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Depression is a common illness that affects many people throughout
the world. About 10-15% of the population will suffer from
depression during their lifetime, and it occurs more frequently in
women and the elderly. A number of treatments are, however,
available for depression, and it can be successfully treated in the
majority of people.
No doubt you are already familiar with at least some of the
symptoms of depression, and have experienced its debilitating effects
on your life.
This booklet contains information about the causes of depression
and its treatment, to help you and your family and friends to understand
your illness. By knowing more about the disorder you will be
able to get maximum benefit from your treatment.
1

Depression is an illness that can seriously impair all aspects of a
person’s life, including personal relationships, performance at work
and enjoyment of leisure activities.
One of the features of depression which can make it difficult to
diagnose, is that no two people will have exactly the same symptoms
associated with the illness. A number of symptoms are, however,
commonly seen:
● irritability
● feelings of guilt and/or helplessness
● feelings of anxiety
● inability to concentrate or make decisions
● reduced appetite
● loss of interest in personal appearance
● loss of interest in favourite activities
● difficulty in sleeping (either in falling asleep when first going to
bed, or waking during the night and being unable to get back to
sleep)
● difficulty getting up in the morning
● constant feelings of tiredness/lack of energy
● changes in weight
● physical symptoms, such as headache or backache.
These symptoms will, typically, develop over a period of several
weeks or months, and several will be present at the same time.
There are many myths and misconceptions about depression. It
is important to know that depression is not:
● just feeling ‘a bit down’
- depression has a profound effect on your everyday life

● a sign of weakness
- depression is ultimately caused by an imbalance of special
chemical substances in the brain, called transmitters, though
personality and life events resulting in stress may have contributed
to the imbalance
● a ‘punishment’ because you are a bad person
- depression is an illness that can affect anyone
● something to feel guilty about
-remember, it is not your fault.
Many people think that depression will go away if the sufferer
just makes an effort to think positively or to go out and enjoy him
or herself. Unfortunately, they do not understand that depression
is an illness that requires specific treatment, just as every other illness
does. This lack of understanding can itself make the depressed person
feel even more helpless and isolated. It also means that people with
depression are often reluctant to tell their friends and colleagues
about their condition.
Sometimes, people become depressed following a particularly
stressful period in their lives, such as the death of a close relative or
friend, or after losing their job, and there is evidence that some
people inherit an increased risk of becoming depressed.
Fortunately, a number of effective medicines and psychological
interventions are available to treat depression, and the illness can be
successfully treated in the majority of people. By visiting your doctor
and having your depression diagnosed, you have already taken the
first step on the road to recovery. Read on to see how you can get
the most from your treatment.
3

Treating depression
Effective treatment of depression usually requires a combination of
medication and counselling or psychotherapy.
A large number of effective medicines are available for the treatment
of depression, but they can be subdivided into four main categories:
● monoamine oxidase inhibitors (MAOIs)
● tricyclic antidepressants (TCAs)
● selective serotonin re-uptake inhibitors (SSRIs)
● serotonin-norepinephrine re-uptake inhibitors (SNRIs).
Your doctor will have given careful consideration to choosing the
individual medication that will be the most appropriate for your
treatment.
It is important to realise that antidepressants do not act immediately,
in the way that, for example, antibiotics do. It may take about 4-6
weeks of treatment
before you will notice a
significant improvement in
your symptoms. In addition,
you will have to continue
taking your medication
for 6-12 months or possibly
longer, to ensure your
recovery is complete.
4

Professional healthcare workers, including your general practitioner
(GP), a counsellor or psychotherapist or a psychiatrist, will be involved
in/with your treatment but you are also an important member of your
care team.
The most important thing you can do is to remember to take your
medication regularly, following the directions from your doctor.
Antidepressants can, however, produce a range of side-effects, including
dry mouth, blurred vision and altered bowel function (diarrhoea or
constipation). If any of these are a particular problem, or if you think
you have developed any other symptoms as a result of your medication,
do not stop taking your medicine, but tell you doctor as soon as
possible about your symptoms. He or she can then decide upon the
most appropriate action to take (e.g. reducing the
dosage, switching to a different product).
Even if you are feeling much better, you should
continue to take your medication and attend regular
follow-up consultations with your doctor. At these visits
you can discuss the ways in which your symptoms have
changed and assess the effectiveness of your treatment.
It is important that you discuss honestly all your feelings and
concerns with your doctor or counsellor. They will not be shocked if
you tell them, for example, that you have had thoughts about suicide,
as these are not unusual in people with depression. There are no
physical measurements, such as temperature or blood pressure, which
give the doctor any clue about your symptoms of depression. Only
you know how you are feeling, and the doctor and counsellor need
this information to ensure that you receive the most effective treatment.
5

Your GP will make the initial diagnosis of depression, and will start
treatment with one of the antidepressant drugs. The choice of
medication will be influenced by the particular types of symptoms
that you have described, the side-effects of the different medication
available, and also your GP’s knowledge of other aspects of your
health (e.g. whether you are already taking medication for another
condition).
It is important that you take your medication regularly, and that you
discuss any concerns about your illness or its treatment with your GP.
6

It is only by knowing exactly what your
needs and concerns are that your GP can
ensure that you will receive the most
effective treatment.
Your GP may provide you with
counselling or you may be referred to a
specialist counsellor. Your GP may also
refer you to other healthcare professionals,
such as a psychotherapist or a psychiatrist,
depending upon your symptoms and your
response to treatment.
Your doctor will want to see you
regularly throughout your treatment.
During these consultations you may:
● discuss how you are feeling and whether
your symptoms are improving
● review any problems you may have as
a result of side-effects of your
medication
● consider whether any changes in your
treatment are needed
● discuss any other concerns that you
may have about your illness or its
treatment, including aspects of your
life that may be influencing your
response to treatment

What your counsellor
can do
Many people with depression find that a course of counselling can
help them to identify why they have become depressed. Counselling,
used in addition to antidepressants, is an important part of the
treatment of depression. Counselling will help your recovery and
reduce the chances of the illness coming back.
Just as no two people have exactly the same symptoms of depression,
their needs for counselling will also differ. Your counsellor will want
to build up a detailed picture of your life, including information
about your employment and your family, as well as your symptoms
of depression and how they started. This will help him or her to
decide upon the most appropriate counselling approach for you.

Counselling may take many different forms. For example, someone
who has become depressed following the death of a loved one may
need help to come to terms with their feelings of loss and grief, while
someone with feelings of anxiety may be taught relaxation techniques.
Contrary to what many people believe, counselling is not always
a ‘soft option’. It can often be difficult to admit to some of the
feelings you may be experiencing, or to relieve a past trauma.
However, many people find that they feel better once they have
discussed these things. It is important that you attend your counselling
sessions regularly so that you can work through such experiences
together with your counsellor, helping you to recover as quickly as
possible from your illness.
9

Depression can be a difficult illness for your family and friends
to understand. It is confusing and distressing for them to see someone
they love become withdrawn and irritable, and show no interest in
activities that he or she previously enjoyed. If they do not realise
that you are ill, they may feel hurt or rejected when you refuse their
invitation to join in social activities.
It is important for your family and friends to understand that
depression is a serious illness, but that it can be treated successfully.
They also need to be aware that it take some time for you to make
a full recovery and that, contrary to popular belief, depression is not
something that you can just ‘snap out of’.
If you have difficulty talking about your illness to family and
friends, you may decide that you would like your doctor to explain
your condition and its treatment to them. Once they understand
the nature of your illness, your family and friends can help by
reminding you to take your medication and encouraging you to go
to your counselling sessions. As you begin to recover, you will want
to start building up your social activities again, but your friends
should realise that you need to do things at your own speed, and
should not feel hurt if you turn down some of their invitations.
They will understand this better if you talk to them openly about
your illness and the way you feel.

Depending upon the nature of your symptoms and their response
to treatment, your GP may decide to refer you to another healthcare
specialist, such as a psychotherapist or a psychiatrist.
A psychotherapist will work with you to identify particular areas
in your life that may have contributed to the development of your
depression. He or she will then help you to address these problems,
possibly by learning new patterns of behaviour, or by confronting
specific fears or anxieties.
You should not be alarmed if your are referred to a psychiatrist.
Just as your GP would refer you to a cardiologist if you had heart
disease, he or she may decide that you would benefit from treatment
by someone who specialises in the care of people with mental illnesses.
As a specialist, the psychiatrist will have access to a wider range of
treatment options than are available to your GP.

Some people find it helpful to talk to others with depression. It can
be reassuring to know that you are not the only person to experience
the feelings of hopelessness that have troubled you recently. You can
also exchange ideas about techniques that can help you to feel better
about yourself during your treatment.
Your doctor or counsellor should be able to provide contact
details for self-help groups in your area, if you are interested in
joining such a group.
If you have access to the Internet, you will find that there are a
number of sites devoted to depression. Many of these have been
developed by people with depression, and they may provide you
with useful information about your illness and helpful hints on how
to manage it.
For further information on depression visit:
www.depnet.co.za
www.lundbeck.com
www.firstsupport.co.za
SADAG
South African Depression and Anxiety Support Group:
Tel: 0800 567 567
www.sadag.org
Alzheimer’s/Dementia Support Services:
Alzheimer’s SA:
Help Line 0860 102 681
National office 011 478 2234
www.alzheimers.org.za
Dementia SA:
021 421 0077/8
021 418 5888
E-mail: info@dementiasa.org
www.dementiasa.org
Parkinson’s Disease:
Parkinson Association
011 787 8792
www.parkinsons.co.za

Use this page to fill in useful addresses and telephone numbers. For
example, you may like to include your doctor, counsellor and support
group. You could also include appropriate Internet addresses.
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Name _______________________________________________
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Conversion of Raw Scores to SDS Index
(Index = Raw Score Total x 100)
Maximum Score of 80
Raw
Score
SDS
Index
RAW
Score
SDS
Index
Raw
Score
SDS
Index
20 25 40 50 60 75
21 26 41 51 61 76
22 28 42 53 62 78
23 29 43 54 63 79
24 30 44 55 64 80
25 31 45 56 65 81
26 33 46 58 66 83
27 34 47 59 67 84
28 35 48 60 68 85
29 36 49 61 69 86
30 38 50 63 70 88
31 39 51 64 71 89
32 40 52 65 72 90
33 41 53 66 73 91
34 43 54 68 74 92
35 44 55 69 75 94
36 45 56 70 76 95
37 46 57 71 77 96
38 48 58 73 78 98
39 49 59 74 79 99
80 100
The SDS Index can be interpreted as follows:
SDS Index
Equivalent Clinical Global Impressions
Below 50 Within normal range, no psychopathology
50-59 Presence of minimal to mild depression
60-69 Presence of moderate to marked depression
70 and over Presence of severe to extreme depression
© W.W.W. Zung, 1974, 1989

Everybody needs support
during difficult times
The mySupport Programme:
There for you during your
recovery from anxiety
and depression

The mySupport programme is an online, confidential, secure, anxiety and
depression support programme with the following benefits:
Information :
Health library on depression and anxiety
Podcasts eg: what to expect from antidepressants
Ask the expert – disease related questions
Monthly professionally qualified guest speakers on various topics
Videos on different psychiatric disorders
Self rating scales to monitor your progress
Support :
Forum to share thoughts
Coping tips e.g.: diet, exercise
Appointment reminders
Go to www.firstsupport.co.za to see all the
benefits of the mySupport programme
Ask your doctor about the mySupport programme
and get connected
Major sponsor of the SA Depression and Anxiety Support Group (SADAG) Tel: 0800 567 567. www.sadag.org
Brought to you by Lundbeck in the interest of
patient well-being
MO/09/11

Lundbeck South Africa (Pty) Ltd.
252 Montrose Avenue, North Riding 2194
PO Box 2171, North Riding 2162
Telephone +27 11 699 1600
Facsimile +27 11 795 2252