I think I might be depressed but don’t know how to fix it – Dr Zoe Williams answers your questions

IT’S quite amazing how much worse you can feel when dehydrated.

You can be left not just thirsty, but lethargic, fuzzy-headed, groggy, dizzy and with a dry mouth and tongue.

Other signs you’re dehydrated include dark yellow pee, and needing to pee less often than normal.

When it’s hot outside, it’s even more important to stay topped up on H2O.

You may need to increase your fluid intake from the recommended six to eight glasses of water if you’re out in the heat a lot and exercising in warmer weather.

Use it as a chance to up your fruit and – cucumber and watermelon are particularly hydrating!

Here’s what readers asked me this week…

Q: SUFFER from tiredness and lack of energy. I’ve already had blood tests, which didn’t reveal anything.

I eat a decent diet. I work nights, which probably doesn’t help.

I never feel like I sleep properly and never wake up refreshed.

I’m always tired and have a fuzzy head and feel like I want to go straight back to sleep.

It affects my life negatively, as when I wake up, rather than doing useful stuff like going to the gym, doing chores or cleaning the house, I just sit around feeling tired like I want to go back to sleep. I do feel like I suffer with low mood, so maybe it’s depression?

I drive a lorry overnight, so it doesn’t provide much mental stimulation and I’ve also got money problems and don’t feel happy in my life.

I’m single, I’ve got a job I don’t like, not much social life and with my job it feels hard to improve those, given the above. I feel like it’s a vicious circle. Do you have any suggestions?

A: Firstly, thank you so much for writing in. All too often people sit in your situation without trying to change it.

Your situation is clearly getting you down and it’s certainly possible that you have some depression.

There is a questionnaire that we use to screen for depression. You can access it online, it is called PHQ-9.

Please make another appointment with your GP and take your PHQ-9 score with you, along with your email, so they can see how you’re feeling — it’s eloquently written.

If you’ve had bloods that have come back clear, the first thing I’d try and tackle would be your sleep.

There’s the saying that everything will be better in the morning and sleep has incredible restorative powers.

Sleep deprivation affects our hormones, including those that are important for feeling happy, calm and for managing stress.

Sleep is also when our brains order and store what’s happened that day.

Lack of sleep long-term can have serious physical and mental health implications.

If your GP thinks you do have depression, they may recommend talking therapy and explore antidepressants, too.

There are plenty of things you can try.

Did you know that regular exercise can be as effective as either antidepressant medication or talking therapy at managing mild to moderate depression?

It can really help to improve sleep too. Finding the motivation can be the challenge, especially if energy levels are low.

My advice is to set a daily goal, such as just a ten-minute brisk walk.

It doesn’t sound like much, but is enough to start to make a difference to your brain chemistry, and if it feels good once you’re walking, you might extend the time or up the pace to a jog some days.

If you can get out for a walk in nature, even better, or with a friend, better still.

Building in rewards can help too. If you can make it to the gym, treat yourself to a film when you get back to relax.

If you manage to do some chores, maybe buy a little plant as a reward ­— studies show taking care of plants improves mental health.

You’d benefit from taking small but sustainable steps towards wellness alongside speaking to your doctor.

Please keep in touch. Let me know how you’re getting on. Your letter will resonate with people so it’d be good to know your outcome.

Q: I’VE had ear catarrh for over a year.

I’ve been using steam inhalation regularly, which helps somewhat but does not completely clear it.

It’s one sided. I also use decongestants. As nothing seems to rid me of it completely, is there a drug a GP could prescribe?

A: While we’re more used to catarrh in our throats or nose, it can build up in the ears.

It typically occurs if there is swelling causing a blockage to the Eustachian tube, which connects the middle ear (behind the eardrum) to behind the nose.

Part of the tube’s role is to remove any fluid that accumulates in the middle ear.

Excess fluid build-up can be caused by inflammation due to a cold or allergy — but it can be caused by pollutants and being around a lot of smoke or a bacterial infection, but this would likely also give other symptoms, such as pain and fever.

If it’s been bothering you for several weeks, make an appointment with your GP. Speak with a pharmacist about steroid nasal sprays too, which can take a week or two to work, but can be effective.

Nasal washes and decongestants may help too.