Depression, Illness and Injury
Feeling unusually low in mood or depressed is not uncommon following critical illness or injury. For instance, up to 30% patients experience low mood in the months that follow a heart attack (Baumeister et al., 2011) or an intensive care admission (Wade et al., 2012). Patients often describe a sense of irony – that in the weeks that follow discharge from hospital, once they are safely home and surrounded by relieved family and friends, that distressing psychological reactions such as low mood should then start to occur.
There are several treatment options for people feeling low in mood after a hospital admission. We hope this article provides some clear suggestions, to help patients make more informed decisions.
The first thing to emphasise is that feeling low after a hospital admission is common and people often recover independently within a month of being home. Ensuring good sleep hygiene, taking regular exercise, following a healthy diet and (if relevant) smoking cessation are all well-established first-line strategies for improving mood.
For some people, low mood can persist, despite implementation of these basic self-care strategies. In these circumstances, we recommend patients meet with a clinical psychologist or discuss with their GP.
The main symptoms of depression are a loss of pleasure in activities that were once enjoyable. A person with depression may also feel tearful, irritable or tired most of the time, and have problems with sleep, concentration and memory. Mild to moderate depression is when a person has symptoms that make life more difficult than usual, while severe depression is when a person has many symptoms, which can make life extremely difficult.
For mild-moderate depression, anti-depressant medication is not recommended in the UK. Instead, National Guidelines (NICE 2009) recommend that patients receive Cognitive-Behavioural Therapy (CBT) with a psychologist. CBT refers to a collection of psychological treatments that are based on the theory that thoughts, feelings, behaviour and our physiological responses are all connected. If we change one of these, we can alter the others.
For moderate-severe depression, anti-depressant medication is recommended alongside a psychological treatment.
Rethink Health specialises in providing psychological treatments for adults who are experiencing low mood or depression. We work online with people from all over the country. Research evidence is clear that online sessions achieve similar outcomes to in-person sessions and are equally or more effective. Find out more about this research here.
1. Baumeister, H., Hutter, N., Bengel, J. (2011). Psychological and pharmacological interventions for depression in patients with coronary artery disease. Cochrane Database of Systematic Reviews, Issue 9.
2. Wade DM, Howell DC, Weinman JA, Hardy RJ, Mythen MG, Brewin CR, et al. Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Critical care (London, England) 2012 Oct;16(5):R192.
3. NICE CG91 (2009). Depression in adults with a chronic physical health problem: recognition and management
