).

ELECTROCONVULSIVE THERAPY (ECT)

ECT is a procedure that involves passing carefully controlled electronic currents through the brain, in order to change brain activity. It is used to treat people with severe forms of depression (including psychotic depression). It has been recognised as a highly effective form of treatment that often brings quick results. Many people's beliefs about ECT are based on past practices. Today, ECT is safe; it is administered under the direct supervision of a psychiatrist, while the patient is under general anaesthetic. During the procedure, a brief, mild electric shock is delivered to your brain via electrodes placed on your head. A series of treatments are usually given over a number of weeks. The main side effect is memory impairment, but this is generally only mild and temporary.

SOCIAL SUPPORT

Support from partners, family and friends can play an important part of the recovery process and help relieve feelings of isolation. They may provide social/emotional (e.g., understanding, listening, encouragement), physical (e.g., assistance getting help, transportation) and financial (e.g., paying bills, buying food) support. Other forms of help include support groups specifically for depression; allowing you to connect with people having similar experiences either in person or online. Online groups are good if you find it difficult to get out of the house (both mentally and/or physically) to attend meetings in person. These groups can also be a source of support for partners and other family members who are trying to understand their loved one’s condition.

Further information

Anxiety and menopause

Anxiety and stress library booklist

Depression library booklist

Act-Belong-Commit

beyondblue

Black Dog Institute

Headspace (for 12-25 year olds)

Lifeline

Mental Health Association Queensland

Mindhealthconnect

MoodGYM

ReachOut (for 14-24 year olds)

SANE Australia

References

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  14. Andrews, G. (2000). Anxiety Disorders: Recognition and Management. Australian Family Physician, 29p.337-341. Retrieved March 5, 2016, from: www.racgp.org.au/download/documents/AFP/2011/June/201106kyrios.pdf

  15. beyondblue. (2016). Social Phobia. Retrieved March 5, 2016, from: www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/social-phobia

  16. beyondblue. (2016). Obsessive Compulsive Disorder. Retrieved June 15, 2016, from: www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/ocd

  17. Jefferys, D., & Burrows, G. (1996-2002). Obsessive compulsive disorders. MediMedia

  18. Ibid.

  19. Peach Tree Perinatal Wellness. (n.d.). Post-Traumatic Stress Disorder. Retrieved March 7, 2016, from: www.peachtree.org.au/post-traumatic-stress-disorder

  20. Reavley, N., Allen, N., Jorm, A., Morgan, A., Ryan, S., & Purcell, R. (2013). A Guide to What Works for Anxiety (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 7, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0762

  21. beyondblue. (ca. 2015). Anxiety and Depression: An Information Booklet. Hawthorn West, Vic: beyondblue. Retrieved March 1, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0885

  22. beyondblue. (2016). Treatments for Anxiety. Retrieved March 8, 2016, from: www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety

  23. Jorm, A.F., Christensen, H., Griffiths, K.M., Parslow, R.A., Rodgers, B., & Blewitt, K.A. (2004). Effectiveness of Complementary and Self-Help Treatments for Anxiety Disorders. Medical Journal of Australia, 181p.S29-S46. Retrieved March 10, 2016, from: www.mja.com.au/journal/2004/181/7/effectiveness-complementary-and-self-help-treatments-anxiety-disorders

  24. beyondblue. (2016). Other Sources of Support. Retrieved March 8, 2016, from: www.beyondblue.org.au/get-support/treatment-options/other-sources-of-support

  25. beyondblue. (2016). Who Does it Affect? Women. Retrieved March 10, 2016, from: www.beyondblue.org.au/who-does-it-affect/women

  26. beyondblue. (2016). The Facts. Retrieved March 10, 2016, from: www.beyondblue.org.au/the-facts

  27. beyondblue. (ca. 2015). Anxiety and Depression: An Information Booklet. Hawthorn West, Vic: beyondblue. Retrieved March 1, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0885

  28. Burcusa, S.L., & Iacono, W.G. (2007). Risk for Recurrence in Depression. Clin Psychol Rev, 27

  29. beyondblue. (ca. 2015). Anxiety and Depression: An Information Booklet. Hawthorn West, Vic: beyondblue. Retrieved March 1, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0885

  30. Black Dog Institute. (2012). Causes of Depression. Retrieved March 11, 2016, from: www.blackdoginstitute.org.au/docs/Causesofdepression.pdf

  31. Ibid.

  32. beyondblue. (2016). What Causes Depression? Retrieved March 11, 2016, from: www.beyondblue.org.au/the-facts/depression/what-causes-depression

  33. Ibid.

  34. Ibid.

  35. beyondblue. (2016). Psychological Treatments for Depression. Retrieved March 15, 2016, from: www.beyondblue.org.au/the-facts/depression/treatments-for-depression/psychological-treatments-for-depression

  36. Ibid.

  37. State of Victoria, Australia, Better Health Channel. (2014). Cognitive Behaviour Therapy. Retrieved March 14, 2016, from: www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy

  38. Braiker, H. (2001). Getting Up When You're Feeling Down: A Woman's Guide to Overcoming and Preventing Depression. Lincoln, NE: Universe

  39. beyondblue. (2016). Psychological Treatments for Depression. Retrieved March 15, 2016, from: www.beyondblue.org.au/the-facts/depression/treatments-for-depression/psychological-treatments-for-depression

  40. Black Dog Institute. (2012). Treatments for Depression. Retrieved March 15, 2016, from: www.blackdoginstitute.org.au/docs/Treatmentsfordepression.pdf

  41. MBCT.com. (n.d.). Your Guide to Mindfulness-Based Cognitive Therapy. Retrieved March 15, 2016, from: http://mbct.com

  42. Tynan, R.J., Weidenhofer, J., Hinwood, M., Cairns, M.J., Day, T.A., & Walker, F.R. (2012). A comparative examination of the anti-inflammatory effects of SSRI and SNRI antidepressants on LPS stimulated microglia. Brain Behavior, and Immunity, 26(3), p.469-79

  43. Jorm, A., Allen, N., Morgan, A., Ryan, S., & Purcell, R. (2013). A Guide to What Works for Depression (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 17, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0556

  44. State of Victoria, Australia, Better Health Channel. (2014). Depression and Exercise. Retrieved March 17, 2016, from: www.betterhealth.vic.gov.au/health/conditionsandtreatments/depression-and-exercise

  45. Jorm, A., et al. (2013). A Guide to What Works for Depression (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 17, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0556

  46. Ibid.

  47. Andrews, G., Cuijpers, P., Craske, M.G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. Public Library of Science ONE, 5(10)

  48. Jorm, A., et al. (2013). A Guide to What Works for Depression (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 17, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0556

  49. beyondblue. (2016). Other Sources of Support. Retrieved March 8, 2016, from: www.beyondblue.org.au/get-support/treatment-options/other-sources-of-support

  50. Jorm, A., et al. (2013). A Guide to What Works for Depression (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 17, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0556

  51. Linde, K., Berner, M.M., & Kriston, L. (2008). St John's wort for major depression. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD000448

  52. Mischoulon, D. (2007). Update and Critique of Natural Remedies as Antidepressant Treatments. Psychiatric Clinic of North America, 30(1), p.51-68

  53. Form, A.F., Christensen, H., Griffiths, K.M, & Rodgers, B. (2002). Effectiveness of Complementary and Self-Help Treatments for Depression. Medical Journal of Australia, 176(10), p.84-96

  54. Ibid.

  55. Jorm, A., et al. (2013). A Guide to What Works for Depression (2nd ed.). Melbourne, Vic.: beyondblue. Retrieved March 17, 2016, from: www.resources.beyondblue.org.au/prism/file?token=BL/0556

  56. Ibid.

  57. Ibid.

For help understanding this fact sheet or further information on anxiety and depression, women in Queensland can contact the Health Information Line on 3216 0376 (within Brisbane) or 1800 017 676 (toll free outside Brisbane), or email us via the Contact Us form.

Last updated: October 2016

© Women's Health Queensland Wide Inc. This fact sheet was originally published by Women's Health Queensland Wide Inc (Women's Health) as two separate fact sheets: the Anxiety Disorders fact sheet (December 2002) and the Depression fact sheet (June 2000). These were revised by Kirsten Braun and the Editorial Committee at Women's Health in September 2004, September 2006, and October 2007. The two fact sheets were amalgamated and revised by Joanna Hartmann and the Women’s Health Editorial Committee in June 2016.

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