Depression and low mood (young people)
Anxiety, panic attacks, obsessions and hallucinations
For some people, depression can be accompanied by anxiety and for some the symptoms of anxiety maybe more severe than those of their depression. Depression and anxiety can also be associated with feelings of panic and the experience of panic attacks, as well as obsessions or obsessive behaviour. Some people with depression can also experience hallucinations although this is rarer.
Anxiety and panic attacks
Many of the young people we spoke with experienced anxiety and for several, it was inseparable from depression. Young people described the experience of anxiety as a “loss of control”, being “frightened”, continuous “worrying” and “stress”, “panic”, “racing mind”, “overanalysing” and inability to function. Anxiety could also manifest itself in various ways. For many, an anxiety or panic attack caused them to hyperventilate, to feel dizzy, faint and sick and some people passed out. A few people also described sensory changes, for example not being able to see clearly or hear properly during an acute anxiety attack. One woman described an anxiety attack as; “(It’s) like an electromagnetic field of like suddenly I cannot function”.
Having an anxiety attack could be a scary experience and a couple of young people said they’d thought they were “going mad” or “losing their mind”. Some also described an intense sense that they were going to die.
Erika-Maye describes a panic attack. She hyperventilates, can pass out and all she can think of is that she is going to die.
Erika-Maye describes a panic attack. She hyperventilates, can pass out and all she can think of is that she is going to die.
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I’ll hyperventilate, and when I’ve built myself up into a panic attack I can’t think logically. The only thought that seems to go through my brain is I’m going to die. This is it, I’m dying, I’m dying, I’m dying. Because you can’t breathe properly and things go fuzzy ‘cos the blood rushing around, you can’t see properly, and although you can be told, “It’s okay, you’re not gonna die,” it doesn’t help. I don’t really know of anything that helps properly. Paper bag obviously helps the hyperventilation but the headache afterwards is horrible [laughs].
I’ve passed out a couple of times because my breathing just won’t even out. I’ve had some particularly bad ones where I’ve passed out several times in the same panic attack. ‘Cos I come back round and I start hyperventilating straight away, which is an achievement I think. I deserve a badge for that really, they’re not fun [laughs], they’re very scary both witnessing them and having them is very hard.
Tom describes the state of acute anxiety as 'a parallel universe'.
Tom describes the state of acute anxiety as 'a parallel universe'.
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You’re in this place, this state of anxiety with you know a different perception on life, just like you’re in some kind of parallel universe, literally like some kind of parallel universe, where people are talking to you but it’s not getting through, and it just looks really weird, and you’re thinking, “What is this all about?” You know.
So your Mum’s saying to you, “Look,” okay, it gets to, it got to the stage where I was sitting there, and my Mum’s going, “Look you’re safe, there’s nothing wrong, you know you’re at home, forget all the worries that you have. It doesn’t matter.” You know, she was great. But it didn’t mean anything; it didn’t mean anything because the person that was saying it to me didn’t look real. She, you know, she looked like a, you know I could see perfectly well, but my perception of things was just out of the window, it was just, you know is altered. And I think a good description of how it was at the time was it could be said to be like, if you won the lottery, you won 50 million, it wouldn’t make a difference and you’d just say, “Oh,” you know you’d just think like it’s completely irrelevant, don’t need it, doesn’t matter. And it’s that important, well it’s that significant that you would just, you wouldn’t care.
Young people described experiencing anxiety and panic attacks from as often as 5-6 times a day to a couple of times a month. Some experienced low levels of anxiety, which one man described as “toned down anxiety” which they’d learnt to manage or cope with over time. In the long term, anxiety made young people feel “exhausted” and “drained”. Constant worrying, overanalysing and stress took up a lot of energy and a couple of them said that “The more you try fight it, the worse it gets”. Many people also said anxiety had knocked down their confidence and self-esteem. One woman said:
“It [anxiety] makes me angry because I feel like a failure. I feel like I shouldn’t let the anxiety consume me and that I should be able to get through it, especially after all the support I’ve been given.”
A few young people also talked about the experience of phobias. This wasn’t necessarily linked to depression. For a couple of people, anxiety symptoms included the development of social phobias about social situations or meeting people, or agoraphobia; the fear of leaving the house or being in public places. One person also described her intense phobia of particular objects.
For some, anxiety was more of a continual underlying stressful and unpleasant state of mind whereas others were able to distinguish particular triggers which caused them to have panic attacks. These triggers included for example particular people or contexts, feeling under pressure or extreme stress. A couple of people said their attacks just came “out of the blue” or that literally “anything” could set one off.
In the main, hearing voices was an unpleasant experience for young people as the voices were often negative; making “snide” comments, ridiculing and putting them down. Hence, for some, hearing voices contributed to paranoia and a sense that other people were talking about them or that others were “against” them. Some people said that there was really no way to control the voices, just ways to “manage” them, learn to “ignore” them or live with them. One of the things people said they could do was to distract themselves, by listening to music or focusing intensely something else.
At worst, anxiety could become “debilitating” or include phobias.
Anxiety is draining and makes Sara feel physically drained as her brain is constantly on 'overdrive'. (Read by an actor).
Anxiety is draining and makes Sara feel physically drained as her brain is constantly on 'overdrive'. (Read by an actor).
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The actual kind of feelings, they, physically you just feel so tired all the time. Like it, I think it drains your energy a lot, it might be a mental problem but it definitely physically drains you. Because constantly, well my anxiety level is constantly worrying about things, it just kind of, your brain’s running on, like overdrive all the time. And with depression it’s kind of yeah your brain is running on overdrive, but thinking about what you said like, you know, it’s, you know,“I hate my life, this is so bad, I hate this, I hate everything, I hate,” you know it’s just constantly, “I don’t like this, I’m tired,” it’s just constantly, it’s a bit like endless clockwork it just keeps going.
It does like physically drain you, so if you, if you don’t keep yourself busy and you just sit there, and you just feel so tired. It, it you know you don’t feel like, especially when you’re having a low mood, if you can’t get yourself out of it you can’t do anything that day, it’s just, you know I can’t, yet sometimes I want to sit in the library and study and if I’m having a bad day I’ll just start feeling sleepy, I’ll, you just, you just wanna go to sleep, you don’t feel you want to do anything, you just wanna sleep.
A few young people also talked about the experience of phobias. This wasn’t necessarily linked to depression. For a couple of people, anxiety symptoms included the development of social phobias about social situations or meeting people, or agoraphobia; the fear of leaving the house or being in public places. One person also described her intense phobia of particular objects.
Erika-Maye has a severe phobia of compasses and is unable to use them in exams.
Erika-Maye has a severe phobia of compasses and is unable to use them in exams.
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I used to get pushed down stairs a lot, people would swear at me and spit at me, throw compasses at me. My friend who tried to kill herself, she cut her wrists in front of me, and I told one of my then friends about it, we then fell out, and she spread it round. Because I’d then developed a thing where I could not have my wrists exposed, I got very edgy about that, people then took to drawing red lines over their wrists and waving them in my face. And throwing compasses at me, throwing rocks at my head.
I still can’t handle compasses. I’ve had a complete phobia of them for ages now. And take compasses as an example, that’s a good one, if I know I’m going to have to go into a maths class where people are gonna be using compasses, even if I’m not going to be using them myself, I can worry about it for hours. And then build myself up so I’m so anxious, or like for a week, and go with what happened in my maths exam, where they told me I didn’t have to do the questions involving a compass, they got permission from the exam board for me not to do those questions. But one of the helpers in the exam didn’t know this; saw I didn’t have a compass on my table, threw one down at my desk. To which I screamed and ran out of the room [laughs]. I react in such a good way.
Some young people had sought help for anxiety. Medication, such as particular antidepressants or beta blockers had helped some, and CBT (Cognitive Behavioural Therapy) had been really helpful for many. A few said they’d just tried to “ignore” the problem or said they tried to cover up their anxiety and hide or lie about the attacks as they found them “embarrassing” or felt social pressure to always be happy.
When Jack started having panic attacks, he realised he couldn't keep ignoring his experiences but had to 'deal with this stuff'.
When Jack started having panic attacks, he realised he couldn't keep ignoring his experiences but had to 'deal with this stuff'.
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But, when it really, and I don’t know whether this is this isn’t really related to depression really, but when it really hit was when the massive physical symptoms came in, panic attacks, panic attacks and stuff like that when I realised, I felt, I don’t think I was actually properly actually looking at everything, I think I was still ignoring a few things. Because I was adopting this massive scheme of structure and organisation, I was saying, “No I can’t have any emotion in, within this, very, I don’t know, business, not not business, but organisational thing”.
And so I think I was ignoring my feelings and eventually I think my head was going, “Look no no you’ve gotta, you’ve got to deal with this stuff and,” so it just sent out these messages of panic attacks. I couldn’t be in, first, I remember the first ones I ever had were in school assembly and stuff, and I couldn’t escape. And I said, “Oh I have to leave, I have to leave,” and just you know so that was, obviously that was when you know everything kind of happened very physically and so I just thought well I’ve got to get some help.
Beth used to try and hide the fact that she was having panic attacks as she'd always been 'the party goer' and the one who's 'always fine'.
Beth used to try and hide the fact that she was having panic attacks as she'd always been 'the party goer' and the one who's 'always fine'.
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I would say be sat in a night club and everyone was having fun and I’ll be having fun and I wouldn’t necessarily be drunk at all and suddenly I’d feel like I was all by myself, completely closed off in like a bubble and I’ll, aah it was just the weirdest feeling, I would feel like, “Oh my God, I have to get out of here, I have to get away.” And I’d look around and all I’d really want was someone to say, “Are you okay?” But obviously you’re so good at the act it was just smiling and no-one would ever knew unless I told them, and I knew in my head I would be thinking these things in my head, if I told them right now how I felt everyone would be asking if I was okay, and just things like that, everyone, I would get, but I didn’t want that.
I am the party goer, I am the person that’s always fine and does okay, so I didn’t really, I didn’t feel like too much pressure was on me but I didn’t want to kind of let that slip. I didn’t want the looks of sympathy that I got from my Mum and that kind of thing. I wanted to you know escape with my friends.
And it would happen every now and then, I just had to get away from the place, and then I’d wonder if anyone would even notice and obviously you’re in a busy club, so who would really notice anyway. And every now and then I would just go home, and everyone would think I’d done that White Ninja thing where you drink too much, and then kind of just wandered home, but I would never ever say the real reason.
Obsessions
Several young people described different obsessions they had and a couple said they had OCD (Obsessive Compulsive Disorder). Young people described obsessions with patterns and order, checking and organising, cleaning and hygiene, eating and calorie counting and fear of infections or germs. One woman said;
“My obsessions….it’s not like I have a constant one, it becomes this new thing of you know every couple of months that, it just depends…”
Jack used to worry about being sick, germs and washing his hands.
Jack used to worry about being sick, germs and washing his hands.
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Worries like, worrying about being sick, when I was a child I used to, used to have cold sweats, I couldn’t, wouldn’t be able to get to bed, and like my Mum had, my Mum and my Dad used to pat me to go to sleep because I used to worry about being sick. I’d say, “I’m going to be sick this evening. I’m gonna be sick this evening.” And another point about the whole, how physic, how everything turns physical is that whenever I used to worry about being sick, I felt sick. And and you know I actually felt sick, and you know, and that… I can’t think of any other silly worries, really but it was really fear of germs as well, that was the first ever worry, silly worry I had and. And that was you know having to wash my hands around 7 times a day and a lot of people say, well that’s a common symptom of obsessive compulsive disorder, but I know I am and they’re still trying to kind of diagnose that. But I don’t know it was that, I used to have to wash my hands all the time, it was just… and my skin started to crack because I used too much soap and stuff like that, but yeah stilly worries like that.
Blondel doesn't like feeling out of contol and describes her OCD as "a coping mechanism".
Blondel doesn't like feeling out of contol and describes her OCD as "a coping mechanism".
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The strange thing is that I hate being this way and I hate feeling this way, but with the anti-depressants they almost block out the part of my mind that triggers the OCD, and where that might be a good thing in some people’s eyes, to me I feel lost because I’ve depended on it for so long it’s become a part of me, so with the part of my mind being blocked out and you know suppressing my moods, I’m unable to function. And so it’s almost like, I know it sounds ridiculous, but I almost miss the OCD because it’s been my way of you know, it’s been my way of coping, it’s been my way of life.
So without it I’m quite lost, and I question well you know, “Who am I now?” So it’s, it’s a difficult thing for me because the, you know the counselling I’m, I want to beat the OCD you know, it’s, I don’t want to live with it for the rest of my life, but at the same time you know, after ten years it’s like, well how I cope without it? And that’s something we’ll have to learn to deal with also.
Some people had had these obsessions from an early age, others said for them obsessions had become a coping strategy or a way to “control” their low moods and depression. A couple pointed out that for them, an obsessive mindset had also proved beneficial in situations where they were required to intensively focus on one thing, such as school work or, for one man, intense long term physiotherapy. One young man said, about feeling obsessive over his school work during GCSEs; “I welcomed being generally anal with everything”.
Young people agreed that there was little understanding or awareness about obsessions and OCD and in school they had been labelled as “rebelling” or misbehaving because of their obsessive behaviour.
Hallucinations
Hallucinations are rare in ‘straightforward’ depression but some of the people we spoke with had experienced hallucinations, either “hearing voices” or seeing “imaginary friends” or other visual perceptions. For some, these experiences had again started when they were young while for others, the voices appeared during their childhood or teenage years.
Erika-Maye says she always knew she was 'ill' with depression but up till her teens she'd thought everyone hears voices.
Erika-Maye says she always knew she was 'ill' with depression but up till her teens she'd thought everyone hears voices.
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I was referred up to the Children’s hospital in [place name], because of what we now know as Chronic Fatigue. But the doctors couldn’t find anything wrong with me and the blood tests came back normal. So they referred me up to the [hospital name], and when she found out I had depression, and when she found out I self harmed, she wouldn’t, she basically told me everything was psychological. And kept me in hospital for 5 days. I wasn’t allowed to go until I’d seen a psychiatrist, psychologist, and social worker, and it was when the psychiatrist asked me at one point, do you ever hear voices? And I went, “Well yeah, doesn’t everyone?” And she said, “No not really.” And that’s when I realised okay, this isn’t normal. I always knew that I was ill. I knew that I had depression, obviously from the diagnosis from when I was 13, and it wasn’t something that just went away after a couple of months. So I knew I had the depression, but I always thought the voices were something everyone heard, ‘cos everyone always describes like a conscience or something, and I kind of connected it to being the same kind of thing.
In the main, hearing voices was an unpleasant experience for young people as the voices were often negative; making “snide” comments, ridiculing and putting them down. Hence, for some, hearing voices contributed to paranoia and a sense that other people were talking about them or that others were “against” them. Some people said that there was really no way to control the voices, just ways to “manage” them, learn to “ignore” them or live with them. One of the things people said they could do was to distract themselves, by listening to music or focusing intensely something else.
Frankie and Sian say that you can get used to hearing voices but that on bad days they get louder and can be scary.
Frankie and Sian say that you can get used to hearing voices but that on bad days they get louder and can be scary.
Sex: Female
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Frankie' They [voices] keep telling me to hurt myself, I tend to just like make sure I ring someone or I’ve got like music on as a distraction so I can’t hear them as much. but yeah it can be quite scary at times. They can be quite, it, it, you’re like, with paranoia’s fine but you feel like someone’s controlling you, you feel like someone’s in your head and it’s really not a nice feeling. When, especially when you’re not thinking rationally. It’s a case of, “Oh God” you know, “Someone’s controlling me, I’m not in control of myself.” But other than that when I’m a rational person I’m just, yeah I can pretty much ignore them. You know I’m sort of used to them now, I’ve basically had to accept the fact that.
Sian' You get used to them don’t you?
Frankie' Yeah.
Sian' You get used to them but sometimes it can be hard to, to, you have days, good days and bad days where they sometimes they’re louder than others. Like most of the time they’re always there but sometimes they’re just a bit louder and,
Frankie' yeah. And basically I’ve just have to accept the fact that I’m gonna have them for the rest of my life. Because that’s a, you know a physical manifestation of my stress and my depression. So anytime I get stressed I’m gonna hear voices pretty much, ‘cos my body loves me, and it likes scaring me. So yeah pretty much it can be really scary.
Sian' Can be scary, but at times, sometimes it feels like, to me, my voices sometimes give me advice on things, it’s like sometimes they tell me to do things that does help me out, but other times like they tell me to do things that really not going to help me out at all it’s stuff that’s going to get me into loads of trouble. And it’s just try and figure out what are the good times and what are the bad times. You have to like control yourself.
Distracting the mind, like listening to music or reading a book can help Mandy not to focus on the voices.
Distracting the mind, like listening to music or reading a book can help Mandy not to focus on the voices.
Sex: Female
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Frankie' You can’t control them [voices]. Managing them in a way so they don’t affect you in a bad way, could it be like from listening to music so for you it’s a distraction or you can’t hear them as clearly or basically as like if especially if you’ve had them for a few years you build up sort of an immunity, to what they’re saying. And because they repeat it and stuff basically getting used to what they’re saying, you expect it, but as Sian said, it depends on how good a day you’re having or how bad a day you’re having.
Mandy' Becomes like background noise doesn’t it?
Frankie' Yeah.
Mandy' ‘Cos if you’re focussing on like a book or something and you’ve got the telly on in the background, it’s like that, it’s like background noise.
Frankie' Yeah.
Mandy' Mostly, music’s the main one that they suggest even so,
Frankie' Yeah.
Mandy' Try and help distract among other things but the rest are a bit weird.
[Laughter]
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Last reviewed June 2017.
Last updated December 2011.
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