Depression

 

Depression is fairly common, affecting about one in 10 people at some point during their life. The symptoms of depression can be complex and vary widely between people. But as a general rule, if people have depression they will feel sad, hopeless and lose interest in things that they enjoy. The symptoms persist for weeks or months and are bad enough to interfere with work, social life and family life.

There are many other symptoms of depression and someone is unlikely to have all of those listed below.
Psychological symptoms include: 

  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling guilt-ridden
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • having suicidal thoughts or thoughts of self harm

Physical symptoms include: 

  • moving or speaking more slowly than usual
  • changes in appetite or weight (usually decreased, but sometimes increased)
  • constipation
  • unexplained aches and pains
  • lack of energy
  • low sex drive (loss of libido)
  • changes to the menstrual cycle
  • disturbed sleep

Social symptoms include: 

  • not doing well at work
  • avoiding contact with friends and taking part in fewer social activities
  • neglecting hobbies and interests
  • having difficulties in home and family life

Reviewed June 2019 by the East Kent Mental Health Commissioning Team. For content suggestions, updates or information please email: EKmentalhealth.commissioning@nhs.net.

There are different severity levels of depression. Following referral the level of depression will be assessed using a PHQ-9 questionnaire.

The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression:

  • The PHQ-9 incorporates DSM-IV depression diagnostic criteria with other leading major depressive symptoms into a brief self-report tool.
  • The tool rates the frequency of the symptoms which factors into the scoring severity index.
  • Question 9 on the PHQ-9 includes suicide ideation.
  • A follow up, non-scored question on the PHQ-9 screens and assigns weight to the degree to which depressive problems have affected the patient’s level of function.

PHQ-9 Scores represent:

  • 5-9 - Minimal Symptoms
  • 10-14 - Minor depression
  • 5-19 - Major depression
  • >20 - Major Depression, severe
 

Tier 1: Community Mental Health Support:

  • Live Well Kent: Live Well Kent can help improve your mental and physical health and wellbeing. It is a free service for anyone over 17. Call: 0800 567 7699 | E Mail: info@livewellkent.org.uk | Website: www.livewellkent.org.uk | Leaflet: SKC Live Well Kent Leaflet
  • IAPT / NHS Talking Therapy: IAPT is available for the treatment of adult anxiety disorders and depression. These therapies are available for people aged 17+.  This service is free at the point of access and people can refer themselves into the service. For the South Kent Coast CCG IAPT  leaflet: SKC CCG IAPT Provider Leaflet

Tier 2: Support based in Primary Care

  • IAPT / NHS Talking Therapy: IAPT is available for the treatment of adult anxiety disorders and depression. These therapies are available for people aged 17+.  This service is free at the point of access and people can refer themselves into the service. For a list of South Kent Coast CCG IAPT Providers leaflet: SKC CCG IAPT Provider Leaflet.
  • Primary Care Mental Health Specialist service: Primary Care Mental Health Specialist service (PCMHS) has been introduced to support a safe and positive discharge from Secondary services for people with long term stable mental health conditions (clusters 7, 11 and 12) into primary care.
    Invicta Healthcare Referrals: Invicta PCMHS Referral form email to: invictahealth.mentalhealthreferrals@nhs.net 
  • The Mental Health Social Work Service: The mental health social work service works with individuals aged 17-65 years with mental health needs and social care issues. It also provides a service to carers. The service supports people to enhance their independence and achieve social care goals. It is a single service across primary and secondary care.Tel: 03000 416161 Mon – Fri 8.30-17.00 | Out of hours - 03000 419191 | Email: mentalhealthreferrals@kent.gov.uk | Leaflet: Mental Health Social Work service| Referral Form: MH Social work referral form

Tier 3: Specialist Mental Health Services

Specialist Adult mental health services in Kent are provided by the Kent and Medway Partnership Trust KMPT. Referral  to KMPT is by letter.

or if the patient is known to community mental health services for local duty office (9 - 5) for advice and referral:

  • Deal: 01304 865464
  • Dover: 01304 216666
  • Folkestone / Hythe: 01303 227510
  • Thanet: 01843 85520
  • Or for out of hours contact the Crisis Home Treatment Resolution Team: 07623 514 687.

If the patient is NOT known to mental health services and there is a need for urgent or emergency mental health help and support please call the 24/7 Single Point of Access on 0300 222 0123 or text 07860 022819.

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