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Managing severe depression can be a major challenge. The incidence of depression in society is escalating rapidly, possibly as a consequence of our over busy, never stopping lifestyle. Finding ways to assist people to overcome this mental illness may include antidepressant medication, cognitive therapy and sessions with Psychologists, Psychiatrists or General Practitioners.

It is recognised that depression will affect different people to different degrees. Milder depression may be helped with counselling and lifestyle adjustment perhaps in relation to nutrition and exercise. Some people also benefit form being taught relaxation techniques.

More severe depression can require treatment as an inpatient and possibly even ECT.

But what about the role of self help books and information that is available on the internet? Is that any good at helping people, especially those with more severe variants of the illness?

Recent research from the University of Manchester has found that these low-intensity interventions do indeed play a useful role as part of a stepped model of care.

Understanding what is happening to you and why you may be experiencing certain symptoms or feeling the way you do can be very helpful to assist in coming to terms with a diagnosis of depression.

In the study, 2470 patients with depression aged 35-45, being treated on an outpatient basis were included in a meta-analysis of several studies to see whether providing such low intensity interventions proved useful.

What the researchers found was that those individuals diagnosed with more severe depression at baseline had at least as good clinical benefit from self help books and internet information as those diagnosed with less severe forms of depression.

One of the best self help books I have come across is  “Brain Fuel Depletion – making sense of anxiety and depression”  written by Peter Symons. Peter himself has battled severe depression and his book describes in beautiful simplicity how if the brain runs low of certain essential fuels, depression can result. Happily now fully recovered from his depression Peter wrote the book to allow others to also understand why they too may have developed the condition and what can be done to help manage it.

In England at least, the recommendation is currently to offer all patients with depression these type of low intensity options. It will be interesting to see whether this, by helping people to understand why their brain is behaving the way it is will result in proving to be a cost effective way of managing depression.

If you know someone you think might be suffering from some form of mental distress, anxiety or depression, perhaps you could talk to them and suggest either a self help book such as Peter’s “Brain Fuel Depletion” as a first start or that they make an appointment for a check up with their local doctor. The worst thing is to ignore the symptoms, because untreated depression can cause significant disability and could even lead to self-harm.


Peter Bower et al. Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data. BMJ, 2013; 346 DOI: 10.1136/bmj.f540

Dr Jenny Brockis

Dr Jenny Brockis is a medical practitioner and internationally board-certified lifestyle medicine physician, workplace health and wellbeing consultant, podcaster, keynote speaker and best-selling author. Her new book 'Thriving Mind: How to Cultivate a Good Life' (Wiley) is available online and at all good bookstores.

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