It is suggested that depression is common in student nurses. As potential professionals who will be responsible for caring for people with depression, it is a condition we should all be well aware of.
NICE guidelines for depression suggest talking therapies for all depression, as well as anti-depressant medication for moderate to severe cases. As someone who has had depression, I think it is important to note this emphasis on talking therapies and view depression not only as an illness which can be helped by medication but also as a state of mind which has a psychological function in protecting us. This is because by acknowledging depression, and taking responsibility for its existence, we take a beneficial step in tackling its effects.
’[…] By acknowledging depression, and taking responsibility for its existence, we take a beneficial step in tackling its effects.’
Depression often strikes when we are overwhelmed or threatened. Sometimes it appears without apparent cause, although I believe it is always a sign that something, somewhere is not as it should be. This could be through past or present experiences, or future fears that may or may not be obvious. In protecting us from these feelings, depression may have numerous benefits.
Nothing can be disappointing when you are depressed.
Nothing can hurt as much as living because you are trapped in a vacuum away from the world.
Nobody can take away the hope, because there is none. Nobody can make you feel worse about yourself than you already do. And nothing can feel bad if there is only numbness.
I was once reprimanded by someone for suggesting that depression is a state of melancholy. It was by a person who supported the view that it is an entirely physical state which requires pharmacological treatment. I was told that people with depression are victims of a disease and it is the worst time of their lives. I had to disagree with this.
Depression, to me, was certainly not worse than trying for success, having close friendships and relationships, and trusting and believing in a happy future, only to be let down or fail.
‘As a drug abuser loses the best years of their life to using, depression can also result in many lost years.’
Depression is not worse than that. It is not greater than the horrific problems in our society. It is not worse than war or death. It is not grief or loss or hate. Depression is a protection from all of those things and more. It is a bubble - a black and lonely one, but a safe one.
To portray all depressed people as victims of an illness may be wrong because it gives them no insight into the need to change the way they think. Yet despite that, it is a coping mechanism. People may not be ready or want to change just yet, and that is fine too.
As a drug abuser loses the best years of their life to using, depression can also result in many lost years. The months spent hiding from the world, frightened of the unknown, are fruitless; realistically nothing else could be miserable for such long periods. But with respect - and I speak from experience - depression, for the person who is experiencing it, is their space.
To leave it may involve the use of medication, but it also undoubtedly involves looking inward and examining why depression is a place which one so often returns to.
‘The only alternative is living - and it can be a wonderful thing.’
Depression stops everyone and everything ‘getting in’. It is a burglar alarm for the psyche. I believe many people with depression have the potential to turn off their own alarm of protection because the actual risk of burglary is low. However, to do so they need help and support to ensure the threat is not too high, and coping strategies in place to manage fear of the alternative.
The only alternative is living - and it can be a wonderful thing.
Nurses see all aspects of living; we feel people’s emotions every day at work. Perhaps this is why as a profession we are at such risk of burnout and depression. We need to support each other in learning to cope with this, by being non-judgemental and open about depression, reducing the stigma that we all face whilst negotiating life’s complicated but rewarding journey.
It is an effort that will not only benefit our patients but also us as nurses.
Caroline Estrella is a newly qualified nurse studying towards her masters