Understanding Depression: A Guide for Fitness Professionals

As fitness professionals, you play a vital role in supporting the overall well-being of people. Beyond the physical aspects of training, it is essential to recognise and respond to mental health challenges that some of your clients may face. The likelihood that some of your clients will suffer from this disorder is high, considering that 1 in 7 Australians will experience depression in their lifetime. Further, almost half of the people who experience a mental health disorder do not get help. This is due to a number of factors, one of them being that people can have difficulty detecting the signs or understanding that they have a mental health condition. You, as fitness professionals, are well positioned to see the early warning signs as depression begins to develop, if you know what to look for. 

Depression is more than just a temporary feeling of sadness or low mood. It is a complex mental health disorder characterised by persistent and intense feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. It can significantly impact all domains of life, a person’s ability to function at home and work, and in relationships and it decreases overall quality of life. Depression cannot be fixed by ‘cheering up’, ‘hardening up’ or ‘getting over it’. 

The DSM-5 outlines specific criteria for diagnosing depression. To receive a diagnosis of Major Depressive Disorder, a person must exhibit five or more of the following symptoms that last for at least two weeks, representing a change from previous functioning. These symptoms must be present nearly every day:

  1. Depressed mood: A persistent feeling of sadness, emptiness or hopelessness.
  2. Loss of interest or pleasure: A significant decrease in enjoyment or interest in previously enjoyable activities. 
  3. Significant weight change: Unintentional weight loss or gain.
  4. Sleep disturbances: Insomnia or excessive sleeping. 
  5. Psychomotor changes: Observable agitation or slowness in physical movements.
  6. Fatigue or loss of energy: Persistent lack of energy or feeling tired despite rest.
  7. Diminished ability to think or concentrate: Difficulty focusing, making decisions, remembering or experiencing slowed thinking. 
  8. Recurrent thoughts of death or suicide: Frequent thoughts of death, suicidal ideation, or suicide attempts.
  1. Sudden decline in motivation: Noticeable lack of enthusiasm or decreased commitment to their training program.
  2. Changes in appetite or weight: Unexplained weight loss or gain, or significant changes in eating habits.
  3. Fatigue and low energy levels: Consistently feeling exhausted, lacking energy during workouts, or difficulty recovering between sessions. 
  4. Social withdrawal: A decrease in social interaction, avoiding group activities, or general disinterest in connecting with others.
  5. Increased irritability or emotional sensitivity: Frequent mood swings, irritability, or emotional outbursts disproportionate to the situation or out of typical character. 
  6. Difficulty concentrating: Reduced ability to focus during sessions or difficulty following instructions.
  7. Decline in self-care: Neglecting personal grooming, hygiene, or overall appearance.
  8. Disrupted sleep patterns: Insomnia or excessive sleeping, beyond their usual routine. 
  9. Overly negative attitudes: interpreting situations as negative, negative views of the self and the future, expressing a sense that everything is hopeless or futile. 
  10. Suicide and self-harm signs: expressing opinions that there is no point in life or staying alive, saying that others would be better off without them, wearing long sleeve shirts in the heat or when they previously did not, bandages covering arms, visible cuts or burns on skin. 

Note that some of these symptoms presenting alone could be due to a number of reasons unrelated to mental health. However, if they are presenting together, it could be due to depression. Remember, it is not your role to diagnose, but it is your role to monitor your clients overall wellbeing and suggest they get the right help.

If you suspect a client is experiencing depression, it’s crucial to approach the situation with empathy, respect and care. Here are some guidelines to consider:

  1. Create a safe and supportive environment: Foster and open and non-judgemental atmosphere where clients feel comfortable discussing sensitive topics such as their mental health. 
  2. Ask direct questions while being gentle. For example: “I have noticed a difference in your level of energy and that you appear to be very low lately. I am worried that you might be struggling depression. Is it ok if we talk about that?” 
  3. Ask people what supports and resources they have. For example: “Who do you have in your life you can talk to about these issues?” “What are you doing too look after yourself” Then encourage them to lean on these people and use the resources they have. 
  4. Encourage people to seek professional help. Suggest they consult their GP, or contact a mental health professional who can provide an accurate diagnosis and the right treatment. You could possibly normalise this by offering a story about how you or someone you know has seen a psychologist before and how they found it helpful. This can reduce the stigma and resistance of seeking mental health treatment. 
  5. Don’t be pushy: if you sense resistance, be gentle. Just plant the seed; let them now you notice, that you care, that you are happy to chat more when they are ready. Then continue to sensitively suggest they use the resources they have and seek professional help. 
  6. Be flexible and adaptable: Modify training programs as needed to accommodate energy levels and overall wellbeing. However, don’t stop encouraging consistency and pushing for enthusiastic engagement. Be careful not to collude with your clients in avoidance of training by being too adaptable– we all know that exercise is an essential part of recovery from mental struggles. 

If you suspect your client might be experiencing suicidal thinking, it is ok to ask them directly. It will not place the idea on their mind or influence them to act on it. In fact, it might be a relief for them to be asked. You can say “Are you having thoughts about hurting yourself or ending your life?” 

If this is the case, urge them to call Lifeline or call Lifeline for them on 13 11 14. Encourage them to go to their GP immediately to be formally assessed for depression and to be given the right medications or referrals.  

If you have serious concerns for their safety, phone their next of kin on their intake form to let them know. 

If the danger is imminent, tell them that you will get them help, then call the ambulance. 

If you are unsure of the level of danger, it is always better to call for help and have professionals take over. 

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