Many people find it hard to seek help for a mood disorder. In spite of a growing
awareness of depression and bipolar disorder, misunderstandings persist – and
these can deter people from seeking help as readily as they would for other more
obviously 'physical' illnesses.
In this section we aim to lead you through the logical steps involved in seeking help,
and to provide you with information and explanations of the different steps along the
We also recognise that for most people, 'help' involves a combination of approaches.
So you'll find information on both professional help and other forms of help.
Please note that the information in this section (or anywhere on this site) is not
intended as a substitute for professional medical advice, so please see a qualified
health provider if you have any health concerns.
In an emergency you can also visit your local hospital's emergency department.
When to seek Help
Everybody feels down or sad at times. But it's important to be able to recognise
when depression has become more than a temporary thing, and when to seek help.
The following are a list of the features that may be experienced by someone with
- Lowered self-esteem
- Change in sleep patterns
- Change in mood control
- Varying emotions throughout the day
- Change in appetite and weight
- Reduced ability to enjoy things
- Reduced ability to tolerate pain
- Reduced sex drive
- Suicidal thoughts
- Impaired concentration and memory
- Loss of motivation and drive
- Increase in fatigue
- Change in movement
- Being out of touch with reality.
As a general rule of thumb, if your feelings of depression persist for most of every
day for two weeks or longer, and interfere with your ability to manage at home or
outside the home, then you would benefit from assessment by a skilled professional.
It's also important to recognize that many of the above features could be caused by
or related to other things, such as a physical illness, the effects of medications, or
stress. A trained professional will help in assessing such things.
Allow yourself to seek help. Struggling on alone can prolong the depression.
When to seek help for bipolar disorder
If you have experienced an episode of mania or hypomania, it's best to seek
professional help as soon as possible. It may indicate that you have bipolar disorder,
which, if left untreated, will likely involve further episodes of mania or hypomania.
Bipolar disorder is not an illness which goes away of its own accord but which often
needs long-term treatment.
- High energy levels – with the individual feeling 'wired' and 'hyper',
extremely energetic, experiencing racing thoughts, talking more and talking
over people, making decisions in a flash, being constantly on the go, and
feeling less need for sleep.
- Positive mood – feeling confident and capable, optimistic, that one can
succeed in everything, more creative, more happy and perhaps feeling 'high
as a kite'.
- Irritabililty – reflected in irritable, impatient and angry behaviours.
- Inappropriate behaviour– becoming over involved in other people's
activities, by increased risk taking (including over indulging in alcohol and
drugs and gambling excessively), saying and doing outrageous things,
spending more money, having increased libido; dressing more colourfully
and with disinhibition.
- Creativity – experienced as 'seeing things in a new light', seeing things
vividly and with crystal clarity, finding one's senses are heightened and
feeling quite capable of writing the 'great Australian novel'.
- Mystical experiences – can be experienced by believing that there are special
connections between events, that there is a higher rate of coincidence between
things happening, feeling intensely at one with nature and appreciating the
beauty of it and the world around, believing that things have special significance.
More extreme expressions of mania (but not hypomania) may have the added
features of delusions and hallucinations.
Accurately diagnosing bipolar disorder is a task for a professional. A first step is to
see your local GP, who will likely refer you to a psychiatrist for assessment and
Where to Seek Help
A good first place to start in getting help is to visit your local general practitioner
(GP). Let him or her know if you think you might have depression or bipolar disorder.
Your GP will either conduct an assessment of you, or refer you to someone else,
such as a psychiatrist or a psychologist.
If you have depression, your GP may recommend some psychological intervention,
such as cognitive behaviour therapy or interpersonal therapy, and might prescribe
antidepressant medication to relieve some of the symptoms of depression.
Because mental health problems are common issues in general practice these days,
many GPs are used to dealing with depression and other mental health problems.
Some take a special interest in mental health issues and undergo additional training
in the area. If you don't feel comfortable talking to your own GP, find another one
with whom you do feel comfortable. It is important that you feel comfortable talking
about how you are feeling with your GP so they have as much information to help
you as possible.
If you are having trouble tracking down such a GP, you could telephone general
practices in your area to find out whether any doctors in that practice have a
particularly strong interest in mental health and, if so, whether they are taking on new
patients. (Ask to speak to the practice manager.)
beyondblue has a national listing of health practitioners with an interest and/or
expertise in the treatment of depression and anxiety. This list is searchable by
suburb and so is a useful way of finding practitioners in your local area.
Psychologists, psychiatrists and counsellors are other professionals trained to
provide help for depression and mood disorders. You will need a referral from your
GP to see a psychiatrist or a psychologist (and this will either eliminate or reduce
Social workers, occupational therapists and registered nurses are also trained in
Support group is a small group of people with a particular condition, such as depression, anxiety or bipolar disorder, who meet regularly to discuss their their
experiences, their problems and their strategies for coping. Some support groups meet online.
What are the benefits?
Research shows that hearing from and sharing with others with similar experiences can be very helpful. A support group can provide the following gains:
- show you that you are not alone
- help develop new skills in relating to others
- permit you to 'open up' and discuss your situation and feelings
- give practical skills and advice – such as how to draw up and stick to a treatment plan
- provide new coping strategies – share your solutions and learn from others' experience
- offer a safe place to sound off about frustrations of living with a disorder
- supply strategies for managing any stigma associated with your disorder
- strengthen motivation to stick with a treatment plan.
Support groups for family and friends
Family members/friends can also benefit from their own support group:
- they learn more about the disorder and become more constructively involved in recovery
- they hear of new strategies for coping, reducing stress and getting community resources
- they gain increased appreciation of the importance of sticking with a treatment plan.
Most people know that having a healthy diet is vital to good health. We tend to generally feel better when we eat well.
To summarise the key dietary guidelines for adults in Australia as developed by the National Health and Medical Research Council:
- Eat plenty of vegetables, legumes and fruits
- Eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain
- Include lean meat, fish, poultry and/or alternatives
- Include milks, yoghurts, cheeses and/or alternatives. Reduced-fat varieties should be chosen, where possible
- Drink plenty of water
- Limit saturated fat and moderate total fat intake
- Choose foods low in salt
- Limit your alcohol intake if you choose to drink
- Consume only moderate amounts of sugars and foods containing added sugars.
A number of studies have shown that, in addition to looking after your diet and general nutrition, there are some specific dietary approaches that may help depression and mood disorders. They are:
- avoiding alcohol
- avoiding caffeine if you're sensitive to caffeine (however further research is necessary)
- increasing the amount of Omega 3 oils in your diet
- avoiding sugar (however further research is necessary).
Feeling tired and being less motivated in general are two very common symptoms of
depression. This means that exercise is often the last thing that people feel like
doing when they are experiencing depression. However, regular exercise has been
shown to have very positive effects upon mental wellbeing. Whilst vigourous
exercise releases endorphins (the 'feel good' chemicals that also alleviate pain) into
our bloodstream, even gentle to moderate exercise increases serotonin, which has a
number of benefits including lifting our mood and helping to counteract insomnia.
The good news is that exercise doesn't need to be strenuous for us to feel some of
its many benefits.
How does exercise help depression?
- Increasing energy levels
- Helping to get a good night's sleep
- Providing distraction from worries and rumination
- Providing social support and reducing loneliness if exercise is done with other people
- Increasing a sense of control and self-esteem, by taking an active role in the individual's own recovery.
Evidence for the benefits of exercise in managing depression
- Numerous studies have shown that people who exercise regularly experience fewer symptoms of depression and anxiety than those who do not exercise regularly
- Several trials have shown that regular exercise of moderate intensity can be an effective treatment by itself for mild to moderate depression
- Two trials have found that 16 weeks of regular exercise is equally effective as an SSRI antidepressant medication in the treatment of mild to moderate depression in older adults who have been inactive
- Research also suggests that exercise can further assist depression in individuals with depression who have responded only partially to an antidepressant medication
- Both aerobic exercise (e.g. brisk walking, cycling or jogging) and resistance or strength training (e.g. weight-lifting) have been found to be beneficial for depression.
The National Physical Activity Guidelines for Australians recommend:
- a minimum of 30 minutes of moderate intensity exerciseon most, preferably all, days of the week (an example of 'moderate intensity' exercise is brisk walking where you notice a slight increase in breathing and heart rate)
- exercising for at least 10 minutes at a time – the 30-minutes total does not need to be continuous – you can combine short sessions of different activities to a total of 30 minutes or more each day
- being active in as many ways you can each day (e.g. use the stairs).
The National Physical Activity Guidelines for Australians recommend:
- Start slowly and build up gradually. For example, if you have not been exercising at all, start with a 10-15 minute walk each morning, and gradually increase this to 30 minutes per day
- Set short-term realistic goals for exercising each week (e.g. 3 x 20 minute walks per week). Plan to exercise at specific times of the day that fit in with your lifestyle and write your plan down
- You don't have to join a gym – try a variety of different types of activities to find those that you enjoy (e.g. swimming, walking the dog, jogging whilst listening to music, riding a bike, gardening, bushwalking, yoga, weight-lifting)
- Give yourself a break – if you don't stick to your exercise plan, simply start again from where you left off
- Remember that it can take time for the benefits of exercise to occur. (Most exercise studies showing a significant reduction in depression have examined exercise programs of at least 8 weeks).